Jornal de Doenças Tropicais e Saúde Pública

Abstrato

Visceral Leishmaniasis Control Strategies in Sudan: A Review with Recommendations

Omer Hammam*, Joseph Hicks

Problem: Visceral leishmaniasis is one of the neglected tropical diseases, and it is fatal in 95% of cases if left untreated. For more than a hundred years, the disease represents a significant Sudan problem, spreading to new regions.

Aim of the study: Evaluate existing control measures for VL in Sudan and develop recommendations for strengthening these control measures based on an analysis of the evidence around alternative control measures from similar contexts.

Methodology: This dissertation is an in-depth secondary data analysis from literature and unpublished data. Due to limited access to MoH data, personal communications with officials were done.

Findings: The disease is spreading to new regions due to ineffective control measures, and the latest control plan is failing to achieve the target. Lack of governance and leadership were identified as management problems preventing the National Leishmaniasis Control Program (NLCP) from working. Furthermore, Sudan's existing control strategies were examined against the WHO recommended priorities and compared with successful strategies from other endemic countries. The analysis found that the NLCP focuses mainly on case detection and treatment but has ineffective surveillance, while vector control, reservoir control, and health education are neglected.

Conclusion and recommendations: Sudan is far from achieving the WHO target of eliminating VL as a public health problem in 2030. The study emphasized NLCP's strong national and international partnerships to consider short- and long-term recommendations. The short-term recommendation includes the establishment of Monitoring and Evaluation to ensure the NLCP accountability, establishing clinical mentoring teams to supervise the VL treatment centres at the twelve endemic states, and starting WHO recommended web-based surveillance.

The long-term recommendations include operational research to study evidence-based vector control with apriority to OutDoor Residual insecticides Spraying impact, reservoir host control measures, and study VL diagnostics and treatment regimens. The study also recommends introducing female Community Health Workers to enhance VL's health education, which is mainly affecting children in Sudan.