Combating yellow fever outbreak in Darfur States, Sudan, 2012

Abstract

Background: Dengue is the most important arboviral disease worldwide and a major public health problem in tropical areas. The increasing case burden is associated with an expanding geographic range and increasing intensity of transmission in affected areas.Knowledge of spatial and temporal patterns in dengue transmission at a sub-national level is relevant for two main reasons: it can provide insights into the biological and ecological mechanisms that drive transmission, and it may facilitate predictions of the magnitude, timing and location of future dengue epidemics.Methods & Materials: For both of these purposes we have analyzed, with wavelet analysis, phase analysis and Granger causality, the spatial and temporal pattern of propagation of dengue epidemics in different countries in Southeast Asia.Results: The results reveal spatial heterogeneity in the propagation of the annual epidemic. Each year, epidemics are highly synchronous over a large geographic area at regional scale. In most of the cases, travelling waves emanate from a few rural areas and move towards the regional capital where epidemics occurred 1-3 months later than elsewhere. These results clearly refute the main paradigm of urban origin of dengue propagation, urban centres are thought to act as a reservoir of the virus from where it can spread to the rest of the country. Conclusion:These findings constitute a new starting point in the understanding of the processes driving dengue spread and can aid the targeting of vector-control interventions and the planning for dengue vaccine implementation.

Concomitant outbreaks of yellow fever and hepatitis E virus in Darfur States, Sudan, 2012

“…Co-existence of such infections with shared cardinal clinical features is believed to affect both sensitivity and predictive power of a case definition, with a direct effect on hindering outbreak control dynamics. The nationally recommended operational case definition of YF during that outbreak was any case of fever, vomiting with or without jaundice, or bleeding tendency in the absence of positive blood film for malaria or any other obvious cause of fever [12]. According to that case definition, the total suspected cases that had been reported to the national disease surveillance system was 844, with 171 deaths, resulting in a case fatality rate (CFR) of more than 20%.…”

Health Disparities: A Perspective on Internal Migration and Health Behavior in Sudan

“…Environmental health services and consequent outcomes [45] are areas of great concern for all miners since limited facilities and services of poor quality (if any exist) are all that is available to them [31], a situation resembling that reported in Indonesia [46]. Miners in Indonesia have limited access to safe water and defecation or toilet facilities.…”