SSMJ February 2026
Editorials
January was Cervical Cancer Awareness Month, a critical moment to reflect on the state of cervical cancer prevention and care. In South Sudan, awareness of the disease is slowly growing, but it remains uneven and largely concentrated in urban areas, leaving many women and girls beyond the reach of lifesaving information and services.
News, Reports and Policy
Learning About Global Health?
Clinical Guidance
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder with a high global prevalence, including in Indonesia. Metformin is the most commonly used first-line therapy. However, disease progression often necessitates combination therapy. Dapagliflozin, an SGLT2 inhibitor, has been shown to reduce blood glucose levels and body weight. This review aims to compare the effectiveness, safety, and cost-effectiveness of metformin, dapagliflozin, and their combination in patients with T2DM. A literature search was conducted through PubMed, NCBI, and Google Scholar using relevant keywords.
Research
Human immunodeficiency virus (HIV) and cancer have a complicated interplay in their pathobiology, resulting in malignancies associated with viral infection. This study sought to establish the prognostic factors and survival outcomes among patients diagnosed with cancer with known and unknown HIV status. The study employed a hybrid design, combining retrospective and prospective cohorts from 2019 to 2021. Three hundred and seventy-nine cancer patients with known and unknown HIV status enrolled at the oncology clinic in Kisumu County were recruited via multi-stage and stratified sampling.
Maternal birth position refers to the physical postures a woman assumes during delivery and is classified by some authors as either horizontal or upright. The upright birth positions include squatting, kneeling, hands-and-knees, and sitting. Women who give birth in an upright position experience several benefits compared to those in a horizontal position. This includes shorter second-stage labour, a good Apgar score, reduced risk of obstetric injuries, operative deliveries, and postpartum haemorrhage. The World Health Organisation (WHO) recommends that every woman in labour be allowed to give birth in a position of her choice, with greater emphasis on the upright birth position due to its proven benefits.
Pneumonia is an acute lung infection causing painful breathing and hypoxia. Classified as CA40 in the International Classification of Diseases, it includes infectious pneumonia but excludes pneumonitis. Infectious pneumonia presents with fever, chills, and cough with sputum. It is mainly caused by Streptococcus pneumoniae and respiratory syncytial virus, with less common causes such as Haemophilus influenzae type b and Pneumocystis jiroveci.
Self-medication (SM) is ‘the use of medicines to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of prescribed drugs for chronic or recurrent diseases or symptoms’. Patients make the decision when they believe the severity of their symptoms warrants drug therapy, but not to the extent of justifying a physician’s consultation. According to the World Health Organization (WHO), SM serves a purpose, such as the convenience of obtaining appropriate medications for conditions that do not require consultation, but such medications should be prescribed by law only if proven to be fit for the purpose.
Post-stroke epilepsy (PSE) is defined as unprovoked seizures occurring more than seven days after stroke onset and is a common neurological complication of both ischaemic and haemorrhagic strokes. Large stroke, cortical involvement, haemorrhagic stroke or haemorrhagic transformation, and early seizures are predictors of post-stroke epilepsy.
Non-communicable diseases (NCDs), principally cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes mellitus, account for approximately 70% of global deaths and represent one of the most pressing public health challenges worldwide. Cardiovascular diseases alone contribute about 32% of all NCD-related mortality, followed by cancers (17%), chronic respiratory diseases (7%), and diabetes (3%).
According to the most recent Riskesdas survey data, anaemia is a major health issue among Indonesian teenage girls, with prevalence rising from 37.1% in 2013 to 48.9% in 2018. Because of blood loss during menstruation, teenage girls are regarded as high-risk for iron deficiency anaemia. The World Health Organization (WHO) defines anaemia as a haemoglobin (Hb) level of less than 12.0 g/dL in a girl aged 12 to 14 years and in a non-pregnant woman aged 15 to 18.
Case Reports
Pilocytic astrocytoma (PA) is a rare but common low-grade glioma affecting children and young adults. It has a favourable prognosis and a high survival rate with appropriate management. Despite slow growth, PA often presents with significant symptoms due to its tendency to reach a large size, especially in paediatric patients, where compensatory mechanisms can delay detection. PA mimics a brain abscess.
Summaries
Fish floss, locally known as Gɛ̈r in the Dinka language, is a traditional preserved fish product widely consumed in the swampy grasslands (Toich) of Twic East County, Jonglei State, South Sudan. It is primarily produced from catfish (Clarias spp.) and mudfish (Protopterus spp.), although Nile perch (Lates niloticus) may also be used. The product plays an important role in local food security due to its long shelf life, high protein content, and cultural significance.
At the South Sudan Physicians virtual meeting on 6th September 2025, there was a consensus to establish a South Sudan postgraduate programme in General Internal Medicine. It was also agreed to adopt the Fellowship training programme of the East, Central and Southern African College of Physicians (ECSACOP) by setting up a recognised ECSACOP training centre at Juba Teaching Hospital once the hospital has been approved for training by ECSACOP. The South Sudan Physicians Association has been admitted as a member of ECSACOP, paving the way for training to begin in South Sudan.
In the UK, each Medical Royal College offers the Medical Training Initiative (MTI). The Royal College of Physicians of London (RCP) MTI is one of the longest-running schemes and is overseen by an experienced MTI team within the RCP Global Department. At any given time, approximately 150-180 doctors from across the globe are working in RCP MTI posts.
Over the past four years, the Association of Gynecologists and Obstetricians of South Sudan (AGOSS) has made significant progress in strengthening medical education, professional collaboration, and clinical practice through its annual scientific conferences. These conferences have become a cornerstone of our efforts to improve maternal and reproductive health services in a country where the health system continues to face enormous challenges.
Resolutions of the 4th Annual Scientific Conference of the Association of Gynecologists and Obstetricians of South Sudan (AGOSS) - 16 November, 2025