Dengue fever has spread into Sudan's capital for the first time on record, as the country tackles its widest ever outbreak of the disease, exacerbated by an under-funded health system, officials say.
At least 45 people have died out of at least 2,576 cases recorded since July in 12 of the country's 18 states, according to a health ministry report this week seen by Reuters.
Dengue fever symptoms include fever, muscle pain, nausea, and rashes, but it tends to be more severe and sometimes fatal on repeat infection, making its containment a long-term concern.
"What we see in the health facilities is the severe cases of dengue, which means that what we are seeing is just the tip of the iceberg," Dr Nima Abed, World Health Organisation representative in Sudan, said.
Most people do not go to the doctor because the symptoms are not severe enough or they don't realise they have dengue fever, he added.
Although dengue fever is endemic in Sudan, outbreaks were previously concentrated in peripheral provinces, and had not spread through the country.
The outbreak comes at a time when Sudan's long underfunded health system is under particular strain. After a coup in 2021, most of Sudan's main backers withdrew development aid.
With help from the United Nations and charities, the health ministry has been able to provide diagnostic tests, mosquito nets and care facilities to help counter dengue infections, ministry official Dr Leila Hamadelnil said.
But Abed said such funds could run out.
"I cannot say it is sufficiently funded to contain the outbreak everywhere," Abed said, noting in particular the cost of funding health workers, who have often gone on strike in Sudan.
Dengue fever is carried by a species of mosquito that thrives in domestic settings, laying eggs in pools of water in and around homes, making areas without running water particularly vulnerable, and monitoring of breeding sites labour-intensive.
(Reporting by Nafisa Eltahir; editing by Aidan Lewis and Andrew Heavens)