The National Burden of Selected Diseases and Injuries in Sudan in the Year 2002

Abstract

This case study was conducted to pretest the burden of disease methodology in Sudan settings. It aimed at measuring the burden of selected diseases and injuries in Sudan in 2002, using Disability Adjusted Life Years (DALYs). The diseases were Malaria, Measles, Protein energy malnutrition, Low birth weight, Maternal hemorrhage, Diabetes Mellitus and Road traffic accidents. It also aimed to analyze the sensitivity of the burden to changes in the weights given to different disabilities. A search for local studies and reports providing epidemiological data on these diseases was conducted. Preliminary epidemiological estimates were developed from the data. The estimates included mortality rates, incidence rates, prevalence proportions, case fatality hazards, remission hazards, average duration and relative risk of mortality. The preliminary estimates were entered into disease modeling computer software; DISMOD. This produced internally consistent mortality and incidence rates that were used to calculate DALYs for each disease. For both males and females, low birth weight accounted for the highest burden followed by protein energy malnutrition, malaria, measles, Diabetes Mellitus and road traffic accidents, with maternal hemorrhage preceding the latter in females. The rank order of the diseases varied in the different age groups. The change in disease burden when using a different set of disability weights was the greatest in diseases with a high disability burden and in those were the difference between the disability weights given to a condition is large. The validity of disease burden estimates was reduced by uncertainties arising from different sources. The study revealed deficiencies in epidemiological data of the diseases under study. Further revisions and improvement of the methods used, with refinement of the final estimates of incidence and mortality of the diseases under study, were recommended. It is also important to conduct a full analysis of all disease and injury burden in Sudan. More reliable epidemiological data should be provided by improving Abstract V the vital registration system, and conduction of population based longitudinal studies and national surveys.