Tuberculosis awareness in Gezira, Sudan: knowledge, attitude and practice case-control survey.

This case-control study aimed to assess tuberculosis (TB) awareness and its associated sociodemographic characteristics in Gezira, Sudan. New smear-positive TB patients registered in Gezira in 2010 (n = 425) and age-matched controls who attended the same health facilities for other reasons (n = 850) formed the study sample. Awareness was measured using a modified standard World Health Organization TB knowledge, attitude and practice instrument. There was no significant difference between TB cases and the controls in overall levels of TB awareness. About two-thirds of TB cases and controls had good TB awareness. Respondents' sex was associated with awareness among the controls. Age, level of education, type of residence and type of occupation were significantly associated with TB awareness, whereas marital status had no effect. The good level of TB awareness found among TB cases and controls is a baseline for further TB awareness-raising among the Gezira population.

Tuberculosis awareness in Gezira, Sudan:knowledge, attitude and practice case-control survey

This case control study aimed to assess tuberculosis [TB]awareness and its associatedsociodemographic characteristics in Gezira, Sudan.New smear-positive TB patients registered in Gezira in 2010 [n - 425]and age-matched controls who attended the same health facilities for other reasons [n = 850]formed the study sample.Awareness was measured using a modified standard World Health Organization TB knowledge, attitude and practice instrument.There was no significant difference between TB cases and the controls in overall levels of TB awareness.About two-thirds of TB cases and controls had good TB awareness.Respondents' sex was associated with awareness among the controls.Age, level of education, type of residence and type of occupation were significantly associated with TB awareness, whereas marital status had no effect.The good level of TB awareness found among TB cases and controls is a baseline for further TB awareness-raising among the Gezira population

تهدف دراسة الحالات والشواهد هذه إلى تقييم مدى الوعي بالسل، والسمات الاجتماعية والديموغرافية المصاحبة له في الجزيرة بالسودان. واعتمدت عينة الدراسة على مرضى السل الجدد إيجابيي اللطاخة المسجلين في ولاية الجزيرة بالسودان في عام 2010 [العدد = 425]والشواهد الذين يضاهون الحالات في السن ممن حضروا إلى المرافق الصحية نفسها لأسباب أخرى [العدد = 850]. وتم قياس مدى الوعي باستخدام المقياس المعدل لمنظمة الصحة العالمية لقياس المعارف والمواقف والممارسات. ولم يكن هناك أي فروق يعتد بها بين حالات السل والشواهد من حيث المستوى الكلي للوعي بالسل. ولقد اتضح أن ثلثي حالات السل والشواهد لديها مستوى جيد من الوعي بالسل. وأن جنس المستجيب للدراسة يؤثر على مدى الوعي بين الشواهد. فالسن، ومستوى التعليم ونمط الإقامة ونوع المهنة كلها من الأمور التي ترتبط بشكل كبير بمدى الوعي بالسل، في حين نجد أن الحالة الزواجية لم يكن لها أي أثر. ومن ثم فإن مستوى الوعي الجيد بالسل لدى الحالات المصابة به ولدى الشواهد تمثل خط الأساس لإذكاء المزيد من الوعي بالسل لدى سكان ولاية الجزيرة

La présente étude cas-témoin visait à évaluer la sensibitisation à la tubercutose et les caractéristiques sociodémographiques associées dans l'état de Gézira [Soudan]. L'échantillon de l'étude était compose de nouveaux patients a frottis positifs pour la tuberculose au Gézira en 2010 [n = 425]et de témoins appariés pour l'âge qui consultaient dans les mêmes établissements de santé pour d'autres motifs [n = 850]. Le degré de sensibilisation à la maladie a été mesuré à l'aide de l'instrument standard modifié de l'Organisation mondiale de la Santé évaluant les connaissances, les attitudes et les pratiques en matière de tuberculose.Aucune différence significative n'a été observée entre les patients tuberculeux et les témoins dans les niveaux généraux de sensibilisation à la tuberculose.Environ deux tiers des patients tuberculeux et des témoins avaient un niveau de sensibilisation à la tuberculose satisfaisant.Dans le groupe des témoins, les hommes et les femmes n'avaient pas le même niveau de sensibilisation à la question.L'âge, le niveau d'études, le type de résidence et la profession étaient des facteurs nettement corrélés à la sensibilisation à la tuberculose, contrairement à la situation matrimoniale.Le niveau satisfaisant de sensibilisation à la tuberculose observé chez les patients atteints de tuberculose est un point de départ pour l'augmentation de la sensibilisation à cette maladie dans la population du Gézira

