Blue Nile State Research Articles

Frequency and complications of falciparum malaria among febrile staff members of UN deployed to Northern Sudan

Malaria is a mosquito-borne parasitic disease, common around the globe especially in poorest countries. It is inevitable and remediable, yet it is still killing many people every year, 90% of them are in Africa. Malaria is an important threat to tourists, soldiers and employees travelling or working in endemic areas. The present study was carried out among UN staff members working in regions of Damazin, AL Obayid, kosti and areas of Blue and White Nile States. Study period comprised five years from Jan 2006 to Dec 2010. Febrile patients both males and females were screened for malaria. Thereafter, the malaria positive patients were further screened for Plasmodium falciparum andPlasmodium vivax. P. falciparum was found in 80% of febrile patients. Most of the patients (63.6%) presented in the first two days of febrile illness and the largest number ofFalciparum malaria cases was reported from July to October each year. Mean index offalciparum malaria at presentation was a major factor in determining hematological and liver functions derangements and the time taken for fever to settle after starting either of two antimalarial drugs, that is, quinine or artemether. Key words: Plasmodium falciparum, plasmodium vivax, quinine, artemether, falciparumIndex.

What Makes a State? Territory

What makes a state? Under the Montevideo Convention, a prospective state must meet four criteria. It must have a territory, with a permanent population, subject to the control of a government, and the capacity to conduct international relations (sovereignty). Of these requirements, territory presents the major obstacle. Although the world has no shortage of groups seeking independence (who would gladly form governments and relations with other states), it does have a shortage of real estate. A new state necessarily takes territory from an existing state. Since existing states make international law, it is no surprise that the law is designed to make it very difficult for a new state to form out of an existing state's territory. Territorial integrity, along with sovereignty and political independence, form the of that states enjoy under international law. From these rights, the notion has emerged that new states can only be formed with the of the existing state where the territory lies. The triumvirate of rights has long been the standard lens through which the international community views self-determination and the creation of new states. It has become increasingly clear, however, that rigid adherence to these principles can lengthen conflict and create negative incentives. If is required and not forthcoming from the state--and it usually is not--independence groups are forced onto the path of obtaining by force. States, meanwhile, feel secure in their territorial integrity, which more often than not puts them on the path of the violent suppression of independence movements. This cycle feeds upon itself, with devastating consequences. Too often, states respond to independence movements with atrocities, as in Sri Lanka, in Sudan--first Darfur and now South Kordofan and Blue Nile States--in Burma, and now in Syria. In the former Yugoslavia, the international community's rigid adherence to traditional notions of state creation wasted precious time and allowed momentum for genocide to build. In reality, international law's elaborate framework for self-determination and statehood provides independence-seeking groups with only two options. They can fight their way out, as South Sudan did, and obtain consent at gunpoint. Alternatively, they can suffer so many human rights violations that democratic states are forced by their constituents to intervene and essentially extract the new state from the predecessor state, as with the case of Kosovo. Either way, the likely result is more violence. As scholars and practitioners of international law, our efforts to deal with this problem are clouded by a false notion of consent. Although genuine exists in some rare cases, as in Czechoslovakia, most of the time consent is a misnomer because it occurs at gunpoint. Consent for the independence of South Sudan cost millions of lives and decades of war. In Northern Ireland, was achieved only after a long, bloody terrorism campaign. In Bougainville, was extracted only after a decades-long conflict. Now for the good news: recent developments in international law are providing new pathways for the international community to conceptualize and manage self-determination and the creation of states. First, under the responsibility to protect (R2P) doctrine, sovereignty is no longer absolute. …

