Title:
Impact of the 2023 Armed Conflict of Sudan on Routine Malaria Data Reporting: Trend Analysis of Three Key Impact Indicators (January 2020- March 2025)
Authors:
Alnaeem, Khlood Fathi Hassan
Place:
Amsterdam, The Netherlands
Publisher:
KIT Institute
Year:
2025
PAGE:
70
Language:
En
Subject:
Health and Poverty
Keywords:
Malaria surveillance, conflict affected settings, Sudan DHIS2, malaria impact indicators, mixed methods
Abstract:
Background: Malaria remains a leading cause of morbidity and mortality in Sudan, accounting for most outpatient visits and hospital admissions in 80% of the states. The health system, already fragile, was further destabilized by the April 2023 conflict, which severely undermined health surveillance infrastructure and triggered a major displacement crisis. No prior study has investigated the conflict’s impact on routine malaria surveillance data reported to DHIS2. Methods: This study analyzed quarterly malaria impact indicators from DHIS2 for 17 states (excluding Khartoum) from January 2020 to March 2025. A mixed-methods approach was adopted. Quantitative analysis included time trend comparisons pre- and post-conflict, and interrupted time series analysis (ITSA) for 11 states with complete post-conflict data. Qualitative data were gathered through key informant interviews, using a semi-structured format and deductive framework analysis guided by questionnaire themes. Results: Significant variation of the indicators was observed across states. Darfur, South, and West Kordofan states showed persistent missing data post-conflict, whereas northern and eastern states continued consistent reporting, corroborated by qualitative findings of improved reporting in these areas. ITSA revealed a significant immediate decline in reported malaria cases per 100,000 population during the conflict quarter, with no further significant changes thereafter. Key challenges identified included destruction of health infrastructure, staffing shortages, unpaid salaries, and communication breakdowns. Discussion: Disparities in surveillance and reporting are largely attributable to preexisting infrastructure and personnel differences, compounded by conflict intensity. Strengthening surveillance, innovative outreach to inaccessible populations, and a unified malaria data system are recommended to improve monitoring and response.
Organization:
KIT (Royal Tropical Institute) Vrije Universiteit Amsterdam (VU)
Institute:
KIT Institute
Country:
Sudan
Region:
Northeast Africa
Training:
Master of Science in Public Health and Health Equity, Epidemiology Track
Category:
research
Right:
© 2025 Alnaeem
Document type:
Thesis/dissertation
File:
G1JvdZlgba_20251211130840164.pdf