South Sudan is thought to be undergoing an epidemiological transition with an increasing burden of non-communicable diseases such as hypertension. No current data exist on the prevalence of these diseases. Blood pressure readings of 5660 blood donors during 2010-12 at Juba Teaching Hospital were analysed. Prevalence of hypertension was 19.3%, positively associated with older age and being male. This has implications for public health policy, indicating a need for prevention, screening and treatment to prevent complications of hypertension.
Tuberculosis (TB) is a chronic inflammatory lung disease caused by Mycobacterium tuberculosis. Sick people with the TB germs (or bacilli) transmit the germs into the air during coughing, sneezing, talking, or spitting. Inhaling a small number of the bacilli leads to infection . When a person with active pulmonary TB disease does not receive treatment, that person will infect on average between 10 and 15 people in a year.
Traumatic brain injury (TBI) is defined as brain injury due to externally inflicted trauma which may result in significant impairment of an individual’s physical, cognitive and psychosocial functioning (1). In an analysis of patients admitted with trauma to Juba Teaching Hospital, Dario Kuron Lado (2) showed that of 652 patients presenting with different patterns of injury due to trauma 12% (47) had suffered head injury.
An understanding of the epidemiology of Mycobacterium tuberculosis is critical for effective control. In this, the first article of a series, the global burden of tuberculosis (TB), risk factors for transmission and the epidemiology of Mycobacterium tuberculosis in South Sudan are reviewed.
This article describes a completed audit cycle of the mode of anaesthesia used for caesarean section at Juba Teaching Hospital (JTH).
There is a large body of evidence available that highlights the benefits of regional anaesthesia over general anaesthesia for caesarean sections (CS). The UK National Institute for Clinical Excellence (NICE) guidelines suggest that “women who are having CS should be offered regional anaesthesia because it is safer and results in less maternal and neonatal mortality than general anaesthesia”(1). In 2006, the Royal College of Anaesthetists proposed standards for best practice, suggesting that a minimum of 95% of elective CS and a minimum of 85% of emergency CS are conducted under regional anaesthesia.
An ordinary ring can get stuck on a finger if it has been worn for a long time. This is most often due to swelling of the finger. Different techniques have been described for removal of such rings but when the finger is grossly swollen and the ring is very thick or a band, these methods are not successful
Background: Tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis. Delays in diagnosis and treatment increase morbidity and mortality from tuberculosis, and the risk of transmission in the community.
When I was working in Uganda I saw several cases of poisoning with organophosphates and was horrified by the mortality. Here I report on a simple study we carried out nearly 10 years ago to find how widespread poisoning was in Uganda.
HIV stigma and discrimination are a daily reality for people living with HIV (PLHIV) and their families. Stigma is prevalent in all countries experiencing HIV epidemics, including South Sudan. It is found within families, in communities, institutions such as health care facilities and places of employment, in the media and in government policies, laws and legislation.
Extract from ‘KAP Survey Report: Aweil East County-Highlands, Northern Bahr el Ghazal state. November 2010’. By Jane Gune, Project Manager (Tearfund DMT South Sudan). Funded by the Canadian International Development Agency.
The carriage of Streptococcus pneumoniae, serotypes, antimicrobial susceptibility patterns and disease development are poorly understood in Yei. Availability of affordable antibiotics over the counter, lack of laboratory infrastructure and high rates of penicillin resistance have the potential to aggravate rates of childhood mortality associated with Streptococcus pneumoniae. There is an urgent need to strengthen microbiological and public health services.
Extract from ‘South Sudan Antenatal Care Clinics Sentinel Surveillance Report 2nd Round September - December 2009’ HIV/AIDS/STI Directorate, Ministry of Health, Republic of South Sudan
The purpose of this beginner’s guide is to start you off on the research journey by outlining the sequence of steps along the research process (see Figure 1) and providing guidance, including signposting other useful resources that can help support each stage of the process.