Humanitarian Obstruction as a Crime Against Humanity: The Example of Sudan

Widespread military violence, much of it targeting civilians, accelerated dramatically this past June in the Soutfi Kordofan region of Sudan, and as of September 1 it had spread to Blue Nile State. Like much of Sudan, South Kordofan and Blue Nile are a highly combustible mix of etiinic animosities, tortured history, and great numbers of heavily armed men (see Small Arms Survey 2011). South Kordofan has the added misfortune of being the Khartoum regime's only oil-producing state following the independence of South Sudan on July 9, 2011. But while geographically in northern Sudan, much of Blue Nile and South Kordofan - and virtually the entire Nuba Mountains area in the center of South Kordofan - identifies with the South culturally, politically, and militarily. Tens of thousands of Sudan People's Liberation Army (SPLA) soldiers are from the Nuba and southern Blue Nile; they refuse to be sent back to the South or disarmed - and if pushed by Khartoum, they will fight to save their lands and cultural heritage. The SPLA-Nordi is now a distinct entity, and considers itself and its political counterpart (the Sudan People's Liberation Movement-North) as fighting an aggressive tyranny in their homelands. This is not hard to understand, particularly in the case of the Nuba. In the 1990s, during die first military action undertaken by the National Islamic Front/National Congress Party, the African people of the Nuba were nearly annihilated; hundreds of thousands were killed or displaced from their fertile lands. Though not a widely known event, there is almost no dissent among students of Sudan that this episode of ethnically targeted destruction was in fact genocide. And one of its most notorious and consequential features was a total embargo on humanitarian aid to the region for much of the 1990s, even as South Sudan was the fitful beneficiary of the U.N. umbrella effort known as Operation Lifeline Sudan. This embargo is of central concern here, given the horrific human suffering and destruction that followed direcdy from it. Khartoum's more recent military offensive in South Kordofan and Blue Nile extends die offensive begun on May 20 in die contested border region of Abyei (which lies immediately to the south of South Kordofan). Only belatedly has the international community acknowledged that the incident cited by Khartoum as casus belliwas merely a pretext and that the attack was premeditated. The same is true of the regime's assault in South Kordofan, where on June 5 tanks and military equipment began to pour into Kadugli, die state capital. Within days widespread and clearly planned military actions were underway, again pitting Arab militias and Khartoum's regular armed forces against the African populations of the region, in particular those of the Nuba Mountains. In Kadugli there were authoritative reports of house-to-house searches for Nuba, who were then piled into catde trucks - or summarily executed. Roadblocks reminiscent of Rwanda in April 1994, and serving the same purpose, were also widely observed. Satellite imagery confirmed the existence of mass graves, as did eyewitness accounts from the ground collected by U.N. human rights investigators (who were shordy thereafter expelled by Khartoum). The presence in Kadugli of a U.N. Mission in Sudan (UNMIS) peacekeeping team did nothing to deter violence, or even protect African Nuba people who sought protection within the U.N. compound. Moreover, all of South Kordofan is within reach of Khartoum's major military air base at el-Obeid, which is just to the north. This has meant a constant aerial assault on civilian and humanitarian targets, especially in the Nuba Mountains - a continuation of the pattern I've analyzed and detailed for die past thirteen years (see Reeves 2011). The aerial offensive in South Kordofan has been extensive and concerted, and the clear goal has been to eliminate the troublesome populations of the Nuba once and for all. …

Ethnobotanical study of medicinal plants in the Blue Nile State, South-eastern Sudan

Ethnobotanical study of medicinal plants used by traditional healers was carried out in the Blue Nile State, South-eastern Sudan. Information was obtained through conversations with traditional healers with the aid of semi-structured questionnaires. Informant consensus, use value, and fidelity level for each species and use category were calculated. A total of 31 traditional healers participated in the study. Fifty three plant species distributed into 31 families and 47 genera were identified as being used to treat one or more ailments. The major source of remedies came from wild plants. The most frequently mentioned indications were digestive system disorders, infections/infestations, pain, evil eye and respiratory system disorders. The majority of remedies are administered orally and decoctions were the most frequently prepared formulation. The collected data may help to avoid the loss of traditional knowledge on the use of medicinal plants in this area. Considering the widespread use of these medicinal plants to treat various ailments, it therefore becomes crucial to scientifically validate the therapeutic uses and safety of these plants through phytochemical screening, different biological activity tests and toxicological studies.

An outbreak of bovine trypanosomiasis in the Blue Nile State, Sudan

BackgroundIn this paper, we report an outbreak of bovine trypanosomiasis in Kurmuk District, Blue Nile State, Sudan that involved an infection with four Trypanosoma species in cattle. The outbreak occurred in June 2010 when indigenous cattle, mainly Kenana and Fulani breed types, crossed the national Sudanese border to Ethiopia and returned. A veterinarian was notified of massive deaths in the cattle populations that recently came from Ethiopia. All animals involved in the outbreak were from the nomadic Fulani group and resident local cattle were not infected and no death has been reported among them. A total of 210 blood samples were collected from the ear vein of cattle. A few samples were also collected from other domestic animals species. Parasitological examinations including hematocrit centrifugation techniques (HCT) and Giemsa-stained thin blood films were carried out. ITS1-PCR, which provides a multi-species-specific diagnosis in a single PCR, was performed.FindingsParasitological examinations revealed that 43% (91/210) of the affected cattle population was infected with two morphologically distinct trypanosomes. Seventy animals (33.3%) were infected with T. vivax and twenty one (10%) with T. congolense. In contrast, ITS1-PCR was able to identify four Trypanosoma species namely T. vivax, T. congolense, T. simiae and T. brucei in 56.7% (80/141). T. brucei showed the highest prevalence of 36.9% (52/141) and the lowest 19% (27/141) was displayed by T. congolense. Furthermore, and because ITS1-PCR could not differentiate between T. brucei subspecies, serum resistance-associated (SRA) gene based PCR was used to detect the human T. brucei rhodesiense in T. brucei positive samples. None of the samples was shown positive for T. b. rhodesiense. The identity of the 400 bp PCR product originating from T. simiae, was further confirmed by sequencing and subsequent phylogenetic analysis.ConclusionsThe outbreak of bovine trypanosomiasis occurred in the Blue Nile State was caused by mixed infection of two or more Trypanosoma species and the conventional parasitological examinations were not reliable in identifying all the species of Trypanosoma involved in the outbreak. It is difficult to determine the cause of the disease for the reason that the current enzootic situation in the resident cattle in the region is poorly understood. The study concluded that there are at least four species of trypanosomes that caused this outbreak in the Blue Nile State. The presence of mixed infections might have exacerbated the severity of the disease. It is hypothesized that variant parasite type(s) might have been introduced to Sudanese cattle when they crossed to Ethiopia, a tsetse belt region.

