Sexually Transmitted Infections (STIs)in Sudan

Geneva Foundation for Medical Education and Research

GFMER Sudan 2012Forum No: ( 2 )

Name of presentersName Position Institution

Sawsan Mustafa Abdalla Associated professor National Ribat University

Waled Amen Mohammed Head, Community Health Nursing UMST

Name Position Institution

Sawsan Mustafa Abdalla Associated professor National Ribat University

Waled Amen Mohammed Head, Community Health Nursing UMST

Name of contributors

Content of the presentation• Introduction• Causes of STIs• STIs in Sudan• Genital Ulcer• Vaginal discharge• HIV/AIDS• VCT centers outcome• Human papilloma virus• Determinants of STIs in Sudan• STIs Health Services-Sudan• Services provided at these centers include the followings• Management protocol in Sudan for STIs• Progress and Future• Recommendations• Conclusion

Introduction

The epidemiological data on STIs in Sudan are scattered and as expected it is difficult to find reliable and valid data. For practical reasons, the sentinel surveillance reports of SNAP and the Safe Motherhood Survey results 1999 seem to be the only currently available data that can be used to visualize the morbidity of the STIs.

Causes of STIs

STIs in Sudan

Urethral

discharg

e

Vaginal

discharg

e

Genital u

lcers

Pelvic i

nflammato

ry dise

ase

Ophthalm

ia neonato

rum 0

10

20

30

40

50

25.9

39.5

13.75.1 2.8

24.9

45.5

7.5 72.3

1999 2001On reviewing the STIs surveillance reports based on the syndromic approach from six states namely Khartoum, Nahr El Neel, Kassala, El Gadarif, Bahr El Jabal and Upper Nile

Genital ulcer

Awareness of people about Genital Ulcer in six states by age group---- increase awareness by age

15-19 years 33-49 years0

10

20

30

40

50

60

70

15-19 years33-49 years

Genital Ulcer

Rural Urban0

10

20

30

40

50

60

70

80

90

HeardNot

Awareness of people about Genital Ulcer in six states by Area/ rural or urban

Vaginal discharge:

Awareness of people about vaginal discharge in six states by age group---- increase awareness by age

15-19 years 33-49 years

40

5760

43

Chart TitleHeard Not

HIV

VCT centers outcome

Positive Negative

17.7

82.3%

HIV/AIDs awareness

Female- heard -15-49 years Male- heard -15-49 years

76.6

88.4

13.4 11.6

Chart TitleHeard Not

Human papilloma virus

About 86% of the cases occur in developing countries, representing 13% of female cancers. Worldwide, mortality rates are substantially lower than incidence.

Determinants of STIs in Sudan

Civil War.Natural disasters.Economic factors.Immigration for workLack infrastructure in health facilitiesFemale Genital Mutilation (FGM)

STIs Health Services-Sudan

Sexually Transmitted Infections (STIs) centers,

distributed in the 15 northern States

Services provided at these centers include the followings:

• Medical care for STIs patients ,• History taking and clinical examination• Correct diagnosis of the case , using a simple

syndromic approach method without need for laboratory testing

• Prescription of the suitable antibiotic

Services provided at these centers include the followings:

• Education on STIs nature of the infection , mode of transmission and prevention & control methods

• Counseling on behavior change , risk reduction and condom use

• Partners management• Follow up of the patients

Management protocol in Sudan for STIs

The protocol followed in Sudan for STIs

management is syndromic approach.

The management includes

History taking, ExaminationCorrect diagnosisEarly and effective treatmentAdvice on sexual behaviorPromotion and/or provision of condoms, partner

notification and treatment,Case reporting and clinical follow-up as appropriate.

Thus, effective, STIs management consists not only of antimicrobial therapy to obtain cure and reduce infectivity, but also comprehensive care of the patient's needs for reproductive health.

Progress

The protocol was endorsed in 2004 by International WHO consultant in collaboration with National – HIV/AIDS Control Programme (SNAP), Federal Ministry of Health.

The syndromic approach was adopted all over the country.

Further, the programme was implemented with partnership with Dermatologists and Obs/Gynae Consultants.

Future

• National STIs committee was formulated in 2011 in order to update the guidelines and protocols of management.

Recommendations

• Provision of raising awareness programs to community at different levels(Students ,high risk groups)

• Policymakers sensitization• Training of health workers included in the

management of STIs• Integration of STIs services through the primary

health care• Make use of the media to deliver massage

Conclusion

• Sexually transmitted infections are still one of the leading causes of morbidity in Sudan

• There are standard guidelines for prevention and treatment of STIs in Sudan and need to be updated

• High risk groups need certain attention• Syndromic Approach is used in the management of

patients.• Awareness is low about different types of STIs and

there management and prevention

Remember

There are more than 600,000 cases hidden need to be detected by us.

References

• Ali, E.B. MANAGEMENT GUIDELINE OF SEXUALLY TRANSMITTED INFECTIONS, FEDERAL MINISTRY OF HEALTH, 2003

• NATIONAL POLICY ON HIV/AIDS, 2004• WHO, Human Papillomavirus and Related Cancers, Sudan, 2010