{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T16:14:36Z","timestamp":1782836076080,"version":"3.54.5"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sudan has a long history of struggling with recurrent cholera outbreaks. The interplay of infrastructure damage, massive displacement, and limited access to safe water and sanitation has increased the risk of cholera transmission. The study aims to identify priority areas for multisectoral interventions (PAMIs) to inform public health policy and ensure evidence-based strategic control of cholera in Sudan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective study, national cholera data from 2016 to 2024 (excluding 2020\u20132022) were used. The Global Task Force on Cholera Control (GTFCC) tool for identifying PAMIs was applied to the analysis. Key epidemiological indicators, such as incidence, mortality, and persistence of cholera, were used to score each geographical unit and were subsequently summed to generate a priority index (PI). Furthermore, vulnerability factors were evaluated, including water, sanitation, and hygiene (WASH) infrastructure, crowded settings, displacement, inaccessibility, and community awareness. A national stakeholder validation workshop reviewed and contextualized the findings to finalize the list of PAMIs. This study also documents the immediate applications of PAMIs for strategic cholera control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A priority index threshold of 6 was established through stakeholders\u2019 consensus, which resulted in the identification of 52 PAMIs. These administrative units account for 80% of reported cholera cases and 77% of deaths, encompassing 31.5% of Sudan\u2019s total population. The identified PAMIs were immediately applied to guide preventive oral cholera vaccine (OCV) planning, resulting in the selection of 40 high-risk localities and the development of Sudan\u2019s first national 3-year OCV plan. In addition, they informed the development of the updated National Cholera Plan (NCP; 2025\u20132030) as a long-term strategy for cholera control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study provides strong evidence-based identification of PAMIs in Sudan and supports local, national, regional, and global efforts to control cholera risk. Targeted interventions in these areas are essential to contain outbreaks and build resilient public health systems. The PAMIs identification exercise informed evidence-based prioritization and planning for preventive OCV deployment and catalyzed the establishment of a national committee that developed the updated national cholera plan (2025\u20132030), reflecting the country\u2019s shift toward proactive and sustainable cholera prevention. Sudan\u2019s experience demonstrates the feasibility and policy relevance of the PAMIs framework, even in highly fragile humanitarian settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1728112","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T06:54:41Z","timestamp":1772693681000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["From evidence to action: identification and strategic application of cholera priority areas for multisectoral interventions (PAMIs) in Sudan (2016\u20132025)"],"prefix":"10.3389","volume":"14","author":[{"given":"Dalya","family":"Eltayeb","sequence":"first","affiliation":[{"name":"Directorate General of Primary Health Care, Federal Ministry of Health","place":["Khartoum, Sudan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Izzoddeen","sequence":"additional","affiliation":[{"name":"Directorate General of Health Emergencies and Epidemic Control, Federal Ministry of Health","place":["Khartoum, Sudan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazza","family":"Abasher","sequence":"additional","affiliation":[{"name":"Directorate General of Health Emergencies and Epidemic Control, Federal Ministry of Health","place":["Khartoum, Sudan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asia","family":"Dahab","sequence":"additional","affiliation":[{"name":"Directorate General of Primary Health Care, Federal Ministry of Health","place":["Khartoum, Sudan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Eissa","sequence":"additional","affiliation":[{"name":"Directorate General of Primary Health Care, Federal Ministry of Health","place":["Khartoum, Sudan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Makwe","sequence":"additional","affiliation":[{"name":"International Federation of Red Cross and Red Crescent Societies","place":["Addis Ababa, Ethiopia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elfadil Mohammed","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Directorate General of Health Emergencies and Epidemic Control, Federal Ministry of Health","place":["Khartoum, Sudan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"ref1","volume-title":"Cholera \u2013 Sudan. Disease outbreak news","year":"2023"},{"key":"ref2","volume-title":"Sudan humanitarian needs overview 2024","year":"2024"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"107788","DOI":"10.1016\/j.ijid.2025.107788","article-title":"Multistate cholera outbreak in Sudan amid ongoing armed conflict, 2023-2024","volume":"153","author":"El-Bushra","year":"2025","journal-title":"Int J Infect Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1186\/s12889-025-22128-1","article-title":"Cholera in conflict: outbreak analysis and response lessons from Gadaref state, Sudan (2023-2024)","volume":"25","author":"Izzoddeen","year":"2025","journal-title":"BMC Public Health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"127402","DOI":"10.1016\/j.vaccine.2025.127402","article-title":"Vaccination against cholera in crisis: coverage and cost efficiency in Sudan (2023-2024)","volume":"61","author":"Izzoddeen","year":"2025","journal-title":"Vaccine"},{"key":"ref6","volume-title":"Sudan deploys oral cholera vaccine in response to ongoing outbreak","year":"2024"},{"key":"ref7","volume-title":"Priority areas for multisectoral interventions (PAMIs): GTFCC guidance note","year":"2023"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1101\/2025.01.03.25319978","article-title":"Prioritizing areas for multisectoral interventions (PAMIs) for cholera control in Cameroon","author":"Ngomba","year":"2025","journal-title":"medRxiv"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e0013078","DOI":"10.1371\/journal.pntd.0013078","article-title":"Mapping of cholera priority areas for multisectoral interventions (PAMIs) using the 2023 GTFCC guidance: the Kenya experience","volume":"19","author":"Kiama","year":"2025","journal-title":"PLoS Negl Trop Dis"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1186\/s41182-021-00376-2","article-title":"Threats and outbreaks of cholera in Africa amidst COVID-19 pandemic: a double burden on Africa's health systems","volume":"49","author":"Uwishema","year":"2021","journal-title":"Trop Med Health"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"S137","DOI":"10.1093\/infdis\/jiy486","article-title":"Global cholera epidemiology: opportunities to reduce the burden of cholera by 2030","volume":"218","author":"Legros","year":"2018","journal-title":"J Infect Dis"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"99","DOI":"10.7196\/sajbl.2023.v16i3.1250","article-title":"Collective responsibility during a cholera outbreak: the case of Hammanskraal","volume":"16","author":"Obasa","year":"2023","journal-title":"S Afr J Bioeth Law"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1728112\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T06:54:41Z","timestamp":1772693681000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1728112\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,5]]},"references-count":12,"alternative-id":["10.3389\/fpubh.2026.1728112"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1728112","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,5]]},"article-number":"1728112"}}