The Sudan Journal of Health Sciences (SJHS) is an open-access, peer-reviewed journal (ISSN 2948-3026) dedicated to advancing health sciences through the dissemination of high-quality research articles. The journal accepts various manuscript types, including original articles, case reports, review articles, and meta-analyses. Authors must follow specific guidelines to ensure the quality and consistency of submissions.
Occupational Health Hazards Control Measures at Dongola Specialized Teaching Hospital, Sudan, 2025
BACKGROUND Occupational health hazards are a major concern among nurses due to their continuous exposure to workplace risks. Ensuring safe practices is essential to reducing occupational injuries and infections. This study aimed to assess nurses’ practices for preventing occupational health hazards and identify associated demographic factors at Dongola Specialized Teaching Hospital, Northern State, Sudan. METHODS An analytical cross-sectional hospital-based study was conducted in 2025 among 140 nurses at Dongola Specialized Teaching Hospital. Data were collected using a structured observational checklist and a self-administered questionnaire to assess socio-demographic characteristics, attitudes, practices, and the occupational safety environment, and were analyzed using SPSS version 26. RESULTS The majority of participants were young (25–29 years) and female (83.6%). Most nurses (64.6%) reported that occupational safety practices and strategies were in place. Good practice was observed in 78.4% of participants, while 9.9% demonstrated poor practice. Hand hygiene compliance was high (87.8%), overall compliance with occupational safety measures was 79.0%, while gaps were observed in PPE use, vaccination, and post-exposure management. CONCLUSION Nurses demonstrated moderate compliance with occupational safety practices. However, gaps remain in key safety areas, highlighting the need for continuous training, improved resource availability, and strengthened occupational safety systems.
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Dental Graduates' Satisfaction and Perceived Usefulness of a Newly Introduced Clinical Dentistry Course at Gezira University, Sudan
BACKGROUND Understanding satisfaction levels among dental students can help inform strategies to enhance educational quality and improve both academic and professional outcomes. This study aimed to assess the perceived satisfaction of dental graduates with the Clinical Dentistry course at the University of Gezira. METHODS A cross-sectional study was conducted among 200 dental graduates from the University of Gezira between 2018 and 2025. Data were collected using a validated, self-administered questionnaire. Statistical analysis was performed using SPSS version 26. Descriptive statistics summarized participant characteristics. The Pearson Chi-square test was used to assess associations between participants' characteristics and satisfaction levels, and a Two-Step Cluster Analysis was conducted to identify distinct perception groups. RESULTS Among the participants, 118 (59.0%) reported dissatisfaction. No statistically significant associations were found between any demographic variable and satisfaction levels (all p > 0.05). Cluster analysis identified two distinct graduate profiles: Confident Builders (n = 134, 67.0%) with 59.7% satisfaction, and Uncertain Strugglers (n = 66, 33.0%) with only 3.0% satisfaction — a highly significant difference (p < 0.001). More than half of the participants reported that the course improved their clinical preparedness and problem-solving abilities. However, concerns were raised regarding time allocation, clarity of expectations, and feedback. CONCLUSIONS The Clinical Dentistry course contributed positively to the development of clinical and cognitive skills. However, improvements in course structure, time management, and feedback mechanisms are required.
Burnout and its Psychological Effect among Health Professionals at Selected Military and Police Hospitals in Khartoum State, Sudan
BACKGROUND Burnout is a psychological syndrome resulting from prolonged work-related stress, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. It negatively affects healthcare professionals’ well-being and quality of patient care. This study aimed to assess burnout levels and their psychological effects among health professionals in trauma and emergency departments at selected Military andPolice hospitals in Khartoum State, Sudan. METHODS A descriptive cross-sectional hospital-based study was conducted in 2022 among 130 healthcare professionals (78 nurses and 52 doctors) working in emergency departments at the selected Military and Police hospitals. Participants were selected using a stratified random sampling technique. Burnout was measured using the Maslach Burnout Inventory (MBI), a validated psychometric instrument measuring emotional exhaustion, depersonalization, and personal accomplishment. Data were analyzed using descriptive statistics and chi-square tests. RESULTS Emotional exhaustion was predominantly moderate in most participants (44.6%), while depersonalization and reduced personal accomplishment showed high burnout in 85.4% and 91.5% of participants, respectively. The overall prevalence of high burnout was 88.4%. Specialty was significantly associated with burnout levels (p = 0.017), with nurses reporting higher burnout than doctors, however, other socio-demographic and work-related factors, including work experience, were not significantly associated with burnout. CONCLUSION Nurses and doctors in emergency departments of Military and Police hospitals in Khartoum State, Sudan (2022) exhibited high levels of burnout, particularly in depersonalization and reduced personal accomplishment. Specialty was significantly associated with burnout, underscoring the urgent need for targeted interventions to reduce workload, provide psychological support, and improve healthcare professionals’ well-being.
Burnout · Emotional exhaustion · Depersonalization · Personal accomplishment · Maslach Burnout Inventory
Sudan's Digital Health Transformation: Vision, Reality, and the Road Ahead
Sudan's health system has been in acute crisis since the outbreak of armed conflict in April 2023. Over the past decade, scattered digital health efforts have emerged: one hospital has begun using electronic medical records, one clinic has developed a maternal health app, and several other tools have been built to combat specific diseases. Each digital product operates independently, so there is no data sharing.This limitation has compounded the huge financial losses inflicted by the ongoing conflict, which has cost the Sudanese healthcare sector approximately $700 million. The gap between what was anticipated of digital health (accessible, equitable care) and its actual delivery (inequitable access that costs lives) is widening. Based on four publications from this journal and current global digital health evidence, this commentary argues that Sudan must commit to three priorities to transition its disparate pilots into a coherent national system: develop a comprehensive data governance law; properly train healthcare providers in digital tools; and conduct Sudan-specific research rather than uncritically replicating models developed elsewhere. Patients can no longer remain dependent on disconnected policy documents — they need a system that remembers them when they walk through the door.