Tuberculosis stigma in Gezira State, Sudan: a case-control study.

OBJECTIVE: To evaluate the prevalence of tuberculosis (TB) stigma and to determine the relation between socio-demographic characteristics and TB stigma among TB cases and their controls in Gezira State, Sudan. METHODS: A case-control study design was used. New smear-positive TB patients registered in Gezira State in 2010 (n = 425) and controls who attended the same health facility for other reasons (n < 850) formed the study population. Stigma was measured using a standard modified World Health Organization TB KAP (knowledge, attitudes, practice) instrument. RESULTS: TB stigma did not differ between TB cases and controls; mild stigma was found in both groups. The higher degree of stigma among both groups was significantly associated with higher age, lower level of education, residence in rural areas, unemployment and poor TB awareness, while sex had no association with the degree of stigma in either group. CONCLUSION: Although TB stigma among the Gezira population was found to be mild, it can affect treatment adherence. Empowering both TB patients and communities by increasing their knowledge through proper education programmes could effectively contribute to the effort of controlling TB in the state.

Assessment of core activities and supportive functions for the communicable diseases surveillance system in Khartoum state, Sudan, 2005-2007.

We conducted a descriptive, retrospective, cross-sectional study to assess the core activities and supportive functions of the communicable diseases surveillance system (CDSS) in Khartoum state, Sudan, for the period 2005-2007. This is the first assessment conducted for CDSS in Khartoum state. The CDSS was studied in terms of core activities and supportive functions. We found that knowledge of the system was 100% at all levels. Data reporting was over the recommended standard of 80% at all levels. Data analysis, epidemic preparedness and feedback were below the recommended standard. All assigned CDSS staff members were trained. Lower levels lacked modern technologies for data reporting and analysis. The CDSS system in Khartoum state is centralized; moreover, the system has not been updated, it is poorly documented and has a shortage of staff at lower levels.

Feasibility of implementing recommendations to improve communicable diseases surveillance--a modified Delphi study.

BACKGROUND: Effective control of communicable diseases requires an effective disease surveillance system (CDSS) which provides information for action on priority communicable diseases. It is the basis for public health decision-making worldwide. Implementation of any public health recommendations for improving a disease surveillance system depends on the acceptability of such recommendations by the relevant stakeholders and the feasibility of implementing the recommendations in practice. OBJECTIVES: The aim of this study was to assess the acceptability and the feasibility of recommended improvements in CDSS among relevant stakeholders in Khartoum state. METHODS: A Delphi consensus process was used in the form of three analytical written rounds and individual face-to-face discussions among relevant stakeholders in Khartoum state to study the feasibility of the recommended improvements in CDSS in Khartoum state. RESULTS: The stakeholders in Khartoum state agreed with most of our statements to improve the CDSS core activities, supportive functions and quality in Khartoum State, and that the existing CDSS in Khartoum state needs to be strengthened with more effective coordination at different levels. Regarding the feasibility of implementing our recommendations, the results of our Delphi survey suggest neither expanding CDSS system, nor including vertical programmes; formulation of updated objectives; improving data management and feedback; strengthening epidemic management, as well as the quality of the system in terms of timeliness, completeness and acceptability. CONCLUSION: This study added strength to our recommendations, based on two previous studies assessing the CDSS in Khartoum state. The Ministry of Health in Khartoum state can implement our consensus recommendations to improve the CDSS system in the future in order to achieve its targeted goals.

