"Mapping Pulmonary Tuberculosis in Khartoum State Using Geographic Information Systems (GIS)"

Abstract

Background: Sudan shoulders the second highest TB burden in WHO-EMRO (Eastern Mediterranean Region). Khartoum state, where this study was conducted, has the highest number of notified TB cases in comparison to other states, with recorded 7,570 and 6,585 case notifications in the years 2007 and 2008 respectively. Mapping PTB cases geographically, using Geographic Information Systems (GIS) to identify geographical areas with on-going TB transmission and exploring various risk factors contributing to this transmission will be of paramount importance in taking effective control measures to combat the emergence and re-emergence of TB in Sudan. Objectives: To map the geographical distribution of PTB cases in Khartoum state over a two years period between 2007-2008 using GIS and to observe variations in population density, disease incidence, and prevalence of PTB. Design: a cross-sectional retrospective, illustrative and descriptive study. Settings: 36 Administrative units and 33 TBMUs in Khartoum State. Population: 6182 PTB patients. Software and devices: ArcGIS 9.3.1 and GPS (Garmin 60CSx). Findings: We successfully mapped the geographical distribution of PTB in large area covering the Khartoum state and found that distribution of PTB cases were attributable to several characteristics of the sociopolitical and socio-economical realities of Khartoum State. PTB cases were concentrated in AUs with areas of poverty, settlement areas of IDPs and poor urban migrants. Conclusions: GIS is a promising technology to study the distribution of infectious diseases in settings like Khartoum where unavailability of systematic population records may partly be overcome by mapping technologies such as Google maps. Pertinent limitations and implications of the GIS use have been elaborated in the thesis.