Digital health technologies · Sudan · Precision medicine · Electronic health records · Data governance · AI-based digital tools
In the final issue of the third year of the Sudan Journal of Health Sciences, I am pleased, on my own behalf and on behalf of the administration of Al-Fajr College, to extend my sincere thanks, appreciation, and respect to all those who have contributed to the success and continuity of this peer-reviewed scientific Journal, including the esteemed reviewers listed in Table 1. The Journal has become, by the grace of Allah and through dedicated efforts, a reputable platform serving scientific research in Sudan and the region. I would like to express my special appreciation to Professor Hasan Abuaisha, Editor-in-Chief, who has led the Journal with wisdom and professionalism, overseeing every detail with a high sense of responsibility, sincerity, and selflessness. His tireless dedication and commitment have been instrumental in ensuring that each issue is published to a standard befitting the Journal’s academic standing.
Growing Up in Crisis: How Sudan’s Conflict is driving Streetism and Homelessness among Children
Street, homeless, street connected, of the street, street involved, street working, from street families, or in street situation, etc..all are terms applied in a way or another to children who are dependently connected to streets, whether for permanent or temporal living; all share the fact of staying for long durations away from families and un-supervised by responsible careers. (1) These phenomena can be described as streetism, which will be referred to frequently in this paper. Streetism refers to a situation where children are strongly and frequently linked with streets for living and/or working without access to basic needs, including education and parental supervision. It commonly indicates a weak family bond (some live on the street and go back to their families at night), inadequate child protection mechanisms, caused by several unequal socioeconomic predictors, including poverty, family breakdown, displacement, weak holistic national social protection systems, etc. (2,3)
Awareness and Utilization of Online Medical Resources Awareness and Utilization of Online Medical Resources among Medical Practitioners at Port Sudan Teaching Hospital, Sudan, 2025
Background: Online medical resources (OMRs) constitute a critical component of global clinical decision-making. However, their utilization and awareness in low-resource settings have not been adequately studied. Methods: This descriptive cross-sectional study was conducted in July 2025 among 174 healthcare professionals at Port Sudan Teaching Hospital. A structured questionnaire was used for data collection. Descriptive statistics summarized awareness and utilization patterns. Associations were tested using Chi-square, and logistic regression calculated predictors of awareness with odds ratios (OR) and 95% confidence intervals (CI) Results: Overall awareness was high (90%), with Medscape (70%) and UpToDate (40%) being the most recognized tools. Free sources like PubMed (30%) and Google Scholar (20%) were most frequently used. The frequency of use was distributed as follows: 19% daily, 35% weekly, 17% monthly, 19% seldom, and 10% never. Poor internet connection (55%), no training (78%), and subscription fees (22%) were the obstacles. Logistic regression showed that awareness was significantly associated with professional role (OR = 2.1, 95% CI: 1.3-3.5) and department (OR= 1.8, 95% CI: 1.1-3.0). Conclusion: Awareness of online resources among practitioners was high, with junior doctors demonstrating greater usage. However, the actual utilization was moderate. Systemic barriers including limited connectivity and inadequate training, were major impediments. Strengthening Institutional support and capacity-building initiatives could enhance the integration of OMRs into routine clinical practice. Keywords: online resources, awareness, utilization, medical practitioners, Sudan
Quality of Life among Amputees with Diabetes Mellitus Attending Two Tertiary Healthcare Centres in Khartoum, Sudan
Background: Diabetes Mellitus is a leading global cause of morbidity and mortality. Diabetic Foot Ulcers, a severe complication of diabetes, often lead to Lower Extremity Amputation, significantly reducing patients’ Quality of Life (QoL). This study assessed the QoL of Sudanese diabetic amputees and diabetic non-amputees using the validated Short-Form-36 questionnaire. Methods: A cross-sectional hospital-based study was conducted between April and August 2019, involving 200 amputees and 200 non-amputees from Ribat University Hospital and Jabir Abu-Ezz Diabetic Centre in Khartoum. Physical and mental health components were analysed alongside demographic and clinical characteristics to determine their impact on QoL between the two study groups. Results: Amputees had significantly lower QoL scores than non-amputees, with physical health scores of 64.6±15.3 vs. 81.6±10.3 and mental health scores of 56.3±19.4 vs. 86.2±12.4, respectively. Males had better QoL than females, and below-knee amputees fared better than above-knee amputees. Overall Conclusion: Diabetic amputees experience a significant decline in QoL, necessitating a multidisciplinary care approach addressing both physical and psychological needs. Specialised rehabilitation centres, including diabetes specialists, educators and dietitians, are needed to manage the physical as well as the psychological sequelae of diabetic amputations. Keywords: Diabetes mellitus, Diabetic foot ulcers, Amputation, Quality of life, Sudan
Differentiating Benign and Malignant Prostatic Lesions using Mucin and DNA Histochemical Staining, Samples from Omdurman Teaching Hospital, Sudan
Background: Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are the most common prostatic diseases in elderly men. Cost-effective methods are required to accurately differentiate benign hyperplasia from prostatic adenocarcinoma. Methods: This is an analytical, cross-sectional study conducted on 109 archival paraffin-embedded prostate tissue samples obtained from Omdurman Teaching Hospital. Data collected included histopathological diagnosis, lesion type, patient age, and Gleason score for malignant cases. Three sections were prepared from each sample and stained using Periodic Acid–Schiff, Alcian blue (pH 2.5), and Feulgen reaction to assess mucin types and DNA intensity. The diagnostic value of these histochemical stains in differentiating benign and malignant prostatic lesions and their association with Gleason grading were evaluated. Results: All 53 BPH cases showed positive staining for neutral mucins with complete absence of acidic mucins. In contrast, PCa samples demonstrated acidic mucin positivity in 22 cases (39.21%), neutral mucin positivity in 2 cases (3.5%), positivity for both mucin types in 17 cases (30.35%), and negativity for all mucins in 15 cases (26.78%). Statistically significant differences were observed between benign and malignant groups regarding mucin type and DNA staining intensity (p < 0.001). Additionally, Gleason score showed a significant association with both mucin type and DNA intensity in malignant cases (p < 0.001). Conclusion: Mucin histochemical stain can be used as a useful biomarker in differentiating BPH from PCa. The intensity of DNA expression using Feulgen reaction may provide valuable prognostic information in prostate cancer. Keywords: Prostate Adenocarcinoma, Benign Prostatic Hyperplasia, Mucin, DNA, Gleason score.
