This document discusses sexually transmitted infections (STIs) in Sudan. It provides data showing high rates of STIs like urethral discharge, vaginal discharge, and genital ulcers in Sudan. It outlines the causes of STIs in Sudan and discusses specific infections like HIV/AIDS, human papillomavirus, and genital ulcers. It also describes Sudan's STI management protocol, services provided at STI centers, and the need to update guidelines and raise awareness about STIs in Sudan and their hidden prevalence.

1. Sexually Transmitted Infections
(STIs)
in Sudan
Geneva Foundation for Medical
Education and Research
GFMER Sudan 2012
Forum No: ( 2 )

2. Name of presenters
Name Position Institution
Sawsan Mustafa Abdalla Associated Professor National Ribat
University
Waled Amen Mohammed Head, Community Health Nursing UMST
Name of contributors
Name Position Institution
Sawsan Mustafa Abdalla Associated Professor National Ribat
University
Waled Amen Mohammed Head, Community Health Nursing UMST

3. 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

4. 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.

5. Causes of STIs

6. STIs in Sudan
50 45.5
45 39.5
40
35
30 25.9 24.9
25
20
15 13.7
10 7.5 7
5.1
5 2.8 2.3
0
Urethral Vaginal Genital ulcers Pelvic Ophthalmia
discharge discharge inflammatory neonatorum
disease
On reviewing the STIs surveillance reports based on the
1999 2001
syndromic approach from six states namely Khartoum, Nahr
El Neel, Kassala, El Gadarif, Bahr El Jabal and Upper Nile

7. Genital ulcer
70
60
50
40
15-19 years
30
33-49 years
20
10
0
15-19 years 33-49 years
Awareness of people about Genital Ulcer in six states by age
group---- increase awareness by age

8. Genital Ulcer
90
80
70
60
50
Heard
40
Not
30
20
10
0
Rural Urban
Awareness of people about Genital Ulcer in six states by
Area/ rural or urban

9. Vaginal discharge:
Chart Title
Heard Not
60
57
43
40
15-19 years 33-49 years
Awareness of people about vaginal discharge in six states by
age group---- increase awareness by age

10. HIV

11. VCT centers outcome
%
82.3
17.7
Positive Negative

12. HIV/AIDs awareness
Chart Title
Heard Not
88.4
76.6
13.4 11.6
Female- heard -15-49 years Male- heard -15-49 years

13. 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.

14. Determinants of STIs in Sudan
Civil War.
Natural disasters.
Economic factors.
Immigration for work
Lack infrastructure in health facilities
Female Genital Mutilation (FGM)

15. STIs Health Services-Sudan
Sexually Transmitted
Infections (STIs)
centers, distributed in the
15 northern States

16. 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

17. 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

18. Management protocol in Sudan
for STIs
The protocol followed in
Sudan for STIs
management is syndromic
approach.

19. The management includes
 History taking,
 Examination
 Correct diagnosis
 Early and effective treatment
 Advice on sexual behavior
 Promotion and/or provision of condoms, partner
notification and treatment,
 Case reporting and clinical follow-up as
appropriate.

20. 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.

21. 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.

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

23. 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

24. 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

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

26. 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