Teaching of major communicable diseases in Sudanese medical schools: a critical look.

This descriptive, cross-sectional study of Sudanese medical schools aimed to describe and analyse the proportion of their curricula currently allocated for teaching of communicable diseases and to assess the teaching methods and student assessment tools. Qualitative and quantitative data were collected from heads of departments and students in 20 of the 27 medical faculties and from ministry of health staff at federal and state levels. Curriculum designs ranged from traditional to innovative, community-oriented programmes. Problems regarding student evaluations were identified. Major limitations included shortages of staff, reference materials and teaching aids. Poor knowledge of students about different aspects of diseases endemic in Sudan was found. Recommendations include curriculum development, staff recruitment and training, and improvement of teaching and training of students.

[A critical view of Arabic curriculum as a requirement for medical schools, Gezira University].

We compared the present Arabic syllabus used in Gezira University Medical School with previous ones. We also surveyed students and Arabic professors in medical sciences on their views on the content and teaching/evaluation procedures and how these contributed to students' understanding of the medical science syllabus. The current syllabus was designed to provide students with Arabic language skills with particular reference to scientific language. The students' opinions differed regarding their understanding of clinical medicine and their interaction with patients and also the benefits to them of research procedures and reporting. The professors considered the syllabus was adequate to achieve its aims but emphasized the importance of varying teaching methods and evaluation.

Gender aspects and women's participation in the control and management of malaria in central Sudan.

This work was designed to study the contribution of women in central Sudan in the control and management of malaria with particular emphasis on gender-related aspects that define women's role and participation. The Blue Nile Health Project (BNHP 1980-1990) was launched in 1980 mainly for control of water associated diseases in central Sudan. The BNHP model was chosen to conduct this work. The study showed that women were actively involved in the implementation of the BNHP strategies as health instructors (murshidat) who constituted 75% of the staff of BNHP unit of health education, as members of village health committees (VHC) where they constituted 40% of the VHC members and also as recipients of the project services. All murshidat were interviewed whereas multistage random sampling for VHC members and recipient women in 40 villages was used to select a sample which was interviewed. The results showed that the murshidat and VHC women members played a major role in the motivation, organization and health education of local communities prior to campaigns of environmental sanitation and vector control. Household commitments and difficulties in communication with the public were the main gender-related factors that contributed negatively to women's activities. Cases of malaria have more considerable socio-economic impact than other common diseases, especially with regard to women's household commitments and work. Recipient women were more concerned with aspects of self protection, management of family cases of malaria and health education programmes. They were less involved in drying mosquito breeding sites and spraying activities of insecticides which had been reluctantly accepted because of allergy and bad odour. Although the majority of women considered antimalarials to be less harmful than effects of malaria itself on pregnancy, they did not realize the role of malaria chemoprophylaxis during pregnancy. This needs more health education. The study showed that the BNHP programme was very successful in recruiting women in control and management programmes. Therefore, health planners are urged to persuade the subordinated communities of women in many African countries like Sudan to play a more active role in the health programmes and welfare of their communities.

Malaria and low birth weight in central Sudan.

A nested case-control hospital study and a midwife-based community cohort study were conducted in Central Sudan during 1989 and 1990 to assess the contribution of mesoendemic malaria to low birth weight. Malarial infection was determined by maternal history, parasitology, and histopathology. There were significant associations between a maternal history of malaria and low birth weight in the hospital study (adjusted odds ratio (OR) = 1.6, 95% confidence interval (CI) 1.2-2.1) and the community study (OR = 1.7, 95% CI 1.3-2.3). Attributable risk percentages were high and were comparable in the hospital study (22.2%) and the community study (24.5%). A significant trend of increased risk of low birth weight was observed with increasing number of reported malaria attacks, with attacks occurring earlier in pregnancy, and with higher parasitemia. In addition, the risk of low birth weight associated with malaria was higher among primiparous women than among multiparous women. The mean birth weight of infants whose mothers had malaria during pregnancy was significantly lower than the mean birth weight of infants whose mothers did not. Malaria treatment, chemoprophylaxis, and use of insecticides decreased the risk of low birth weight and are recommended as appropriate interventions. These measures should target primigravid women and should be initiated early in pregnancy.

An outbreak of dracunculiasis in central Sudan.

This paper describes an outbreak of dracunculiasis in Mazmum, a town in central Sudan. The study included collection of clinical and epidemiological data from 319 patients treated in hospital, a review of the hospital records, a house survey covering a sample of 757 subjects, a school survey covering 1390 schoolchildren, and examination of water sources. The overall incidence of the disease was 23.4%, with most cases appearing in the agricultural season (July-October). Incidence was highest in young females but most severe disability occurred in male patients aged > or = 20 years, of whom more than 60% were unable to work for more than 4 weeks. The disease is transmitted in shallow natural pools, artificial ponds and trenches in rocky hills that hold rain water. All these sources were found to be infested with Cyclops. The outbreak is attributed to deterioration in the structure and management of the water sources, together with a massive population influx from other endemic areas. These observations underscore the importance of co-ordinating efforts to eradicate the disease from African countries.

Teaching of major communicable diseases in Sudanese medical schools: a critical look

This descriptive, cross-sectional study of Sudanese medical schools aimed to describe and analyse the proportion of their curricula currently allocated for teaching of communicable diseases and to assess the teaching methods and student assessment tools. Qualitative and quantitative data were collected from heads of departments and students in 20 of the 27 medical faculties and from ministry of health staff at federal and state levels. Curriculum designs ranged from traditional to innovative, community-oriented programmes. Problems regarding student evaluations were identified. Major limitations included shortages of staff, reference materials and teaching aids. Poor knowledge of students about different aspects of diseases endemic in Sudan was found. Recommendations include curriculum development, staff recruitment and training, and improvement of teaching and training of students