Students’ Satisfaction with Electronic Versus Traditional Paper-Based Examinations, AlNeelain University, Sudan
Background: The rapid integration of technology in higher education has led to increased use of electronic examinations as an assessment tool. This study aimed to compare students’ satisfaction with electronic and traditional paper-based examinations at AlNeelain University and to identify factors influencing their preferences. Methods: A descriptive cross-sectional study was conducted among 378 students from six faculties at AlNeelain University: Nursing, Physiotherapy, Insurance, Law, Engineering, and Statistics. Data were collected using a researcher-developed questionnaire and analyzed using the Statistical Package for the Social Sciences (SPSS) version 16. Results were presented in tables and figures. Results: The majority of participants (97.3%) were aged 22–25 years. Electronic examinations were reported as more stressful by 59.3% of students, while 60% perceived paper-based examinations as more difficult. High satisfaction with electronic examinations as a true reflection of academic performance was reported by 44% of students, whereas 43.1% were satisfied with the time allocated for electronic examinations. Additionally, 59.1% felt that examination formats were not well aligned with their academic specialties, and 48.9% expressed dissatisfaction with the influence of socioeconomic factors on electronic examination experiences. No significant association was found between academic specialty and examination preference (paper pen or electronic) (p = 0.800). Conclusion: Students showed mixed satisfaction with electronic and paper-based examinations. Enhancing electronic examination systems through appropriate support and training may improve students’ confidence and overall satisfaction. Keywords: Students’ satisfaction, electronic examination, paper-based examination.
Correlation of Academic Performance with Motivation, Learning Strategies and Resources Management Scales among a Batch of Pharmacy Students, National Ribat University, Khartoum, Sudan
Background: Motivation, including intrinsic and extrinsic motivations together with self – efficacy, is an important issue that affects college students’ effort towards excellence and is worth studying. Such studies may offer guidance for coaching under-performing students. However, few studies world-wide are reported concerning the effect of motivation on students’ academic performance. In Sudan, according to the literature survey, no such studies are reported. In this study the academic performance of a batch of pharmacy students in relation to motivation, learning strategies and resources management was assessed. Methods: This was a cross- sectional, institution facility based study targeted 91 pharmacy students by the end of biochemistry course in semester 5, academic year 2022-2023. Self-administered questionnaire of the 81-item ‘Motivated Strategies for Learning’ was used to collect data. Data were then tabulated and analyzed using Microsoft Excel version 16.0. Results: Sixty eight completed questionnaire forms were received There was significant correlations of self-efficacy for learning (r=0.3045, p= 0.02) and metacognitive self-regulation (r=0.2289, p= 0.05) with academic performance in the biochemistry course. Weak non-significant correlations were obtained with all the rest of items of motivation (r= -0.1878 to -0.1878), learning strategies (r= -0.0109 to 0.0764 ) and resources management (r= -0.1286 to 0.1103 ). Conclusion: According to students’ scores on the components of the questionnaire, some of them showed positive attitude towards learning, however, this attitude did not reflect on their academic outcome. We recommend continuous college students education and evaluation by tutors and social workers on the issues of motivation, learning strategies and resources management.
Chronic Multi-Orifice Myiasis: A Case Report in a Displaced Pediatric Patient
Introduction: Myiasis is the infestation of live human or animal tissues by dipterous larvae. Nasopharyngeal and multi-orifice infestations are rare, particularly in children. Case Presentation: We report the case of a 12-year-old male from Sudan, displaced to Port Sudan, who presented with a two-year history of flies emerging from his nose, mouth and ears. The infestation began after a fly entered his ear and was incompletely extracted. Later, he developed recurrent expulsion of both dead and live flies. The condition was socially stigmatizing and psychologically distressing. The Laboratory identification confirmed Musca domestica (common housefly) as the causative agent. Management and Outcome: The patient was treated with Ivermectin, Albendazole, and Clarithromycin with planned follow-up. The importance of hygiene, social support, and comprehensive management was emphasized. Conclusion: This case highlights an uncommon chronic presentation of myiasis in a vulnerable pediatric population and underscores the importance of early intervention and public health measures in displaced communities.
