Outbreaks in the Concrete Jungle: A Multi-City Comparative Study of Emerging Infectious Diseases Across Sudan

Ibrahim Mohammed Abu¹,   Basil Mahmoud²,   Abubakr Elamin³,   Omer Kheir⁴, Hiba Ahmed⁵,  Asim Ahmed⁶

Abstract

 Background: Rapid urbanization is reshaping global health landscapes, particularly in low- and middle-income countries (LMICs). In Sudan, urban expansion driven by conflict, displacement, and population growth has intensified public health challenges, heightening vulnerability to emerging infectious diseases (EIDs). This study investigates the relationship between urbanization factors—population density, infrastructure development, and healthcare accessibility—and the transmission of EIDs in Sudanese cities. Additionally, it evaluates the effectiveness of targeted public health interventions in mitigating disease transmission risks .

Methods: A multi-city comparative analysis was conducted across five Sudanese cities: Port Sudan, Kassala, Al-Gadaref, Al Daba, and Dongola. Data were sourced from governmental health records, GIS mapping, and epidemiological reports. Statistical analyses, including multivariate regression, spatial analysis, and time-series trends, were employed to assess the association between urbanization factors and disease incidence.

Results: A significant correlation was identified between population density and disease incidence, with Port Sudan and Kassala exhibiting the highest rates. Cities hosting large displaced populations faced heightened disease risks, primarily due to overcrowded living conditions and restricted access to healthcare. In contrast, cities with robust healthcare infrastructure, higher vaccination coverage, and improved sanitation experienced significantly lower disease incidence rates. Notably, healthcare access and vaccination coverage demonstrated strong negative correlations with disease transmission.

Conclusion: Urbanization significantly influences infectious disease transmission patterns in Sudanese cities. However, localized public health interventions, such as enhanced healthcare infrastructure, targeted vaccination programs, and improved sanitation systems, can effectively mitigate these risks. Policymakers should adopt city-specific strategies that address the unique urbanization dynamics and health challenges of each region.