Tuberculosis in Sudan: systematic review and meta analysis

Abstract

Every year, 10 million people fall ill with tuberculosis (TB). Despite being a preventable and curable disease, 1.5 million people die from TB each year -making it the world’s top infectious disease. TB is the leading cause of death of people with HIV and also a major contributor to antimicrobial resistance. Its presumed that TB was the cause of 1% of the total deaths among inpatients in Sudan in 2017. The current study is aimed to provide pooled prevalence of Mycobacterium tuberculosis among Sudanese as well as to determine any socio-cultural risk factors associated. A systematic review of the literature was conducted and regulated in accordance with the PRISMA Statement. After abstract and full text screening only twenty-six articles met our inclusion criteria and passed the quality assessment procedure. Pulmonary tuberculosis prevalence was assessed in sixteen included studies among participants from Khartoum, Gezira, Kassala, Blue Nile, River Nile, White Nile, Gadarif, Red sea, North Kordofan, Northern State, Sennar and West Darfur States, representing a total sample size of 11,253 participants of suspected individuals such as febrile outpatients, TB patients’ contacts and other groups such as HIV/AIDS patients, hemodialysis patients, School adolescents as well as pregnant women. The pooled prevalence was 30.72% [CI: 30.64, 30.81]. Moreover, Khartoum State recorded the highest pooled prevalence as 41.86% [CI: 14.69, 69.02] based on a total sample size of 2,737 participants. Furthermore, male gender and rural residence were found to be significantly associated with TB infection. Further research with larger sample sizes targeting prevalence and risk factors of TB among Sudanese population is needed to be conducted.

The challenges facing children with pulmonary tuberculosis—a catastrophe of civil war: Letter from Sudan

“…Before the eruption of this war, the PTB cure rate was reported to be 76.5% with treatment success rates reaching 88.2% and a death rate of 6.1% among children, many of whom were HIV positive. 3 Low socioeconomic status, overcrowding, malnutrition and HIV are among the main risk factors that contributed to the increase incidence of PTB. Therefore, Sudan is one of the countries with highest prevalence of PTB in children.…”

“…Therefore, Sudan is one of the countries with highest prevalence of PTB in children. 3 Besides the underfunded, fragile healthcare system in Sudan, the war loaded extra burden and exacerbated the difficult situation of the healthcare system. The war erupted first in Khartoum State then spread to Darfur States and from there to other states including Kordofan and Jazeera.…”

“…Another important challenge is the timely distribution of PTB medication and diagnostic tools, which are essential to prevent treatment interruptions and reduce prevalence of the drug-resistant strains. 3 Despite these efforts, providing PTB services during conflict remains a formidable challenge. The effectiveness of interventions can be limited by factors such as insecurity, logistical barriers and funding constraints.…”