The study was carried out among 334 pregnant and newly delivered women seen at Juba Teaching Hospital in 2009. The objective was to assess the coverage of insecticide-treated bed-nets (ITN) and Intermittent Preventive Therapy (IPT) among these women and the factors associated with their use. Overall 87% of the women used ITN and 61% used IPT. ITN use was positively associated with buying nets, indoor spraying of insecticide and higher household income. IPT use was positively associated with more frequent antenatal clinic visits, indoor spraying and buying
Five years ago we were seeing an increasing number of trauma cases in Juba Teaching Hospital and the situation is even worse today in 2011. The objectives of this study were to:
Determine the magnitude and type of trauma injury as seen in Juba, examine its causes, explore possible solutions.
This article reports a case controlled study of kala-azar done in Fangak County in 2007. Fifty-six percent of the cases were under 5 years old. Most patients came for treatment two months or more after the onset of symptoms.
Outdoor night-time activities and the use of “Smoking” (non-insecticide treated) bed nets were associated with kala-azar infection whereas the use of bed nets during the rainy season decreased the risk of infection.
It is recommended that there should be a greater distribution of treated bed nets and more kala-azar treatment centres in the county.
Malnutrition is a chronic public health problem in Aweil East and North counties with an estimated prevalence of between 15% and 25%.
Underlying contributing factors include: political instability, poor infrastructures, droughts and floods resulting in low crop yields, poverty and limited awareness of good nutrition and health practices.
At the time of the survey there were six decentralised centres feeding severely and moderately malnourished children below 5 years. As well as feeding activities, nutrition and health education was given in order to improve health and nutrition awareness.
The objective of this survey was to assess knowledge, attitudes and practices of mothers (or caretakers) of children admitted in the feeding programme.
Observations and reports of the nodding episodes both from this study and from others in Tanzania and Uganda lead us to speculate that the nodding syndrome may be a particular form of epilepsy found mainly, perhaps only, in this area of Africa. The study in Tanzania, which did MRI scans and EEG recordings (4), concluded that head nodding is “possibly a new epilepsy disorder in sub-Saharan Africa”. A previous study in Lui indicated that EEG results were consistent with a specific encephalopathy, which progresses in well-defined stages, and nodding represents the onset of symptoms and the ictal events common to all stages of epilepsy (5). However until this condition can be further investigated by a clinical neurologist and by doing more EEGs it is difficult to come to definite conclusions.
Fast Facts: Total Population of South Sudan is 8.26 million
Total Area of South Sudan is 644,329 sq. km More than half (51%) of the population is below the age of eighteen. 72% of the population is below the age of thirty 83% of the population is rural 27% of the adult population is literate
51% of the population live below the poverty line 78% of households depend on crop farming or animal husbandry as their primary source of livelihood 55% of the population
has access to improved sources of drinking water...
Juba has a poor road network and few public transport options, with an increasing number of people riding motorised or non-motorised cycles This study seeks to characterise the cyclists (including helmet wearing) and to use the findings to make recommendations to the concerned authorities.
The study found that most of the 3564 observed cyclists were adult males; the proportion using helmets was very small (1%). Many cyclists had an extra passenger, or were carrying a load. More than half the cyclists were riding in the middle of the road. Only 18% of the motorcycles were licensed...
A nutrition survey of young children was carried out by Medair (see http://www.medair.org) and Save the Children in Southern Sudan (SCiSS) (see http://savethechildren.org.uk) in February 2010 (the mid-dry season) in Bilkey and Nyandit Payams, Akobo County. This was in response to a previous evaluation of the nutrition situation in Akobo town in January 2010. This had found that lack of rain had led to a high level of food insecurity, and increasing levels of malnutrition. The objectives of the survey were:
The basic hospital package of care service (BHPCS)1, commissioned by the Department of Curative Medicine in the Government of Southern Sudan (GOSS) and written by specialists of the St Mary’s Hospital–Juba Teaching Hospital Link in January 2010, identified a severe lack of doctors at specialist level. It recommends that the minimum requirements of specialists at each of the three main hospitals in South Sudan over the next five years are...