Staff views about the quality of the Communicable Diseases Surveillance System in Khartoum State, Sudan, 2005-2007: a qualitative study.

Surveillance staff are vital to the success of surveillance of infectious diseases. In this study, we interviewed staff of the Communicable Diseases Surveillance System (CDSS) in Khartoum state individually and in focus groups to assess their views about the quality of the system for the years 2005-07. The quality of CDSS was considered poor because the system was not representative as it included neither the private nor military sectors nor the important teaching hospitals. It also lacked timeliness due to poor documentation, was inflexible since it did not rapidly respond to emerging and re-emerging diseases such as SARS and avian flu in its notification lists, and it did not use the data collected to apply interventions for control and prevention of communicable diseases on a routine basis. While staff were committed to the surveillance system and felt they worked hard, they were also demotivated and in the long run this might affect their performance.

Staff views about the quality of the communicable diseases surveillance system in Khartoum state, Sudan, 2005-2007: a qualitative study

Surveillance staff are vital to the success of surveillance of infectious diseases. In this study, we interviewed staff of the Communicable Diseases Surveillance System [CDSS] in Khartoum state individually and in focus groups to assess their views about the quality of the system for the years 2005-07. The quality of CDSS was considered poor because the system was not representative as it included neither the private nor military sectors nor the important teaching hospitals. It also lacked timeliness due to poor documentation, was inflexible since it did not rapidly respond to emerging and re-emerging diseases such as SARS and avian flu in its notification lists, and it did not use the data collected to apply interventions for control and prevention of communicable diseases on a routine basis. While staff were committed to the surveillance system and felt they worked hard, they were also demotivated and in the long run this might affect their performance

Assessment of core activities and supportive functions for the communicable diseases surveillance system in Khartoum state, Sudan, 2005-2007

We conducted a descriptive, retrospective, cross-sectional study to assess the core activities and supportive functions of the communicable diseases surveillance system [CDSS] in Khartoum state, Sudan, for the period 2005-2007. This is the first assessment conducted for CDSS in Khartoum state. The CDSS was studied in terms of core activities and supportive functions. We found that knowledge of the system was 100% at all levels. Data reporting was over the recommended standard of 80% at all levels. Data analysis, epidemic preparedness and feedback were below the recommended standard. All assigned CDSS staff members were trained. Lower levels lacked modern technologies for data reporting and analysis. The CDSS system in Khartoum state is centralized; moreover, the system has not been updated, it is poorly documented and has a shortage of staff at lower levels

Review article: communicable diseases surveillance lessons learned from developed and developing countries: literature review.

BACKGROUND: Surveillance of infectious diseases is recognized as the cornerstone of public health decision-making and practice. The aim of the evaluation of communicable diseases surveillance systems (CDSS) is ensuring that communicable diseases are monitored efficiently and effectively. The aim of this paper is to reflect on the experiences of both developed and developing countries in the evaluation of CDSS in order to learn lessons from these experiences to improve systems everywhere. METHODS: A literature review of studies published in English in PubMed and databases of the World Health Organization (WHO), and Center of Diseases Control (CDC) from 1981 to 2007 was undertaken assessing CDSS. The studies were divided into those from developed and developing countries. RESULTS: A total of 32 studies were included, 20 from developed and twelve from developing countries. Both developed and developing countries faced difficulties in CDSS. Studies from the developed countries have been analysed based on the quality of the system alone. In developing countries, most of the studies have been on the integrated diseases surveillance (IDSR) and have been performed shortly after the adoption of the IDSR. Thus it might be too early to make a fair evaluation. Some of the systems over-centralized, while some lacked private health sector involvement in the system. Further, some of the systems were affected by conflicts and civil wars which are common problems in developing countries. CONCLUSIONS: None of the countries had ideal CDSS. The strategy of integrated diseases surveillance seems to be functioning well especially in Africa.