Communication for behavioural impact in enhancing utilization of insecticide-treated bed nets among mothers of under-five children in rural North Sudan: an experimental study.

BACKGROUND: Malaria is the leading cause of morbidity and mortality in Sudan. The entire population is at risk of contracting malaria to different levels. This study aimed to assess the effectiveness of communication for behavioural impact (COMBI) strategy in enhancing the utilization of long-lasting insecticidal nets (LLINs) among mothers of under-five children in rural areas. METHODS: A randomized community trial was conducted in rural area of Kosti locality, White Nile State, Sudan, among mothers of under-five children, from January 2013 to February 2014. A total of 761 mothers from 12 villages were randomly selected, 412 mothers from intervention villages and 349 were from comparison villages. RESULTS: The knowledge of mothers, in intervention villages, about malaria vector, personal protective measures (PPM) against malaria, and efficacy of LLINs was significantly increased from 86.9 to 97.3 %; 45.9 to 92 % and 77.7 to 96.1 % respectively. Knowledge about usefulness of PPM, types of mosquito nets and efficacy of LLINs was significantly higher in intervention villages compared to comparison villages (p < 0.05), (η2 = 0.64). Mothers in intervention villages increasingly perceived, post-intervention, that malaria was a serious disease (99.3 %), a preventable disease (98.8 %) and also LLINs as an effective intervention in malaria prevention (92.2 %). This resulted in an increase in the utilization rate of LLINs from 19.2 to 82.8 % in intervention villages compared to comparison villages (p < 0.05) [OR = 4.6, 95 %, CI = (3.72-5.72)], (η2 = 0.64). The average of mothers' knowledge about malaria was increased by 64 % (η2 = 0.64), the use of LLINs was increased by 79 % (η2 = 0.79) and a positive attitude towards malaria was 2.25 times higher in intervention villages than among mothers in the comparison villages. CONCLUSIONS: These results established the usefulness of COMBI strategy for increasing awareness about malaria, developing a positive perception towards malaria prevention and, increasing the utilization of LLINs.

Integrated bio-behavioural HIV surveillance surveys among female sex workers in Sudan, 2011-2012.

OBJECTIVES: To assess HIV and syphilis prevalence, HIV-related behaviours and testing for HIV in female sex workers (FSW) in Sudan. DESIGN: Bio-behavioural surveys using respondent-driven sampling were carried out among FSW in the capital cities of 14 states in Sudan in 2011-2012. HIV and syphilis testing was done by rapid tests. RESULTS: 4220 FSW aged 15-49 years were recruited. The median age of recruited women varied from 21 to 28 years per site. The highest HIV prevalence was measured at two sites in the eastern zone (5.0% and 7.7%), while in the other zones it ranged from 0% to 1.5%. Syphilis prevalence ranged from 1.5% in the northern zone to 8.9% in the eastern zone. Ever having been tested for HIV was reported by 4.4%-23.9% of FSW across all sites. Condom use at last sex with a client varied from 4.7% to 55.1%, while consistent condom use with clients in the month preceding the surveys was reported by 0.7%-24.5% of FSW. The highest reporting of ever injecting drugs was measured at a site in the western zone (5.0%). CONCLUSIONS: The surveys' findings indicate that the highest burden of HIV in FSW is in the eastern states of the country. Condom use and HIV testing data demonstrate the need for HIV interventions that should focus on HIV testing and risk reduction strategies that include stronger condom promotion programmes in FSW and their clients.

A study of the use and impacts of LifeStraw in a settlement camp in southern Gezira, Sudan.

This paper reports a study of the LifeStraw in El-Masraf camp within Gezira State, Sudan. A total of 647 eligible subjects participated in the study. Two week incidence of diarrhoeal rates were estimated by a community survey some four months before and again four months after provision of the LifeStraw. In addition counts were kept of people attending at the community clinic with diarrhoea. Compliance rates were good with 86.5% of people saying they always used it and only 3.7% saying they had never used it. In a before implementation survey 16.8% of participants reported diarrhoea in the previous 2 weeks compared with only 15.3% in a survey after implementation. Similarly 58 people presented to the clinic as a new case of diarrhoea in the four months before compared with only six in the four months after implementation. When compared with diarrhoeal attendances at the regional hospital, this was a statistically significant decline in attendances (p<0.0001). The LifeStraw is likely to find a role as an adjunct to water quality interventions aimed at the home. However, more research is needed to assess the long-term impact and uptake of these devices before their definitive value can be assessed.