Prevalence of Depression and Anxiety among Gezira State Internally Displaced Persons residing in Kassala City, Sudan, 2024
Background: Sudan’s last war recorded the highest wave of Internally Displaced Persons (IDPs) in the world. Gezira State had a large share of IDPs in Kassala city, Eastern Sudan. Studying IDP's health condition, especially mental status, is not less important than food and shelters. Therefore, this study aimed to estimate the prevalence of anxiety and depression among IDPs and their association with socio-demographic variables. Methods: A cross-sectional study was conducted between June and July 2024 among Gezira State IDPs residing in Kassala, who were selected from 191 shelters using a cluster-simple random sampling technique. The prevalence of anxiety and depression was measured using the Hopkins Symptom Checklist (HSCL-25), a validated questionnaire (translated to Arabic) at a cut-off of mean ≥1.75 to consider significant elevation. The association between demographic variables (chi-square test of independence) and the questionnaire items was identified. Variables with a P-value less than 0.05 were considered statistically significant at a 95% confidence interval. Results: A total of 386 participants (101% response rate) were interviewed with trained, graduated medical students. The estimated prevalence of anxiety and depression was 239 (61.9%) and 271 (70.2%), respectively. The association between demographic variables and anxiety was found to be significant in gender, level of education, marital status, employment status, and current financial status. While depression was found significantly associated only with gender. Conclusion: This study found a high prevalence rate of anxiety and depression among IDPs in Kassala, Eastern Sudan. The socio-demographic variables found in association with high prevalence of anxiety were gender (higher in females), level of education (higher in universities level), marital status (higher in married), work status (higher in students), financial (higher in low income); while depression was found significantly associated only with female gender. Implementing any health interventions should include mental health services as priorities in IDP shelters.
An E-Learning Avalanche in Sudanese Medical Education from Emergency Response to Enduring Transformation
FULL TEXT “Those of us who will remember 'e-learning' as a concept, will be similar to those who, referring back to Archimedes’ drawings in the sand, still remember slide projectors, tape-slide or the laser disk: everything changes, everything remains the same.” AMEE guide 32.(1) E-learning, defined as the strategic application of technology to enhance and broaden educational practices, has become a fundamental component of contemporary medical education. In Sudan, its importance has increased significantly in response to various national crises, including the COVID-19 pandemic, the December 2019 revolution, and the 2023 ongoing war. Each of these events has disrupted traditional educational systems and highlighted the necessity for resilient, technology-driven solutions in a country with a rich legacy in medical education, which dates back to 1924 with the establishment of Kitchener Medical College. (2) Today, Sudan is home to 103 medical faculties, comprising 33 public and 70 private institutions. (3) A recent article in SJHS (4) examined the e-learning experiences of educators within undergraduate medical programs. The study indicated that while many educators acknowledged the advantages of e-learning, particularly its flexibility and accessibility, they also faced significant challenges. These challenges included unreliable internet connectivity, limited learner engagement, technical difficulties, and a lack of digital literacy among staff members. Nevertheless, despite these obstacles, the general sentiment among educators remains cautiously optimistic about the potential of e-learning. This article delves into various aspects related to these findings. Necessities and usage of e-learning by e-learner, e-educator and e-systems: E-learning encompasses e-teaching, e-portfolio, and e-assessment, aided by virtual learning environments and learning management systems, with a focus on content delivery and the learning process. The e-learning is considered an avalanche; the term “avalanche” was aptly utilized by Michael Barber and colleagues in their 2013 publication, “An Avalanche is coming: Higher education and the revolution ahead.” (5) In this document, they emphasized the significant statement made by David Puttnam at the Massachusetts Institute of Technology in June 2012. ‘‘It’s tragic because, by my reading, should we fail to radically change our approach to education, the same cohort we’re attempting to “protect” could find that their entire future is scuttled by our timidity”. In low-income regions, e-learning democratizes education by connecting remote learners with expert educators and global resources. It reduces disruptions, promotes flexibility, enhances education quality, fosters inclusivity, and supports Sustainable Development Goal 4. (6) Challenges of E-Learning: E-learning in Sudan is fraught with multifaceted challenges, which span four critical domains. (A) Technology-dependent barriers include fragile infrastructure, intermittent electricity, limited internet access, and reliance on low-bandwidth platforms. Amid the ongoing war, connectivity has worsened, with many relying on satellite services like Starlink, which are logistically challenging and pose security risks. The financial burden is significant, with monthly costs often exceeding one-third of a middle-class salary, making digital education inaccessible for many. (B) Human-dependent, where limited digital literacy among educators and learners complicates the transition to online platforms and diminishes essential elements like mentorship and collaboration. (C) Curriculum-dependent issues, particularly those related to assessment integrity and feedback mechanisms. E-assessment, both formative and summative, presents substantial difficulties in ensuring validity, reliability, and fairness, especially in unstable environments. (D) Youth-dependent challenges have emerged as a critical and often overlooked domain. The pervasive use of social media platforms such as TikTok, Facebook, and WhatsApp has introduced significant "phubbing", digital distractions, diverting learners’ attention from academic tasks and impairing performance. Studies have shown that learners frequently engage in off-task behaviours during online learning, with up to 60% of laptop users spending 