Abdelmagid Nada, Abdalla Omama, Yagoub Abdallah, Taha Abeer, Hyder Altayeb, Yahia Awatif, Hassan Bashar, Ali Marwa, Abdeen Mohammed, Adam Mustafa, Kamal Nadeen, Ezeideen Nader, Altib Osama, MohamedSalih Rahma, Alnour Salma, Koko Sana, Abdelatif Shama, Yahia Waleed, Abdelhade Yousif, Palmer Jennifer, Lokot Michelle, Roberts Bayard
Department of Health Services Research and Policy, Faculty of Public Health and Policy, The London School of Hygiene & Tropical Medicine, London, United Kingdom.
Health in Humanitarian Crises Centre, The London School of Hygiene & Tropical Medicine, London, United Kingdom.
PLOS Glob Public Health. 2025 Jun 20;5(6):e0004814. doi: 10.1371/journal.pgph.0004814. eCollection 2025.
The frequency and severity of disease outbreaks disproportionately impacts settings affected by conflict or with weak health systems. Sudan, facing frequent and recurrent epidemics, struggles with limited resources. Understanding local perceptions of epidemic-prone diseases is vital for designing effective epidemic responses. This study describes the salience and perceptions of epidemic-prone diseases in two urban Sudanese communities. We conducted a cross-sectional qualitative study using freelisting in two communities in Khartoum State: Om Doum in Sharg al Neel locality and a neighbourhood in the Sixth Quarter of Ombadda locality. We purposively selected and interviewed consenting adults and recorded their responses to seven freelisting prompts. We analysed the data using Smith's salience index in Excel to evaluate the frequency and importance of terms, and used a relative salience index to compare terms between lists and sites. We interviewed 32 people in Om Doum and 30 in Ombadda. Epidemic-prone diseases, especially malaria, nose, sinus and throat infections (NSTIs), typhoid and COVID-19, were highly salient as common illnesses, recent outbreaks, and future infections and threats. Cancer and chronic diseases, while less salient, were important. Diseases highly salient as future threats, such as COVID-19 and cancer, were less salient, as likely future infections. Conversely, diseases highly salient as future infections, such as NSTIs and malaria, held lower salience for their future impact. This pattern was more pronounced in Ombadda. Infection prevention measures such as environmental hygiene were highly salient in both sites. Epidemic-prone diseases consistently emerged as significant concerns across sites, with local disease patterns shaping, but not fully explaining, perceived risks. While emphasising local disease burdens in risk communication is important, it may not be sufficient in all sites or for all diseases. Freelisting is useful for rapidly capturing the salience and perceptions of epidemic-prone diseases but requires complementary methods to explore nuanced patterns.
疾病暴发的频率和严重程度对受冲突影响或卫生系统薄弱的地区造成了不成比例的影响。苏丹经常面临反复出现的流行病，资源有限。了解当地对易暴发流行病的疾病的看法对于设计有效的疫情应对措施至关重要。本研究描述了苏丹两个城市社区中易暴发流行病的疾病的显著性和认知情况。我们在喀土穆州的两个社区进行了一项横断面定性研究，采用自由列举法：舍尔格奈勒地区的乌姆杜姆以及翁巴达地区第六区的一个街区。我们有目的地选择并采访了同意参与的成年人，并记录了他们对七个自由列举提示的回答。我们在Excel中使用史密斯显著性指数分析数据，以评估术语的频率和重要性，并使用相对显著性指数比较不同列表和地点之间的术语。我们在乌姆杜姆采访了32人，在翁巴达采访了30人。易暴发流行病的疾病，尤其是疟疾、鼻、鼻窦和咽喉感染（NSTIs）、伤寒和新冠肺炎，作为常见疾病、近期暴发以及未来感染和威胁，具有很高的显著性。癌症和慢性病虽然显著性较低，但也很重要。作为未来威胁具有高显著性的疾病，如新冠肺炎和癌症，作为可能的未来感染，显著性较低。相反，作为未来感染具有高显著性的疾病，如NSTIs和疟疾，对其未来影响的显著性较低。这种模式在翁巴达更为明显。诸如环境卫生等感染预防措施在两个地点都具有很高的显著性。易暴发流行病的疾病在各个地点始终是重大关注点，当地的疾病模式塑造了但并未完全解释感知到的风险。虽然在风险沟通中强调当地疾病负担很重要，但在所有地点或针对所有疾病可能并不足够。自由列举法对于快速捕捉易暴发流行病的疾病的显著性和认知情况很有用，但需要补充方法来探索细微的模式。