A summary and analysis of all recorded emergency and elective caesarean sections (CS) performed at Juba Teaching Hospital (JTH), Juba, Southern Sudan from October 2008 to September 2009 was made. During this period 430 CS were performed giving a mean of 1.2 each day, the main reason being cited as obstructed labour. Thirty of the babies delivered by CS died giving a neonatal morality rate of 7%. Due to various /non-comprehensive reporting methods it is difficult to measure the maternal mortality rate associated with CS...
Findings from specular microscope studies have demonstrated increased endothelial cell loss associated with the use of air for lens implantation. The objective of this study was to evaluate the surgical outcome after cataract surgery with lens implantation using air or viscoelastic to maintain the anterior chamber
Motorcycle related trauma is a major cause of morbidity in those of working age in the developing world1. One hundred and sixteen patients involved in motorcycle related accidents were identified over four weeks at the Juba Teaching Hospital in South Sudan. Of these 84% were male with an average age of 26.7 years...
South Sudan borders countries with significant HIV epidemic profiles. Data on the status of HIV in South Sudan is limited. More than two decades of war have relatively sheltered the country from experiencing an epidemic similar to that in the neighbouring countries. Ironically the coming of peace has the potential of accelerating the development of an epidemic in South Sudan as a result of increased movement of people and altered economic and social activities...
Multi-drug resistant tuberculosis (MDR-TB) is defined as TB that is resistant to the two main first-line drugs (isonaiazid and rifampicin).
Extensively drug resistant TB (XDR -TB) is a relatively rare type of MDR-TB and is defined as TB which is resistant to...
Southern Sudan has one of the highest rates of maternal mortality in world1. However there is very little reliable published data on admissions and mortality rates in secondary and tertiary care. Despite being a large teaching hospital, documentation at JTH is often poor and official statistics on admissions and mortality are sparse and their reliability is sometimes questionable. For this reason we undertook a retrospective descriptive analysis...
Consecutive surveys in Twic County have shown constantly high levels of malnutrition despite the interventions currently being carried out. GOAL, together with other NGOs, has been carrying out feeding responses to alleviate malnutrition, and more recently food security awareness. Programme coverage and meeting international emergency feeding standards have been a challenge due to the low attendance in the various feeding sites.
The first Southern Sudan Household Health Survey (SHHS) was a joint effort of the Ministry of Health, Government of Southern Sudan (MOH-GOSS) and the Southern Sudan Commission for Census, Statistics and Evaluation (SSCCSE). The survey was part of a wider activity that covered the 25 states of Sudan. Whereas this report focuses on the 10 states of Southern Sudan, it includes findings from the 15 remaining States of Sudan. This was considered necessary by the stakeholders for
ease of comparison and reference.
Worldwide there are 247 million cases of malaria annually and nearly a million deaths [1,2]. In South Sudan, especially during the rainy season, malaria is responsible for most admissions and is the leading cause of mortality in the Medical Department of Juba Teaching Hospital (JTH).
Health psychology is a specialty within the discipline of psychology concerned with individual behaviours and lifestyles affecting physical health. The discipline strives to “enhance health, prevent and treat disease, identify risk factors, improve the health care system, and improve public opinion regarding health issues”
The Internet has enabled increasing numbers of healthcare professionals to access flexible, convenient and interactive forms of continuing medical education. The advantages of these computer-based technology tools are clear but they are expensive, may not be available and there is a lack of Information Technology (IT) skills.
Two billion people in low- and middle-income countries have no access to basic surgical care. Surgical conditions account for a significant proportion of the global health burden. Surgery is still not considered a public health priority even though surgical services may be as cost-effective as other well-accepted preventive procedures
Background: Guinea worm disease (dracunculiasis) is an ancient parasitic disease and is set to be the next disease eradicated from the world and the first to be overcome without a vaccine or treatment. South Sudan and Ghana account for more than 95% of global dracunculiasis.