Nationwide cross-sectional survey of schistosomiasis and soil-transmitted helminthiasis in Sudan: study protocol

Cha, Seungman; Hong, Sung Tae; Lee, Young Ha; Lee, Keon Hoon; Cho, Dae Seong; Lee, Jin-Moo; Chai, Jong Yil; Elhag, Mousab Siddig; Khaled, Soheir Gabralla Ahmad; Elnimeiri, Mustafa Khidir Mustafa; Siddig, Nahid Abdelgadeir Ali; Abdelrazig, Hana; Awadelkareem, Sarah; Elshafie, Azza Tag Eldin; Ismail, Hassan Ahmed Hassan Ahmed; Amin, Mutaz

doi:10.1186/s12889-017-4719-4

Cited by 11 publications

(20 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent nationwide survey of over 100 000 school children has now provided compelling evidence to support introduction of mass drug administration programmes and identified modifiable risk factors. The overall prevalence of S. haematobium infection was 5.2%, and S. mansoni 0.06%, but ranged much higher in East Darfur state where S. haematobium prevalence reached over 25% 10. Previous reports have identified even higher focal prevalence; for example in some schools of the White Nile region, 46.5% of sampled children were infected (45% S .…”

Section: Communicable Diseasesmentioning

confidence: 83%

“…Outside the home, water and sanitation in schools and health facilities are also widely inadequate, especially in rural remote areas 9. Added to the diarrhoeal burden is the high prevalence of neglected tropical diseases in certain parts of Sudan, such as schistosomiasis in East and South Darfur States,10 the prevention of which also relies on improvements in household and community water supply and sanitation conditions to complement mass drug administration efforts 11 12…”

Section: Communicable Diseasesmentioning

confidence: 99%

“…Indeed, one of the first ever treatment trials for this disease was conducted in Khartoum 27. Both Schistosoma haematobium and S chistosoma mansoni are present, and being water-transmitted infections, their epidemiology is strongly associated with proximity and exposure to natural freshwater sources 10 28. National control efforts, through mass drug administration, have previously been restricted by a paucity of epidemiological data to support their targeting 29.…”

Section: Communicable Diseasesmentioning

confidence: 99%

See 2 more Smart Citations

In transition: current health challenges and priorities in Sudan

et al. 2019

View full text Add to dashboard Cite

A recent symposium and workshop in Khartoum, the capital of the Republic of Sudan, brought together broad expertise from three universities to address the current burden of communicable and non-communicable diseases facing the Sudanese healthcare system. These meetings identified common challenges that impact the burden of diseases in the country, most notably gaps in data and infrastructure which are essential to inform and deliver effective interventions. Non-communicable diseases, including obesity, type 2 diabetes, renal disease and cancer are increasing dramatically, contributing to multimorbidity. At the same time, progress against communicable diseases has been slow, and the burden of chronic and endemic infections remains considerable, with parasitic diseases (such as malaria, leishmaniasis and schistosomiasis) causing substantial morbidity and mortality. Antimicrobial resistance has become a major threat throughout the healthcare system, with an emerging impact on maternal, neonatal and paediatric populations. Meanwhile, malnutrition, micronutrient deficiency and poor perinatal outcomes remain common and contribute to a lifelong burden of disease. These challenges echo the United Nations (UN) sustainable development goals and concentrating on them in a unified strategy will be necessary to address the national burden of disease. At a time when the country is going through societal and political transition, we draw focus on the country and the need for resolution of its healthcare needs.

show abstract

Section: Communicable Diseasesmentioning

confidence: 83%

Section: Communicable Diseasesmentioning

confidence: 99%

Section: Communicable Diseasesmentioning

confidence: 99%

See 1 more Smart Citation

In transition: current health challenges and priorities in Sudan

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Students in grades 2, 4 and 6 in 15,761 primary schools comprised the study population, and the entire Sudanese population formed the target population for this study. The study protocol of the nationwide survey was published previously [23].…”

Section: Methodsmentioning

confidence: 99%

Epidemiological findings and policy implications from the nationwide schistosomiasis and intestinal helminthiasis survey in Sudan

