Wide Spread of Tuberculosis in Sudan

Sudan is one of the largest countries located in northeastern Africa. Sudan is located in the desert of Sahara. It is a hard climate condition and unfortunately, lack of instability is contributed for the poor conditions. It is between Egypt of the north and the Central African Republic to the southwest. It has a population of almost 28 million. The percentage of 60 percent of Muslims, a quarter are an animist, and 15 percent of Christian. The languages they speak are Arabic, English, Nubian, Tu-Bedawie and Fur. Of the population, it is made of more than 300 tribes mostly being Arab in the north and south of African. In this country, one of the low middle-income countries’ health services are public health care facilities in which it is most free of charge. In an article I read called ‘Exploring Health Insurance Services in Sudan from the Perspectives of Insurers’ it states, “ This country spends about 6.5% of its Gross Domestic Product (GDP) and 8.2% of the general government expenditure on health. Out-of-pocket share is about 70% while the general government expenditure represents only 22.3%” (NCBI, 2018, p. 1).

In Sudan, twice amount of men than 12 women are suspected to be traffickers that are arrested over 20,000 dollars is recovered. Child trafficking is the illegal movement or traffic trade of children typically for slavery, forced labor, or sexual exploitation in which they transfer from the house of any person by different methods. Also, in the ‘Central African Republic Trafficking in Persons’ article it states, “…labor standards, employment, and social protection issues estimates that 12.3 million people worldwide are enslaved forced child labor and sexual and involuntary servitude. Human trafficking is a multi-dimensional threat, depriving people of their human rights and freedoms, risking global health, promoting social breakdown, inhibiting development by depriving countries of their human capital and helping fuel the growth of organized crime” (CIA World Factbook, 2018, p. 1). In Sudan, it is one of many countries that is the source of child trafficking. However, not only is this country subjected to child trafficking but rather women are being forced into prostitution and children are being forced into recruitment to be used as combatants by the government forces and armed groups, and adults are forced to labor.

Most children are taken into military assaults on their own village as well as captured into household’s detainer of slavery. Child trafficking in Sudan has 21% of the highest rate of modern slavery. These children are kept under their own will for the use of unpaid household servants. There have been many cases of these children being sold or the worst sexual abuse. Also, in the ‘Central African Republic’s Poverty Rate’ article it states, “The Central African Republic is among the poorest countries in the world. In 2017, the country had the lowest reported GDP per capita, at $656, and the average person lives on less than $1.80 per day. The Central African Republic’s poverty rate is among the highest in the world, with 62 percent of citizens living on less than $1.90 per day when the data was last taken” (Keown, 2017, p. 1). The main cause of child trafficking is poverty because low-income households sometimes do not have another choice than to abandon their children. Unfortunately, many poor income families increase the risk of children running the streets or orphans making them easy to become an ideal victim for people who are traffickers that do not hesitate on promising vulnerable children to a better life.

In Sudan, the largest parts of the population suffer from poor hygiene, bad infrastructure, and bad water quality. The common disease in Sudan are malaria, dysentery, and other gastrointestinal diseases, and tuberculosis. What is tuberculosis? This disease caused when a species of pathogenic bacteria called Mycobacterium Tuberculosis in which the bacteria usually attack the lungs, however, it can also damage other parts of the body such as the central nervous system, bones, and joints. The spread of tuberculosis is through the air when a person with the disease of the lungs or throat coughs, sneezes, or talks. In Sudan, this disease is a major public health problem, the country carries about 11 to 15% of the tuberculosis burden in the East Mediterranean region. The majority of the time people with this illness of TB do not exhibit any symptoms, the bacteria can remain inactive for many years, therefore, chances of TB develop active over time. In ‘Tuberculosis in Sudan: A Study of Mycobacterium Tuberculosis Strain Genotype and Susceptibility to Anti-Tuberculosis Drugs” it states, “Tuberculosis care and treatment is provided by the National Tuberculosis Control Program under the auspices of the Ministry of Health and by a number of non-governmental organizations (NGOs) who provide care to displaced persons, including those living in refugee camps. Treatment is also provided by the private sector. At the time of this study, the Sudan National TB Program treatment policy was for an intensive phase of rifampicin, isoniazid, pyrazinamide, and streptomycin daily under direct supervision for two to three months until the patient becomes smear-negative followed by eight months of isoniazid and ethambutol” (BMC, 2011, p. 1). Although, some non-governmental organizations insist patients to national programs providing treatment using their own products. Tuberculosis treatment in private ownership is not standardized.