40% of class time on non-academic activities. (7) Moreover, it may be linked to anxiety and depression. (8) In Sudan, the excitement surrounding unfolding war events is heightened by a constant craving for news updates. The analysis conducted by M. B. M. Ahmed et al. (9) Highlights the resilience and satisfaction of Sudanese learners but also reveals significant levels of depression, anxiety, and stress that need attention. Bhat et al. highlight the importance of thoughtfully integrating digital learning tools while prioritizing in-person, experiential learning to equip students with essential skills for patient care and professional development (10). Unlocking the potential of e-learning: strategic insights from Sudan: Due to ongoing conflict, economic instability, and health emergencies, e-learning is evolving from a temporary fix to a necessary strategic transformation. Sudan's educational landscape presents unique opportunities for scalable and sustainable digital education focused on resilience, equity, and innovation. Sudan has several potentialities for enhancing digital education: (A) Sociocultural capital: The collectivist ethos and strong diaspora engagement promote collaborative online learning, with digitally savvy youth driving peer-led initiatives. (B) Mobile-first outreach leverages high mobile phone usage for cost-effective content delivery, enhanced by digital learning infrastructure from the COVID-19 pandemic. In early 2025, there were 21.6 million active mobile connections in Sudan, representing 42.4 percent of the population.(11) (C) Curricular flexibility: The diverse medical curricula in Sudan are suited to blended learning approaches. (D) Commitment to professional development: Sudanese educators’ dedication to digital pedagogy and culturally responsive teaching can improve e-learning outcomes. (E) Research-driven innovation: Emerging research highlights implementation gaps, leading to context-sensitive solutions for better digital education quality. (F) Lifelong learning: Digital platforms support ongoing professional development, aligning with the WFME trilogy criteria (12) and the global health workforce development goals. Strategic pillars for implementation: Drawing from global best practices and regional insights, we propose six foundational pillars for an effective e-learning strategy in Sudan: (A) Governance: Develop national policies, ethical frameworks, and quality standards to guide digital education. (B) Stakeholders’ partnership: Form partnerships with telecom companies, local institutions, global networks, and diaspora experts to ensure sustainability and secure funding. Promote collaboration for resource sharing, faculty exchange, and joint virtual and mixed reality simulation. (C) Technology infrastructure: Invest in reliable, accessible, and equitable digital tools, including mobile-first platforms and offline content delivery. (D) Curriculum mapping should align competencies, milestones, and Entrustable Professional Activities (EPAs) (13) With blended delivery formats, differentiating online and experiential components. The Vallée et al. systematic review (14) highlights that blended learning outperforms traditional methods in health education, improving knowledge retention and learner satisfaction. (E) Capacity building: Implement competency-based training for educators and learners, emphasizing digital literacy, mental resilience, and culturally relevant pedagogy. (F) Research and Informatics: Establish continuous evaluation mechanisms using learning analytics, AI-driven feedback systems, and adaptive learning technologies. (Figure 1) Conclusion: A blueprint for resilient medical education: E-learning in Sudan is no longer a stopgap; it is a cornerstone of educational resilience. The convergence of crisis and innovation presents a unique opportunity to transform medical education into a more equitable, modern, and sustainable blended system. Strategic investment in infrastructure, educator development, and learner-centred models will be essential. Mobile technology and affordable data plans offer promising avenues to reach underserved populations, reduce costs, and expand access in partnership with tele companies. By embracing these opportunities and addressing barriers through inclusive policies and evidence-based planning, Sudan can pioneer a resilient a blended e-learning framework that not only withstands disruption but thrives in its wake, serving as a model for other low-income, crisis-affected nations. References: 1. Ellaway RH, Masters K. AMEE Guide 32: e-Learning in medical education Part 1: Learning, teaching and assessment. Med Teach. 2008;30(5):455-473. doi:10.1080/01421590802108331pubmed.ncbi.nlm.nih+1 2. Public Relations Office of the Civil Secretary’s Department, editor. Sudan Almanac 1949. Khartoum: Sudan Government and McCorquodale & Co; 1949.data.uib 3. Ministry of Higher Education and Scientific Research (Sudan). Vision and mission. Khartoum: Sudan Ministry of Higher Education and Scientific Research; 2025. Available from: http://www.mohe.gov.sdcmi+1 4. Mohamed M, et al. E-Learning Experiences and Challenges among Faculty Members in Alfajr College’s Undergraduate Medical Program, Sudan. Sudan J Health Sci. 2025;3(1):31-34.sjhs.fajr 5. Barber M, Donnelly K, Rizvi S. An Avalanche is Coming: Higher Education and the Revolution Ahead. London: IPPR; 2013. Available from: http://www.pearson.com/avalanchescribd+1 6. United Nations Educational, Scientific and Cultural Organization (UNESCO). Digital Learning and Transformation of Education. Paris: UNESCO; 2025. Available from: https://www.unesco.org/en/digital-educationunesco+2 7. Flanigan AE, Titsworth S. The impact of digital distraction on lecture note taking and student learning. Instructional Science. 2020;48(5):495-524. doi:10.1007/s11251-020-09516-6scholar.google+2 8. Koessmeier C, et al. Analysis of the distractions in youth due to social media and the effects on their concentration abilities. JMIR Ment Health. 2021;8(12):e30207. doi:10.2196/30207pmc.ncbi.nlm.nih 9. Ahmed , et al. Sudanese Medical Students’ Satisfaction with Online Learning and Its Association with Their Psychological Distress. Sudan J Health Sci. 2023;2(2):40-51.sjhs.fajr 10. Bhat R, Mohammed OEAH, Srinivasamurthy SK, Saherawala BA. Reviving Observation-Based Learning for Zoomers in Medical Education: Looking Beyond Sight and Connecting Dots. AMEP [Internet]. 2025 Aug 15;16:1411–9. Available from: https://www.dovepress.com/reviving-observation-based-learning-for-zoomers-in-medical-education-l-peer-reviewed-fulltext-article-AMEP 11. DataReportal. Digital 2025: Global Digital Insights. 2025. Available from: https://datareportal.com/digital-2025unesco 12. World Federation for Medical Education (WFME). WFME Global Standards for Quality Improvement in Medical Education. Copenhagen: WFME; 2020.scholar.google 13. ten Cate O. A primer on Entrustable Professional Activities. Perspect Med Educ. 2013;2(1):40-5. doi:10.1007/s40037-013-0036-7 14. Vallée A, Blacher J, Cariou A, Sorbets E. Blended learning compared to traditional learning in medical education: Systematic review and meta-analysis. J Med Internet Res. 2020;22(8):e16504. doi:10.2196/16504
