1. 1 EL RAHAD FIELD RESEARCH CENTRE - CHALLENGING HEALTH PROBLEMS - WESTERN SUDAN SULAIMAN, S. M. M.Sc. (LSHTM), Ph.D. ( U. of Khartoum) Research Professor Prof. Suad M. Sulaiman, Tropical Medicine Research Institute P.O.Box 1304, Khartoum 11111, SUDAN ( tropmed@sudanmail.net) Prof. Suad M. Sulaiman, Tropical Medicine Research Institute P.O.Box 1304, Khartoum 11111, SUDAN ( tropmed@sudanmail.net)

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4. 4 - Area : 2.5 million sq. km. ( Administratively divided into 26 states). - Population : 36,080,373 (2.79 % growth rate) - Borders : 7 African & 2 Arab countries & Red Sea. - Civil War(s) : - North & South >35 yrs (1955–71 & 1983 – present ) - Nuba mountains - Ethiopia / Eritrea - Uganda - Economy : Agriculture, farming & animal husbandry (main income generating). Oil & gold were recently extracted.

5. 5 Research activities of TMRI are : Epidemiology, diagnosis, immunology for control of the tropical diseases prevalent in the country ( i.e. malaria, schistosomiasis, onchocerciasis, leishmaniasis, trypanosomiasis) through applied field research, training and capacity building in collaboration with the national control programmes and academic institutions.

6. 6 KURDUFAN – Mid West Sudan

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8. 8 Health problems in West Sudan : As there are no rivers in the western parts of Sudan, people depend on rain water for domestic and agricultural uses. El Rahad town has a permanent man-made lake (Turda) which stores rainwater for human, animal and agricultural needs. Thus, the Turda became a source of water-borne infections. Health services in the area are minimal. Malaria, urinary bilharziasis, giardiasis and other infections are major health problems.

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12. 12 A project to study the effects of urinary schistosomiasis on the nutritional status of the school children was conducted in El Rahad area of North Kordofan State (West Sudan). Project was initiated at TMRI with funding from Danish Bilharziasis Laboratory (DBL/DANIDA) (1995 – 97).

13. 13 Results : - Urinary schistosomiasis was a major public health problem in the area ranging from 20 – 75%. - Malaria was an even more serious problem, with a prevalence of 30-36 % in school children during the rainy seasons (1995 – 1997).

14. 14 Studies continued (1997-99) : -A controlled study to assess efficacy and community acceptance of using insecticide impregnated material (national dress, Thobs) was successfully conducted showing a significant decrease in malaria transmission and incidence in the study village with high community acceptance. - Reduction of urinary schistosomiasis among the community mainly school-children by treatment and health education.

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17. 17 The State of Kordofan donated a building to TMRI & research team to be established into : “ Malaria & Water Borne Diseases Research & Training Centre ” (1999)

18. 18 Objectives of the El Rahad Center will be : - Provide a teaching & research base equipped with the basic needs for health/environment related problems. - Build an independent collaborative research capacity to address the health and environmental problems of the area and the resident communities. - Increase, in a sustainable manner, the capacity for health research in the community and educate/train the human resources to meet their health priorities and needs.

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24. 24 The intervention village (El Rigela)

25. 25 Main Outcome: - The primary study of using impregnated thobs reduced the malaria prevalence in El Regeila village from 53.8% to 1.3% after one year of intervention (1998-1999). -Urinary bilharziasis in school children (36-60%), needs annual praziquantel treatment - Community was encouraged to build a health clinic, a solar energy light installed and place was used for children immunization & treatment.

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30. 30 Conclusions: The presence of a health research team in the area to identify and assist in solving the main problems will allow for evidence-based improvement of health services, training of personnel and community participation in dealing with and implementing of research results into policy.

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