Structure, functions, performance and gaps of event-based surveillance (EBS) in Sudan, 2021: a cross-sectional review.

BACKGROUND: Event-based surveillance (EBS) is an essential component of Early Warning Alert and Response (EWAR) as per the International Health Regulations (IHR), 2005. EBS was established in Sudan in 2016 as a complementary system for Indicator-based surveillance (IBS). This review will provide an overview of the current EBS structure, functions and performance in Sudan and identify the gaps and ways forward.  METHODS: The review followed the WHO/EMRO guidelines and tools. Structured discussions, observation and review of records and guidelines were done at national and state levels. Community volunteers were interviewed through phone calls. Directors of Health Emergency and Epidemic Control, surveillance officers and focal persons for EBS at the state level were also interviewed. SPSS software was used to perform descriptive statistical analysis for quantitative data, while qualitative data was analysed manually using thematic analysis, paying particular attention to the health system level allowing for an exploration of how and why experiences differ across levels. Written and verbal consents were obtained from all participants as appropriate. RESULTS: Sudan has a functioning EBS; however, there is an underestimation of its contribution and importance at the national and states levels. The link between the national level and states is ad hoc or is driven by the need for reports. While community event-based surveillance (CEBS) is functioning, EBS from health facilities and from non-health sectors is not currently active. The integration of EBS into overall surveillance was not addressed, and the pathway from detection to action is not clear. The use of electronic databases and platforms is generally limited. Factors that would improve performance include training, presence of a trained focal person at state level, and regular follow-up from the national level. Factors such as staff turnover, income in relation to expenses and not having a high academic qualification (Diploma or MSc) were noticed as inhibiting factors. CONCLUSION: The review recommended revisiting the surveillance structure at national and state levels to put EBS as an essential component and to update guidelines and standard operation procedures SOPs to foster the integration between EBS components and the overall surveillance system. The need for strengthening the link with states, capacity building and re-addressing the training modalities was highlighted.

Hazards analysis, within departments and occupations, for hepatitis B virus among health care workers in Public Teaching Hospitals in Khartoum State; Sudan.

BACKGROUND: Infection with hepatitis B virus (HBV) can lead to a range of clinical illnesses. OBJECTIVES: To examine hazards of hepatitis B virus associated with clinical departments and occupations; among health care workers in Public Teaching Hospitals in Khartoum State, Sudan. METHODS: The study was a cross sectional, facility-based study. It was conducted on stratified two-stage cluster random sample of 843 subjects of whom 324 were at high-hazard, 445 at moderate hazard, and 74 at low hazard; depending on degree of exposure to blood and body fluids of patients. To assess hazards of HBV among departments and occupations of HCWs, non-parametric Methods of Chi-square test, was used. RESULTS: For Anti-HBc vulnerable departments was Renal Dialysis (100%); while for occupations was midwives (73.3%). For carrier rate (+ve HBsAg), highest rate found in department of Management (6.8%); while for occupations was Midwives (6.7%). Regarding immunity (+ve Anti-HBs), the highest percentage found in the department of Dentistry (25.9%); while for occupations was associated with Doctors (14.8%). For a profile of high infectivity (+ve HBeAg), the most vulnerable department in terms of HBV hazards was the Surgery (1.4%); while for occupations was nurses (0.9%). CONCLUSION: There was a significant association for infection rate of HBV with occupation and type of department. The most hazardous departments, was Surgery with a profile of high infectivity rate, followed by other departments (medicine, pediatrics, psychiatry & ophthalmology). As for occupations, the most hazardous group was nurses group with a profile of high infectivity rate.

Past Medical History of Blood Transfusion; Surgical Operation; Vaccination against HBV; Cutter Scar and Tattoo; and HBV Infection Among Health Care Workers in Public Teaching Hospitals in Khartoum State; Sudan

Background:Infection with the hepatitis B virus (HBV) can lead to a range of clinical illnesses. Hepatitisis a general term meaning inflammation of the liver and the most common cause is infection with a variety of different viruses. All of these can cause an acute disease and symptoms lasting several weeks includingyellowing of the skin and eyes; dark urine; extreme fatigue; nausea; vomiting and abdominal pain.Aim:This study examined the prevalence of sero-epidemiologic markers of hepatitis B virus (HBV)among health care workers (HCWs) in Public Teaching Hospitals in Khartoum State; in the year 2004. Itattempted to determine the relation of the past medical history of blood transfusion; surgical operation;vaccination against HBV; cutter scar and tattoo with HBV infection among HCWs.Method:The study is anobservational; cross sectional; facility-based study. It was conducted on stratified two-stage cluster randomsample of 843 subjects. The study followed multivariate analytical techniques; using Multiple DiscriminantAnalysis (MDA); and some non-parametric tests using Chi-square test results:Among the 843 subjectstested for all HBV markers (Anti-HBc; HBsAg; HBsAb; and HBeAg); the prevalence of Anti-HBc; HBsAg;HBsAb; and HBeAg was found to be 57 (CI95:53-60); 6 (CI95:4.0-8.0); 37 (CI95:34-40) and 9 (CI95:7-11) respectively. The prevalence rate differs according to past medical historyfactors. Significant association of past medical history factors was found with seroprevalence of HBsAgmarkers (P0.05). No significant association was found with any of the past medical history factors forseroprevalence of Anti-HBc and HBeAg and HBsAb markers (P0.05).Conclusion:Tattooing and itsduration had shown significant result with HBsAg

User satisfaction with services provided by a drug information center in Sudan.

OBJECTIVE: The services of the Ministry of Health Drug Information Center--Khartoum State were evaluated by assessing users' satisfaction. METHOD: Four hundred and twenty-three subjects were recruited from center records using a systematic random sampling technique. Subjects who consented were interviewed by telephone using a specially designed semi-structured questionnaire. Descriptive as well as comparative analyses were carried out. Differences between groups were tested using the Chi-square test when applicable. RESULTS: The majority of users surveyed (89.6%) had called the center from within Khartoum State and 10.4% of users had called from other states. Of the enquiries, 36.1% were from pharmacists, 29.5% from physicians, and 22.3% from laypersons. The vast majority (93.1%) of respondents were educated to degree level or higher. Approximately one fifth, one half, and one third of the users surveyed had consulted the center >5 times, 2-5 times, and once, respectively. More than 90% of users rated the services provided as good to excellent and 94.7% declared their probable intention to continue utilizing the center in the future. CONCLUSION: The center succeeded in satisfying and retaining its users by providing an acceptable quality of service.