Interpersonal and Institutional Challenges to Advocacy in Nursing Practice in Khartoum State, Sudan
Background: Nurses play a pivotal role in advocating for their patients and have a substantial impact on healthcare policies at local, regional, and national levels. Their advocacy efforts influence not only the overall health of the population but also the advancement of the nursing profession. Despite this, nurses face significant barriers in fulfilling their advocacy roles. This study aims to identify the interpersonal and institutional challenges faced by nurses in patient advocacy across three nursing disciplines in Sudan: clinical practice, community health, and nursing education. Methods: This is a descriptive cross-sectional design. Data were gathered from 148 nurses working in clinical practice, community health, nursing, and education using structured Likert-scale questionnaire. The data were analysed using frequency distribution, arithmetic mean, weighted arithmetic mean, standard deviation, and a one-sample t-test. Results: The study identified multiple interpersonal and institutional challenges affecting nurses’ advocacy efforts across clinical, educational, and community health settings. These challenges included limited organizational support, imbalance of force with physicians, lack of nurses’ knowledge and competency to decide, as well as not having enough nurses to meet the growing healthcare needs of patients. The nurses’ responses to these aspects were mostly “agree” and “strongly agree”. This makes it harder for nurses to effectively advocate for their patients. Conclusion: Ethical and social factors emerged as critical influences on nurses’ advocacy efforts. Common strategies employed by these healthcare professionals included prioritizing patient safety and educating clients about their rights.
Copyright (c) 2025 Sudan Journal of Health Sciences
The Artificial Intelligence Revolution and Healthcare: Challenges and Opportunities
Editorial - Full Text The end of 2022 and the beginning of 2023 witnessed one of the most important developments of the modern era, represented by OpenAI's launch of its ChatGPT model. Many companies followed suit, launching numerous Large Language Models (LLMs), commonly referred to as Artificial Intelligence. While the world was preoccupied with these amazing developments, we in Sudan were preoccupied with an unfortunate war that erupted during the same period. Hopefully, the war is nearing its end, and this is a good opportunity to return to and discuss Artificial Intelligence. Despite the recent popularity of the term, Artificial Intelligence began with the creation of computers in the middle of the last century. At that time, scientist Alan Turing posed his famous question: Can a machine think? (1) The term was first used in 1956 at the Dartmouth Conference. Artificial Intelligence (AI) can be defined as advanced computer systems capable of simulating human mental abilities, such as thinking, problem-solving, and decision-making. (2) One of the defining moments in human history was the computer IBM’s Deep Blue's victory over the world chess champion in 1997, and the same thing happened again in 2016 when Google’s AlphaGo defeated the world champion in the game of Go. This demonstrates the great capabilities these machines possess, prompting talk of super-intelligence that could control humanity in the future, as science fiction writers have long envisioned. (3) The field of medicine and health, like many others, has benefited from AI in countless applications. Three examples of its applications can be cited: disease diagnosis, treatment, and medical data management. AI has contributed significantly to the diagnosis of many diseases with an accuracy that matches or exceeds human capabilities. Examples include its use in radiological diagnosis of lung diseases in X-rays, and breast cancer in mammograms, as well as diabetic retinopathy with retina images. Tests are also conducted in the process of genetic analysis, predicting future diseases, and developing personalized medicine. (4) In treatment, AI has accelerated the development and testing of many drugs, especially during the COVID-19 era. Surgical robots like Da Vinci Surgical System are examples that use AI, demonstrating high capabilities in complex surgical operations. (5) In medical data management, AI has contributed significantly to rapidly analyzing massive medical data and promptly producing results and predictions that were previously very difficult to achieve. This has helped develop tools to aid timely decision-making. Furthermore, electronic medical records have evolved significantly with the help of AI, partnering with healthcare providers at various stages of patient diagnosis and treatment. (6) Despite its promising uses in the medical field, AI is not without risks and drawbacks. For example, over-reliance on machines can lead to medical errors for which the machine cannot be held accountable. Furthermore, incomplete data in medical records can lead to biased or inaccurate results. Among the biggest challenges are the privacy and confidentiality of patient data, as well as the ethical issues related to AI. (7) Concerning this matter, AI offers significant benefits in medical education. Future doctors are fortunate to have these tools, which have saved them hours of searching. Professors have also benefited from customizing educational content, automated test-scoring, and academic analysis to predict student performance. Nevertheless, many caveats remain, including the lack of reliability of the information provided to students and a lack of reliance on the important human element in education. (8) Not far from medicine and healthcare, a revolution has taken place in the field of scientific research and publishing with the use of AI tools. However, many challenges have emerged, which we, particularly at the Journal, have faced in setting the necessary guidelines for dealing with scientific research. These developments are too numerous to list in words. The Sudan