Management of TB in the Private Sector in Khartoum; Sudan: Quality and Impact on TB Control

Introduction: Sudan has a large and growing private health sector. No survey was done in Sudan to show the extent of the use of private health care services by the population. Also precise data on tuberculosis (TB) diagnosis and treatment in the private sector are not available. Material and methods A facility-based cross-sectional survey was carried out during February2007-June 2007 in Khartoum state; whereby consented private physicians working in the all private clinics (n=110) were interviewed. Results This study showed that a large private sector exist in the country and deliver care to TB patients and reported the non-adherence of this sector to National Tuberculosis Program (NTP) guidelines. 59.1of the interviewed physicians correctly mentioned the TB treatment regimens; only 8(12.3) physicians that reported management of TB patients actually prescribed these regimens to their patients. Similarly; only 10(15.4) physicians requested sputum smear examination for TB diagnosis. Conclusion A considerable proportion of cases is inadequately managed by the private sector and is not notified to NTP. The information delivered by this study can be used to develop a workable Public-private mix (PPM) model with the private sector

History of TB in the Sudan

Introduction: Medical history in Sudan is far from being complete. There are no reliable records.Attempt to write on the projects and development of history of TB in the Sudan is a difficult task.Objective:To study and trace the progress of TB in Sudan during the last century through their historical development.Design: A retrospective study.Methods:Data were collected from the annual reports of the Sudan Medical Services.Libraries and a number of previous studies were consulted.Results: The route of entry of TB in the Sudan is mainly from the North.The South was virgin from TB up to 1930s. Northern Sudanese tribes have a high susceptibility and incidence of TB during 1925-1932 (3.7/1000). The south and the Nuba Mountains were almost free from infection or disease. The infectivity rate was highest in North 4.3while Khartoum showed 3. In the South;Rumbek district; no TB cases were reported before the age of puberty up to 1930.Prevalence of tuberculosis in 1959/1960 was 26.0and the detection rate was only 30.Conclusion: Northern Sudanese contracted tuberculosis while serving in the Egyptian army and cities. The Southern and Western tribes who were almost free from TB infection became highly susceptible to both infection and disease. The infectivity rate remains static during the last 50 years