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background The World Health Assembly endorsed the WHO Neglected Tropical Disease (NTD) Roadmap in 2013, in which NTDs were suggested as tracers of equity in the assessment of progress towards the Sustainable Development Goals. Nationwide surveys were undertaken in all 18 states of Sudan to identify the geographical distribution and to estimate the prevalence and intensity of schistosomiasis and other intestinal helminthiases from December 2016 to March 2017. Methods We used two-stage random sampling. Each district was subdivided into one to three different ecological zones (EZs) based on proximity to water bodies. Probability-proportional-to-size sampling was used to select schools from each EZ. We estimated schistosomiasis and intestinal helminthiasis prevalence by the centrifugation method and Kato-Katz smears. Multi-level mixed-effect models were used to investigate the relationship between the prevalence of infections and risk factors, including improved water or latrine status at the household or school level. We estimated the cost-effectiveness of a one-time mass drug administration (MDA) intervention with 75% coverage at the district and EZ levels. Results A total of 105,167 students from 1772 schools were surveyed. The overall egg-positive rates were: Schistosoma haematobium , 5.2%; S. mansoni , 0.06%; and intestinal helminths, 5.47%. Severe endemic areas were concentrated in East and South Darfur States. Children living in a house or attending schools with an improved latrine were less likely to be infected with schistosomiasis than those without a latrine (adjusted odds ratio, aOR: 0.45, 95% confidence interval, CI: 0.41–0.51 and aOR: 0.75, 95% CI: 0.70–0.81 at the household or the school levels, respectively). Open defecation was strongly associated with schistosomiasis (aOR: 1.50, 95% CI: 1.35–1.66). In community-wide mass treatment at the district level with an 8% threshold for schistosomiasis, 2.2 million people would not benefit from MDA interventions with 75% coverage despite high endemicity, whilst 1.7 million people would receive the MDA intervention unnecessarily. EZ-level MDA was estimated to be more cost-effective than district-level administration under all circumstances. Conclusions Our findings provide updated prevalence figures to guide preventive chemotherapy programmes for schistosomiasis and intestinal helminthiasis in Sudan. Schistosomiasis was found to be common among the inhabitants of fragile and conflict-affected areas. In addition, we found that MDA interventions would be more cost-effective at the sub-district level than at the district level, and there was a strong association between schistosomiasis prevalence and latrine status, at both the household and school levels. This study will help the Sudanese government and its neighbouring countries develop adequate control and elimination strategies.

show abstract

“…This nationwide survey was carried out under the umbrella of the SUKO project, which was the Sudan-Korea collaboration project of schistosomiasis and other intestinal helminthiases control supported by the Korea International Cooperation Agency (KOICA). The survey protocol has been described in detail elsewhere [13].…”

Section: Methodsmentioning

confidence: 99%

Cost implications of a nationwide survey of schistosomiasis and other intestinal helminthiases in Sudan

Elhag

Jin

Amin

et al. 2019

Preprint

Self Cite

View full text Add to dashboard Cite

Background: It is vital to share details of concrete experiences of conducting a nationwide survey, so that the global health community could adapt it to expand geographic mapping programs, eventually contributing to the development of control and elimination strategies with limited resources. A nationwide survey of schistosomiasis and nine other intestinal helminthiases was conducted Objectives: We aimed to describe details of the key activities and components required for the nationwide survey of schistosomiasis and other intestinal helminthiases and to analyze its costs. Methods:We estimated financial and economic costs from the provider's perspective. Cash expenditures incurred to implement the survey were defined as financial costs. We took into account all of the resources invested in the survey for economic costs, including the components that were not paid for, such as vehicles and survey equipment provided by the Ministry of Health, Sudan and the opportunity costs of primary school teachers' time spent on the survey. We ran one-way sensitivity and probabilistic analyses using Monte-Carlo methods with 10,000 draws to examine the robustness of the primary analysis results.Results: A total of USD 1,465,902 and USD 1,516,238 was incurred for the financial and economic costs, respectively. The key cost drivers of the nationwide survey were personnel and transportation, for both financial and economic costs. Personnel and transportation accounted for around 64% and 18% of financial costs, respectively. Conclusions:The cost is expected to vary depending on the quantity and quality of existing laboratory facilities, equipment, and consumables, and the capability of laboratory technicians and sample collectors. Establishing central-level and independent supervision mechanisms to 3 ensure the quality of the survey is equally important. We expect the global health community to draw on this study when developing nationwide surveys of schistosomiasis and other intestinal helminthiases.

show abstract

Nationwide cross-sectional survey of schistosomiasis and soil-transmitted helminthiasis in Sudan: study protocol

Cited by 11 publications

References 19 publications

In transition: current health challenges and priorities in Sudan

In transition: current health challenges and priorities in Sudan

Epidemiological findings and policy implications from the nationwide schistosomiasis and intestinal helminthiasis survey in Sudan

Cost implications of a nationwide survey of schistosomiasis and other intestinal helminthiases in Sudan

Contact Info

Product

Resources

About