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In addition, Sudan being the highest burden of TB it has been estimated of the prevalence of 209 cases per 100,000 of the population. Prevalence was found to vary based off of drug resistance of their geographic origin of the patient, therefore, most of the prevalent in patients originating from the Northern region and less prevalent of those from the East. TB was mainly found in patients belonging to 14 of the 48 tribes in Sudan. In Sudan, statistics have shown that this country is considered to have an intermediate of HIV and AIDS of the adult prevalence of the ages 15 through 49 prevalence in Sudan was estimated 26,000 of living with HIV and there were 12,000 HIV annual deaths. The increase of HIV testing for TB patients, therefore, patients are set for antiretroviral therapy.

In ‘Conflict and Tuberculosis in Sudan: A 10-year Review of the National Tuberculosis Programme, 2004-2014” it states, “High loss to follow up and failing treatment success rates were found in conflict and non-conflict zones, which represents a significant public health risk. Further analysis of the TB response and surveillance system in both zones is needed to confirm the factors associated with poor outcomes. Using context-sensitive measures and simplified pathways with an emphasis on displaced persons may increase access and case notification in conflict zones, which can help avoid a loss to follow up in both zones” (PMC, 2018, p. 1). One main challenge addressing health issues is financing. For example, Sudan is one of many countries in northeastern Africa that is considered a very low-income population, therefore, they do not have enough finances to treat their patients of TB.

Additionally, one way of preventing tuberculosis is by having people in Sudan cover their own mouth with a tissue or cloth when coughing or sneezing after doing so sealing the tissue in a plastic bag then throw it away, by doing so it can prevent others from touching the tissue or cloth and receiving the terrible disease. After, doing this one prevents the next will be to having people in this country wash their hands. Washing your hands in the most important thing we as people can do to prevent getting any sicknesses that may lead to a possible disease. However, though by ensuring that people of Sudan will wash their hands more is by making sure to increase their poor hygiene. In ‘South Sudan: Safe Water, Sanitation, and Hygiene” it states, “Water, sanitation, and hygiene (WASH) are linked in many ways. Poor hygiene, inadequate access to clean drinking water, and lack of sanitation facilities cause millions of people to die from the preventable disease each year, and children are particularly affected. In South Sudan, one-third of children under the age of five suffer from diarrhea. Continuing conflict and neglect in the country have also made access to clean water scarce, a situation that often leads to inter-community conflicts” (Malteser International, 2018, p. 1). In addition, decreasing the mortality rates of tuberculosis in Sudan is by providing better-filtered water to citizens would be more beneficial to preventing TB.

A secondary option, to preventing Tuberculosis in Sudan is providing the necessary education for people with the disease. People with this disease need to how to make sure not to pass down to others. Statistics show that people in this country do not know the proper cause of tuberculosis. Sudan is one of the poorest countries, therefore, people do not have access to the proper health care or education. An article I read it states, “The reinforcement of health education, total DOT programs coverage for all TB patients, and working on identified determinants are highly recommended to reduce the spread of MDR-TB in Sudan. NTP-Sudan should also coordinate with the private sector to refer TB patients to appropriate TB management units to ensure that the management of TB cases is under program supervision. In addition, addressing concerns with rural residence and smoking where these occur, together with an implementation of DOT programs and health education, will be crucial in stopping the spread of MBR-TB in Sudan. We will be monitoring such developments in the future” (Monadil H. Ali, 2019, p. 1).

Thus, Sudan suffers through many epidemics just like any other country in the world by stopping these epidemics is through working together.