war inflicted many tragedies, destruction, and devastation of infrastructure, yet there is still an opportunity to catch up with the World in AI. Here, we acknowledge the role of the numerous national institutions that worked during the war to provide healthcare with impartiality and dedication. Sudan, like other developing countries, needs to adopt AI more widely. This begins with its inclusion in university curricula, in addition to increasing support for the acquisition of AI-based devices and technologies. Most importantly, the enactment of laws and regulations that facilitate and regulate the use of AI. References: Lawrence Livermore National Laboratory. The birth of artificial intelligence [Internet]. st.llnl.gov; [cited 2025 Apr 27]. Available from: https://st.llnl.gov/news/look-back/birth-artificial-intelligence-ai-research#:~:text=In%201950%2C%20English%20mathematician%20and,machine%20is%20capable%20of%20thinking IBM. What is AI? [Internet]. IBM.com; [cited 2025 Apr 27]. Available from: https://www.ibm.com/think/topics/artificial-intelligence#:~:text=Artificial%20intelligence%20(AI)%20is%20technology,and%20respond%20to%20human%20languageE Berman M. Deep Blue beats Kasparov in chess [Internet]. EBSCO Research Starters; 1996 Feb 10 [cited 2025 Apr 27]. Available from: https://www.ebsco.com/research-starters/sports-and-leisure/deep-blue-beats-kasparov-chess#:~:text=In%201997%2C%20Deep%20Blue%2C%20an,significant%20milestone%20in%20artificial%20intelligence Hosny A, Parmar C, Quackenbush J, Schwartz LH, Aerts HJWL. Artificial intelligence in radiology. Nat Rev Cancer. 2018 Jun;18(8):500-510. doi: 10.1038/s41568-018-0016-5. Available from: https://www.nature.com/articles/s41568-018-0016-5 Hatherley J, Bjerring JC, Munch LA, Kinderlerer A, Threlfall L. Clinical applications of artificial intelligence in robotic surgery. J Robot Surg. 2024 [cited 2025 May 12]. Available from: https://link.springer.com/article/10.1007/s11701-024-01867-0 Arora A, Lawton T, editors. Artificial intelligence in healthcare: transforming the practice of medicine. Future Healthc J. 2024 https://doi.org/10.7861/fhj.2021-0095 Lekadir K, Galimzianova A, Betriu A, et al. FUTURE-AI: International consensus guideline for trustworthy and ethical artificial intelligence in healthcare. BMJ. 2025 Feb 5;388:bmj-2024-081554. https://doi.org/10.1136/bmj-2024-081554 Mansourzadeh A, Rasouli S. The Future of Medical Education: A Review of the Opportunities and Challenges of Artificial Intelligence Integration. Med Edu Bull. 2024 Dec;5(2):973-82. Available from: https://www.medicaleducation-bulletin.ir/article_210557.html
Sudan's War: Health System Resilience and Lessons Learned - The Minister of Health Perspective
Sudan, a vast country amid Africa, has been afflicted for more than two years by an ongoing war as a result of the rebellion by the Rapid Support Forces (RSF) initially against the Sudanese Armed Forces (SAF) then the Sudanese nation, unarmed civilian, in Khartoum and rapidly escalating to a nationwide catastrophe. The war has severely disrupted the government's functions, including the fragile Health System, altering the epidemiological pattern, worsening the double burden of diseases, and escalating epidemics and outbreaks. During the very early days of the war, the RSF militia had either occupied, looted or destroyed the top hospitals, the National Public Health Laboratory, the Central Blood Bank, and the National Medical Supply Fund Warehouses, limiting access to essential medical services. Federal Ministry of Health (FMOH), being responsible for policy development, strategic planning, and financial and technical support to the States, took its immediate response to the catastrophe and set the top priorities for action. A blended modality for managing the work was established with the strengthening of the Emergency Operating Centre, resulting in a perceptible health system resilience. Despite the devastating damage, the country is still standing and even starting to move on. The high resilience of the country’s government, augmented by community solidarity and the support of partners, has a big role in preventing the health system from collapsing. Many Lessons learned, we could share with public health ministers currently grappling with war, or those who may face similar situations. Declaration: This article represents the views and opinions of the author alone and does not necessarily reflect the official position or policies of the Sudan Journal of Health Sciences (SJHS) or any affiliated institutions.
Copyright (c) 2025 Health-System-Resilience-Sudan-War
Radiological Measurement of Urethral Length in Sudanese Adult Males Using Retrograde Urethrogram: A Retrospective Study at DOAMDI Center, Khartoum (2021-2022)
Background: Accurate measurement of urethral length is vital for understanding various urological conditions and guiding clinical practices. This study aims to establish baseline data on urethral length within a Sudanese population and to identify potential influencing factors, addressing a gap in the existing literature. Methods: A retrospective analysis was performed on 266 radiological images obtained from patients at a medical facility in Sudan. Data collection included demographic information, such as marital status and anthropometric measurements, although challenges were encountered in obtaining complete patient contact information. Urethral lengths were measured using standardized radiological techniques by trained radiologists to ensure consistency and minimize measurement variability. Results: The analysis revealed that the total average urethral length was 22.1 cm (SD 1.7), with the anterior urethra measuring an average of 16.4 cm and the posterior urethra of 5.4 cm. However, the absence of prior studies in the region limited the ability to compare these findings with existing literature. Variability in measurements was noted, attributed to differences in the techniques used by various radiologists. Conclusion: The results highlight measurable anatomical variation compared to international data, reinforcing the importance of developing population-specific references. Establishing such normative values is essential to minimize iatrogenic injury and to guide the design of urological instruments. However, the study is limited by its single-center design, retrospective nature, and the exclusion of abnormal patients. Further multicenter studies are recommended to validate and expand on these results. Ethical constraints encountered during data collection emphasize the importance of developing strategies for more robust methodologies in urological studies.
