Current Status of Tropical Diseases Hospital and HIV Clinic

Prepared by Nada Fadul, MD

Introduction● On December 22, 2019, I conducted a visit to the Omdurman Tropical Diseases Hospital and

the Omdurman VCT and ART Center.

● During the visit I met with the Medical Director of the hospital Dr. Amal Ahmed who gave us a

tour of the hospital and explained the history of the hospital and the challenges it faced during

the previous regime

● The previous MOH attempted to replace the tropical diseases hospital with a dermatology

hospital even though the need for inpatient dermatology is non-existent, evident by the fact

that there are 1-2 admissions a month for dermatology related issues. The hospital now has

been changed to Tropical Diseases AND Dermatology.

History● The hospital was established in 1974● Agreement between the Federal MOH, University of Khartoum- Endemic

Diseases Institutie, and National Research Institute○ MoH provided the building○ U of K to provide the staffing○ National Research Institute built the lab and outpatient clinic

● Major research center for endemic and tropical diseases with published research

● Major referral center and outbreak response center

December 2016● The MOH declared there is no need for a tropical diseases hospital after South

Sudan had separated. ● The hospital was changed to a dermatology center and all staff were removed● Patients were told to go to the nearest hospital● Nurses and doctors had to hide some patients in abandoned floors and took

care of them in fear of the previous regime’s MoH abandoning them● A month later there was a Cholera outbreak and the hospital was restaffed to

take care of the outbreak

Active Programs1. TB national program2. Vl national program3. Malaria national program4. And recently HIV centre

since 2018

Tropical Diseases Hospital● The hospital is a referral center for tropical

diseases from other hospitals within Khartoum as

well as other regions in Sudan.

● 5 wards, 60 beds in total

● There is also an outpatient clinic, a pharmacy, a laboratory, as well as a procedure suite.

● The majority of inpatient admissions are for

tropical diseases including Leishmaniasis,

Malaria, TB, and HIV.

Hospital Facilities● The lab is equipped with TB PCR machine that can detect TB as well as RIF and INH resistance.

There is also chemistry point of care machine as well as peripheral smear capabilities. The lab

does not have blood culture nor AFB culture capabilities.

● The central pharmacy is located within the hospital provides medications for outpatient

● The procedure suite is used mostly for dermatological procedures

Future planned activities● TB contact tracing clinic● Leprosy clinics (With lab and pharmacy)● Tropical service integration ..including HIV testing as a

routine for every pt.● Computerized database system

Major Needs● X-ray machine● Upper GI endoscopy● Blood bank refrigerator ● Microbiology lab● Glucometers ● Pulse Oximeters● Monitors● Weight Scales

Omdurman VCT and ART Center

The center is housed in a new

facility that was supported by

the UNDP.

The facility includes an adult

clinic and waiting room as well

as pediatric clinic and waiting

room.

It also includes a lab and a

pharmacy.

VCT Services and Diagnostics● The center provides VCT services to all referred

cases (self referred and suspected cases).

● The testing is done via POC testing, and

confirmation is done by repeat POC and if there is

a discrepancy, a serological test is done for

confirmation.

● Viral load testing is not currently available at the

center but equipment is ready to be installed soon

● CD4 testing is not available

.

ART Services● The center provides ART services to about 4000

patients.

● The drugs are provided by the Global Fund, and

services are provided by a team of counselors and

medical officers as well as a consultant (main lead

consultant was on medical leave).

● The center also includes a pharmacy where drugs

are dispensed to patients. Main regimens include:

TDF, ABC, NVP, EFV, LPV/r.

Support Services● The center is very well structured in spite of limited resources.

● Every patient is seen by the counselor at every visit.

● A detailed psychosocial assessment as well as HIV risk factors and

knowledge assessment is done by the counselor at the first visit and

updated as needed.

● Pregnancy assessment and flow sheet is also completed for pregnant

females.

Main Needs● HIV viral load testing equipment is available but has not been activated

due to power issues.

● The center would welcome training opportunities on HIV and related

comorbidities.

● Electronic Database and Health record

SummaryThe Tropical Diseases Hospital is well positioned to be rehabilitated to take care of urgent and chronic tropical and endemic diseases needs in Sudan

Major needs of the hospital are mostly equipment and staff capacity building

The VCT and ART center is operating with limited resource but creating major impact

Future needs of the center are capacity building and EMR database and equipment

SIDA is well positioned to assist both center achieve excellence by providing technical and logistic support