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During the first 14 months of the Sudan conflict, there have been more violent deaths in Khartoum State alone than the current number of violent deaths recorded for the entire country, a new study suggests.

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The finding comes from a report by researchers from the London School of Hygiene & Tropical Medicine (LSHTM) on the first study to describe patterns of wartime mortality across Sudan and provide an empirical estimate of all-cause mortality in Khartoum State.

In Khartoum State, between April 2023 and June 2024, the researchers estimate over 61,000 people died of all causes, a 50% increase in the pre-war death rate.

Over the same period, it is estimated that there were over 26,000 deaths due to violence in Khartoum State, significantly higher than the 20,178 intentional-injury deaths reported by  for the entire country.

Over 90% of both all-cause and violent deaths in Khartoum State went unrecorded, suggesting the death toll in other regions is also significantly higher than recorded figures.

The new analysis also found that across most of the country, between April 2023 and June 2024, the leading cause of death was preventable disease and starvation.

Deaths due to violence were proportionally highest in the Kordofan (80%) and Darfur (69%) regions, indicating targeted violence in these historically conflict-affected areas.

The researchers used a statistical method known as ‘capture-recapture analysis’ to estimate all-cause and violent (intentional-injury) deaths. This method compares data from multiple sources to arrive at accurate estimates when not all data are recorded. The sources included a public survey shared on social media platforms, a private survey circulated among affected groups, and public social media pages containing obituaries posted by first responders. Data collection was focused on Khartoum State, with a combined total of 6,715 decedent records reported across all sources.

The analysis was conducted to provide accurate and timely mortality data, a critical indicator of the severity and nature of the crisis. This data has the potential to mobilise a humanitarian response, support advocacy for conflict resolution, and compose a historical record for accountability.

The research reveals that since the war began its impact on Sudanese lives has been significant, unrecorded and largely preventable, with important regional contrasts. This has critical implications for impact mitigation efforts and emphasises the need for a scaled-up humanitarian response.

Dr Maysoon Dahab, lead author at the London School of Hygiene & Tropical Medicine (LSHTM), said: "Our findings reveal the severe and largely invisible impact of the war on Sudanese lives, especially of preventable disease and starvation. The overwhelming level of killings in Kordofan and Darfur indicate wars within a war. Efforts to stem further large-scale loss of life undoubtedly rest on vigorous diplomatic and humanitarian efforts to end the war and address its consequences. They must also include robust mechanisms that account for human rights violations and war crimes that fuel the conflict across the country.”

Limitations of the study included that deaths among rural and lower-socioeconomic groups, may have been less likely to be reported because of historically lower access to telecommunication networks. Most deaths reported in the public and private surveys were from Khartoum (60% and 70%) so the researchers only had sufficient data to estimate mortality using the capture-recapture approach solely for the capital state, which is why this was the focus for data collection.

The study is funded by US Government funds through USAID/Bureau for Humanitarian Assistance (BHA) and the Centers for Disease Control and Prevention (CDC) and UK International Development from the UK government.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the funding agencies.

Photo: Khartoum, Burri Allamab, taken on 16/04/2023. Credit: .

Publication

A preprint version of the full report, entitled ‘War-time mortality in Sudan: A capture recapture analysis’, is available here.