Quality of Life Assessment Among Type-2 Diabetic Patients Attending Health Care Centers, Wad Medani, Sudan
Background: Diabetes is a chronic non-communicable disease marked by high blood glucose levels, which, if not managed, could lead to poor quality of life (QoL). Evaluating QoL is essential for effective healthcare interventions. This study aimed to assess the QoL among Type-2 diabetic patients. Methods: A cross-sectional study was conducted in healthcare centers in Wad-Medani, Gezira State, Sudan. The study employed 384 Type-2 diabetic patients who completed a structured Audit of Diabetes- Dependent Quality of Life questionnaire. Results: Sociodemographic data indicated that 43.2% of participants were over 65 years old, 93.8% were married, and 38.5% had only a primary school education. Additionally, 63.8% reported a low-income level. The duration of diabetes varied, with 35.2% having diabetes for 10 to 20 years, and 36.55% reported reasonably well-managed diabetic markers. All participants reported "poor QoL": 8.33% rated as "bad", 60.94% as "very bad", and 30.73% as “extremely bad”. Furthermore, no participant reported proper or perfect QoL. Conclusion: The findings revealed that Type-2 diabetic patients exhibited low QoL scores across all domains. It is recommended that healthcare providers prioritize interventions to improve QoL for Type-2 diabetic patients, incorporating holistic approaches that address psychological, social, and lifestyle factors alongside medical management.
Copyright (c) 2025 Quality-of-Life-Diabetes
E-learning Experiences and Challenges among Faculty Members in Alfajr College’s Undergraduate Medical Program, Sudan
Background: E-learning is a learning experience using various electronic devices and software programs. This study documents the E-learning experience and provides insight into acceptance and barriers. Methods: This is a cross-sectional descriptive study at Alfajr College, Medicine Program, Sudan. The study adopted a questionnaire to interview the teaching staff, aided by a simple interview guide to collect data on the E-learning methods and approach. The college used both synchronized and asynchronized E-learning, using a Learning Management System (LMS). This was supported by user-friendly applications like WhatsApp and Telegram to be used by students. The college developed its own electronic application for assessments and electronic team-based learning that is LMS-augmented. Results: A total of 84 faculty members were interviewed. E-learning was thought to be a flexible educational modality by 73% of the participants, and reasonably convenient to educators to use at their own speed (51% agreed, 20% disagreed, and 29% were uncertain). Barriers to efficiently using E-learning technology were: insufficient/unstable Internet connectivity (94%), decreased students’ interactivity in the online course (87%), technical problems (86%), difficulties in receiving student feedback in the online course (66%), frequent interruptions by family environment at home (58%) and insufficient technology know-how by the faculty staff (41%). Conclusion: Overall, faculty members accepted the technology well. Challenges reported included improving technology systems, more training for faculty staff, and improving student interactions and feedback.
Determinants of Homeless Children in Khartoum City, Sudan
Background: The issue of homeless street children in Sudan is a growing crisis that remains unresolved. This study assesses the situation of homeless children in Khartoum City during 2018, focusing on the determinants of the affected children, and their health consequences. This study aims to spotlight this vulnerable group, assess their conditions, and provide recommendations to mitigate the problem. Methods: This is a descriptive, cross-sectional study that included 156 homeless children aged 6–18 years, based on the United Nations definition of homelessness, which encompasses absolute homelessness (those without physical shelter) and relative homelessness (those with inadequate shelter that fails basic health and safety standards). Data was collected through interviews using an assessment sheet that covered demographics, health access, and Body Mass Index. Results: Economic reasons emerged as the primary cause of homelessness (70%), followed by external factors like war, family issues, and city attraction. Demographically, 70% of the children were male, with a mean age of 12 years, mostly originating from Kordofan, Al-Jazeera, and Khartoum States. While 57% had a basic education, 29% were illiterate. Although most children lived with their families, 6% lived alone. They engaged in informal jobs such as car washing, street vending, and other freelance activities. The health assessment revealed that 75% of these children were underweight. Most had access to healthcare, when necessary, though some reported being denied help. Conclusion: Homelessness among children in Sudan is largely driven by financial hardship, forcing many into child labor. These children face significant educational and health challenges, reflecting the need for urgent interventions to address this crisis.
Original Article Medical Students’ Perception and Satisfaction towards Team-Based Learning at Alfajr College for Science and Technology, Sudan, 2022
Background: Team-based learning (TBL) is an active learning strategy that provides learners with opportunities to apply conceptual information through a series of activities that include individual work, group work and instant feedback. It is defined as an evidence based cooperative learning educational strategy designed around modules that are taught in three stages; learners preparation; individual and group readiness assessment test; and finally, team application. Aim: The study aimed to assess the perception and satisfaction of medical students towards TBL at Alfajr Collage for Science and Technology. Methodology: The study was a cross-sectional study, conducted at Alfajr College for Science and Technology in the year 2022. The targeted group was students from the fourth and fifth levels; the data was collected through a self-administered online interview using a pretested structured questionnaire. The data were entered, cleaned, and analyzed using SPSS version 25. The chi-square test was used for categorical variables. Results: Of 131 interviewed medical students, females were the majority constituting 61%. More than half (53%) of the students found that their performance on the examination is affected positively by their participation in TBL; and the fifth-year students stated that they benefited much from TBL specifically in the surgery course. Nearly 90% of students were satisfied with the TBL approach and they felt that they would recommend the TBL program to other universities in Sudan. There was a significant correlation between the female gender and the perception of the usefulness of TBL (p value = 0.009). Conclusion: Medical students at Alfajr College had positive perception towards TBL and the majority of students were satisfied with the TBL approach. The number of TBL activities during the course was crucial to reinforce the students' benefit from this type of activity. This was reflected in the students' opinion of the benefits of TBL in the surgery course, which happened to have the largest number of activities compared to other courses.