The first laboratory-confirmed imported infections of SARS-CoV-2 in Sudan

Abstract

Background The rapidly growing pandemic of coronavirus disease 2019 (COVID-19) has challenged health systems globally. Here we report the first identified infections of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; aetiology of COVID-19) among recent international arrivals to Sudan and their contacts. Methods Suspected cases were identified clinically and/or epidemiologically. Samples from suspected cases and their contacts were tested in the National Influenza Centre following World Health Organization protocols. Two real-time reverse transcription quantitative polymerase chain reaction assays were used to detect and confirm SARS-CoV-2 infection. Results Seven cases of COVID-19, including two deaths, were confirmed in Sudan between 27 February and 30 March 2020. Suspected cases were identified and tested. As of 30 March, no local transmission was yet reported in the country. Fifty-nine percent of the suspected cases were international travellers coming from areas with current COVID-19 epidemics. Cough and fever were the major symptoms, presented by 65% and 60% of the suspected cases, respectively. By early April, an additional seven cases were confirmed through limited contact tracing that identified the first locally acquired infections in recent contact with imported cases. Conclusions The high mortality rate of COVID-19 cases in Sudan might be due to limitations in test and trace and case management services. Unfortunately, infections have spread further into other states and the country has no capacity for mass community screening to better estimate disease prevalence. Therefore external support is urgently needed to improve the healthcare and surveillance systems.

Acceptability of COVID-19 Vaccination among Healthcare Workers in Sudan: A Cross Sectional Survey

“…The healthcare workers were among the most affected groups by the ongoing COVID-19 pandemic worldwide (20). Since its start in Sudan in March 2020, HCWs were burdened with COVID-19 mortality and morbidity (3,4,21). The current surge of COVID-19 cases leads to severe disruption of collateral health services (5,22).…”

“…First infections of COVID-19 in Sudan were detected among international travelers and returnees who arrived in the country between February and March 2020 (4). Soon later, Sudan has suffered from the widespread of infections and the local dramatic development of the pandemic in lack of adherence among the public community and noncompliance of the individuals to the prevention measures that were promoted by the Ministry of Health (5).…”

The role of integrated programs in the prevention of COVID-19 in a humanitarian setting

“…Sudan is one of the African countries where COVID-19 has spread significantly, lacking community adherence to prevention measures like social distancing. 6 , 7 By 16 May 2021, the number of COVID-19 cases in Sudan reached 34 272, with most of the cases reported in Khartoum state. 8 South Kordofan is one of Sudan's states that has experienced armed conflicts and it has developed into a humanitarian crisis setting.…”

“…These cases and related deaths are significantly low compared with other states of Sudan, such as Khartoum and Gaziera. 6 , 7 However, these states are not impaired by the additional risk of a humanitarian situation like South Kordofan. More importantly, considering that all the detected cases of COVID-19 and deaths in the state are travel-related, it appears that this integration and early preparedness have prevented the establishment of community transmission of COVID-19 in South Kordofan.…”

Obstacles faced by healthcare providers during COVID-19 pandemic in Sudan

“…The health system in Sudan is very fragile and limited because it was ignored and severely underresourced for over 30 years during the last military dictatorship [1]. Therefore, the country was not prepared for the COVID-19 pandemic when it first started locally on March 2020 i.e during the first wave [2]. Since then, the frontline respondent healthcare providers in the country has suffered extremely at the personal, social, and professional levels.…”