Programmes

Tuberculosis

Tuberculosis is one of the major causes of mortality and morbidity in Southern Sudan. Although its exact burden is not known, the incidence is estimated to be 101 sputum smear positive cases per 100,000 population and 228 for all forms of tuberculosis. With the population of Southern Sudan estimated to be 13 million in 2007 (NID data), the burden of smear positive cases in Southern Sudan is estimated to be 13,130 sputum smear positive cases and 29,640 cases of all forms of tuberculosis (including sputum smear negative and pulmonary cases). 2002 to 2007 cohorts indicated the number of new sputum smear positive TB cases increased from 752 to 2513 and 1260 to 4978 for new TB cases of all forms respectively.

These figures are all likely to change when the true results of the population census and studies to quantify the exact burden of TB in Southern Sudan.
TB mortality in Southern Sudan is estimated at 65 per 100,000 people. Analysis of the data from 2002 to 2006 showed an increase in death rate from 4.5% to 6.3%. No studies have yet been done to ascertain the cause of this increased death rate.
Figure 1: Trend of TB notification in Southern Sudan from 2002 till 2007
Fig 2: Age to Sex distribution of new sputum smear positive (infectious) TB cases notified in 2007
Table 1: Breakdown of new TB cases notified from 2002-2007
TB disease type 2002 2003 2004 2005 2006 2007
New sputum smear positive 752 838 979 1656 2105 2513
New sputum smear negative 225 358 484 877 1311 1318
New sputum smear not done/not available 0 0 0 0 0 240
New Extra-pulmonary 283 338 721 1278 1127 907

Figure 3: Trends of TB treatment outcomes in Southern Sudan between 2002 and 2006

Table 2: Breakdown of TB Treatment Outcomes from 2002 to 2006
  2002 2003 2004 2005 2006
Treatment success rate 82.6 89.9 89.8 90.2 86
Failure rate 4.9 3.3 3.3 1.6 1.7
Defaulter rate 7.1 3.9 3.8 4.2 4.7
Death rate 4.5 2.7 2.7 3.3 6.3
Transfer out rate 0.7 0.1 0 0.7 0

In the last 20 years, the tuberculosis situation in Sudan has grown steadily worse due to the displacement of many people during the devastating years of armed conflict. The war has led people to live in overcrowded conditions where poverty is rife, malnutrition is rampant and hygiene is lacking.
Even in the new period of peace and relative stability after the 2005 peace agreement, TB is far from receding in South Sudan. Prevalence of new and relapsed cases of TB has been on the increase since 2001. Thus TB remains one of the major health threats in South Sudan.

In its TB programmes, AAA is carrying out different activities:

  1. Case Finding and Holding
  2. DOTs (Directly Observed Treatment)
  3. Health Education
  4. Trainings
  5. Community Mobilization and sensitization
  6. Mobile laboratory services and clinics in remote areas where there are no health facilities.
  7. Printing/Distribution of IEC materials
  8. Outreach activities.
  9. Integration of TB-DOTs in PHC

Achievements in 2009

  • 1366 TB patients
  • 424 health workers trained/ retrained on TB diagnosis and treatment
  • 111 lab assistants trained/ retrained on TB Microscopy
  • 682 CHWs trained to support DOTS
  • 162 mobile laboratory services carried out
  • 338 community meetings organized
  • 60 Community Based DOT centers established
  • 253,992 people benefited from TB Health Education
  • 7327 IEC materials distributed
  • Construction/rehabilitation of TB wards in Aweil and Tambura