Vaccination and Travel Information for Sudan

SUDAN

 Information current as at:  February 2009 by The D2 Medical centre No1 Fitzwilliam Street Upper Dublin 2 ph 6314500. Th experts in travel vaccines Dublin 2.


Climate: Extremely hot throughout the year, but less so from November to March. 30-40 º Celsius April until November. Sandstorms blow across the Sahara from April to September. In the extreme north there is little rain but the central region has some rainfall from July to August. The southern region has much higher rainfall, the wet season lasting May to October. Summers are very hot throughout the country, whilst winters are cooler in the north.
Capital City: Khartoum
Altitude: 380 metres above sea level
Main Cities: Bur Sudan, Omdurman, Port Sudan, Sawakin
Population: 28,175,000
Land Area (sq km): 2,505,810
Currency: 1 Sudanese dinar = 10 pounds
Languages: Arabic, various tribal languages
Religions: Muslim, Christian, Animist
Economy: Textiles, cement, sugar, soap distilling, shoes, petroleum refining



The D2 Medical advises all travellers to be 'up-to-date' for:

CHOLERA Immunisation is neither required nor recommended.
DIPHTHERIA We recommend the initial childhood series of vaccinations in the first five years of life, with booster doses at ages 11 years, 45 years, and 65 years. Travellers are recommended to have the vaccine 10 yearly esp. if travelling to developing countries, or where there may be a risk of contracting the disease.

HEPATITIS 'A' This is the most vaccine preventable disease for travellers. Strongly recommended but not compulsory for travel to this area. Gammaglobulin is not recommended for travellers.

HEPATITIS 'B' Immunisation is strongly recommended for travellers who will be in the area for 1 month or more.
Transmission of Hepatitis B is through sex or contact with contaminated blood, needles and syringes.


MENINGO-COCCAL MENINGITIS There is current risk of the disease, particularly in the Northern border regions of the country. Immunisation is recommended for travel to these areas.


POLIO Adults who are travelling to areas where poliomyelitis cases are occurring, or where the contracting the disease is possible, and who have received a primary series with either IPV or OPV should receive another dose of IPV before departure. For adults, available data do not indicate the need for more than a single lifetime booster dose with IPV.



RABIES Immunisation is recommended for travellers who will be in rural or remote areas for 1 month or more at a time.

TUBERCULOSIS (TB) Immunisation is not compulsory, and is not recommended for adults.
Children should be immunised at any age.
A skin test is available if immune status is in doubt.


TETANUS We recommend the initial childhood series of vaccinations in the first five years of life, with booster doses at ages 11 years, 45 years, and 65 years. Travellers are recommended to have the vaccine 10 yearly esp. if travelling to developing countries, or where there may be a risk of contracting the disease.

TYPHOID FEVER Immunisation is recommended.


YELLOW FEVER A yellow fever vaccination certificate is required from travellers over 1 year of age coming from infected areas. A certificate may be required from travellers leaving Sudan, particularly if leaving a yellow fever infected area ( see * below )

* World Health Organization:
The following countries and areas are regarded as Yellow Fever infected areas:

Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan (south of 15°N), Togo, Uganda, United Republic of Tanzania, Zambia.
America: Belize, Bolivia, Brazil, Colombia, Costa Rica, Ecuador, French Guiana, Guyana, Panama, Peru, Suriname, Trinidad and Tobago, Venezuela.




Malaria risk, predominantly due to P. falciparum, exists throughout the year in the whole country, including the urban areas. Increased risk occurs during and after the rainy season, June through October, especially in southern Sudan. There is less malaria risk in the desert areas of the extreme north and northwest. Risk is low and seasonal in the north. It is higher along the Nile south of Lake Nasser and in the central and southern part of the country. Areas where there is cause for extra caution: Kirinyaga, Meru North District, and Trans Mara Districts. An alarming extension of this is that some of the previously malaria-free high altitude areas are reporting the disease. Malaria risk on the Red Sea coast is very limited. P. falciparum resistant to chloroquine and sulfadoxine–pyrimethamine reported.

Falciparum malaria accounts for approximately 84% of cases. Other cases of malaria are due to the P. vivax (9%–20%) and P. malariae species (7%), are very rarely P. ovale.

There are five common medications for malaria prevention available in Ireland. They are: chloroquine, doxycycline, malarone, mefloquine, paludrine. To determine the appropriate antimalarial, it is advised that the traveller discuss this with a Worldwise Travellers Health Specialist or other Travel Health Professional. None of the medicines are 100% effective against the disease at all times, and each has its own side effects. These need to be discussed with the intending traveller.

 

General Advice on Mosquito Prevention.
Malaria is transmitted by mosquito bite, so recommend all travellers to the country to:

  • cover exposed skin after dusk when they are at most risk for getting bitten
  • use insect repellent with DEET in it.
  • return before dusk from country areas where malarial mosquitoes are the most active
  • sleep in screened room or use a bed net, remembering to tuck in the edges & spray inside.
  • sleep in air conditioned rooms or rooms with fans. Vapour pads and smoke coils also help. Insect buzzers are useless.

Malaria map of Sudan




GENERAL
Medical facilities in Sudan are extremely limited and medical facilities are not comparable to Western standards. When making a decision regarding health insurance, travellers will need to consider that many foreign doctors and hospitals require payment in cash prior to providing service and that a medical evacuation to an improved overseas facility will be extremely expensive. Uninsured travellers who require medical care overseas often face extreme difficulties.

Minister of Health has warned that potassium bromide has been used as a raising agent in some local bakeries. Medical advice has indicated that it can affect the central nervous system if taken in large quantities.

HEALTH, ACCIDENTS AND INSURANCE
Accidents and injuries are the leading cause of death among travellers under the age of 55. Most are caused by motor vehicle and motorcycle crashes; and to a lesser degree, drowning, aircraft crashes, murders, and burns.

Heart attacks cause most fatalities in older travellers, but infections cause only 1% of fatalities in overseas travellers. Generally, infections are the most common cause of travel-related illness.

Travellers are advised to obtain, before departure, travel health insurance with specific overseas coverage. The policy should include a medical evacuation benefit. Check for any exclusions that are part of the policy, and keep in mind that many insurance policies have terrorism exclusion clauses. The D2 medical recommends that the policy also provide 24-hour access to an assistance centre that can help arrange and monitor delivery of medical care, and determine if air ambulance services are required.

Yellow Fever Map


                                                                                                                                                                 DR JOHN J RYAN MEDICAL DIRECTOR

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