Abstract
BackgroundEstimating the burden of malaria in Sudan is important for evidence-based planning of malaria control. Estimates of malaria burden in terms of DALYs (Disability Adjusted Life Years) were not developed locally. This study synthesized information from different sources to calculate malaria incidence, mortality and DALYs lost in Sudan in 2002.MethodsA search for local studies and reports providing epidemiological data on malaria in Sudan was conducted. Preliminary estimates of incidence rate, case fatality rate and mortality rate were developed from the data found. The preliminary estimates were processed in the disease modelling computer software, DisMod II, to produce internally consistent mortality and incidence rates, which were used to calculate DALYs lost due to malaria.ResultsMalaria incidence in Sudan was estimated to be about 9 million episodes in 2002 and the number of deaths due to malaria was about 44,000. 2,877,000 DALYs were lost in Sudan in 2002 due to malaria mortality, episodes, anaemia and neurological sequelae. Children under five years of age had the highest burden. Males had the highest incidence and mortality, but females lost more DALYs.ConclusionFormal health system data underestimated malaria burden. The burden estimates can be useful in informing decision making, although uncertainty around them needs to be quantified. Epidemiological research is needed to fill data gaps and update the estimates.
Highlights
Estimating the burden of malaria in Sudan is important for evidence-based planning of malaria control
Multiple levels of malaria endemicity are found in Sudan [4], and calculations were based on classification of the 26 states of Sudan into hypoendemic, mesoendemic and hyperendemic areas
Some error would result from comparing the formal health system figures, where the biweekly incidence referred to an average for the whole year, with the results of a survey in a specific season of the year, considering the seasonality of malaria in some parts of Sudan
Summary
Estimating the burden of malaria in Sudan is important for evidence-based planning of malaria control. As part of the general reporting of health events from health facilities or specific surveillance for epidemic preparedness, provided a wide range of information. This resulted in multiple and diverse sources of information about malaria burden in Sudan, each source serving the purpose for which it was established. The problems with these sources are non-representativeness, variability of the sensitivity and specificity of the diagnostic criteria used and variability of the indices measured. Official figures of incidence and mortality reflected cases reported only from (page number not for citation purposes)
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