<em>Ripe or Rotting:</em> Civil Society in the Casamance Conflict

The article explores the role of traditional and modern actors as well as traditional methods in finding a durable solution to the separatist Casamance conflict, which has experienced an uptick in hostilities since 2009. In 2007, the government named a group of traditional actors, the Comité des Sages, as its official interlocutor with the Movement of Democratic Forces in the Casamance (MFDC), which was a armed rebel movement against the government of Senegal. However, the approach did not advance the peace process because their base was too limited, their practices of buying access to the MFDC were not sustainable, and the perception of skimming undermined their credibility. Traditional methods will have a role to play, namely, the reversing of oaths taken by combatants when they joined the MFDC, once a large-scale demobilization of forces is possible. Modern and traditional civil society actors have played a role in peacebuilding efforts in Casamance. They include micro-level village associations with localized access to nearby MFDC bases or combatants from their village, meso-level Senegalese NGOs that implement programs in different parts of the region, and macro-level national organizations and individuals based in Dakar and the Casamance with access to high-level decision-makers. Collaboration among these actors balances their strengths and weaknesses, but their interests must align for the collaboration to succeed. An MFDC call for a referendum on independence, akin to the one held in Southern Sudan in January 2011, was firmly rejected, but a more interesting parallel lies in the popular consultation process identified in Sudan’s 2004 peace agreement for the Blue Nile and South Kordofan states and suggested in the December 2004 agreement. Popular consultations allow citizens to indicate if the agreement has been implemented satisfactorily and should be the definitive solution, while the political conference discusses root causes of the conflict and proposes solutions.

Breast cancer burden in central Sudan.

Breast cancer is a worldwide disease resulting in many deaths. Although breast cancer incidence is lower in Sub-Saharan African countries than in developed countries, African women are more likely than women in the developed world to be diagnosed at later stages of the disease and, thus, are more likely to die from it. This is due to the lack of awareness by women, accessibility to screening methods, and availability of African-based research findings that would influence decision making at the governmental level. This descriptive study was undertaken to shed light on the type, stage and age distribution of breast cancer at diagnosis in women living in central Sudan encompassing al-Gezira, Blue Nile, White Nile, and Sennar States. Cases comprised 1255 women from central Sudan diagnosed with breast cancer and referred to and treated at Institute of Nuclear Medicine, Molecular Biology, and Oncology, from January 1999 to December 2006. Data revealed that 74% of the women were <50 years old or premenopausal. Invasive ductal carcinoma was the most common pathology (82%) and women presenting with stage III or higher tumors that had already metastasized, while ductal carcinoma in situ was the least prevalent (0.5%) finding. Estrogen and progesterone receptors expression were performed on a limited number of samples and the overwhelming majority of cases were observed to be negative for estrogen and progesterone receptors expression.

Gastrointestinal Fistula: Audit of management in a remote hospital

Background: The management of gastrointestinal fistula continues to present considerable challenge to the surgeon in general and gastrointestinal surgeon in particular. Objectives: To audit the management and report the outcome of the gastrointestinal fistula in aremote hospital. Setup: Eldamazeen Hospital is a regional hospital in the Blue Nile state, south east of Sudan. Methods: Retrospective analysis of demographic and clinical data of patients with gastrointestinal fistula admitted to the surgical department in the period from Feb 2003 through Feb 2008. Results: 10(83.3%) patients had high out-put fistula. Two fistulas were complex and 10 were simple. The small intestine was the commonest site of fistula followed by the large bowel. The commonest causes of the gastrointestinal fistula are emergency operations for stab wounds, laparotomy and caesarean section. The overall mortality rate is 2(16, 7%) patients mainly due to inter-abdominal abscesses. Conclusion: Conservative treatment with nutritional support is the corner stay for successful treatment. However, early surgical management of septic foci should be considered.Keywords: Eldamazeen, laparotomy, caesarean, abscesses.

Transforming Pastoralism: A Case Study of the Rufa'a Al-Hoi Ethnic Group in the Blue Nile State of Sudan

Abstract The pastoral sector in the Blue Nile State (Sudan) has been marginalized and impoverished as a result of detrimental state policies, deteriorating environmental conditions and an encroaching civil war. To survive these assaults, poor households among the Rufa'a Al-Hoi group had to settle and engage in activities remotely related to the pastoral sector. However, they found that their circumstances actually improved by gaining access to a number of social and other types of services previously unavailable. Contrary to conventional wisdom, these particular Rufa'a households found their quality of life improving under their new circumstances and did not attempt to return to pastoralism. Recently, such choices attracted other well-to-do pastoral households from the same ethnic group to settle, engage in agriculture and small business and keep some of their livestock on the move with herders, thus transforming their system of livelihood in order to both cope and reap the benefits from the changing situation.

Protocol between the Government of Sudan (GOS) and the Sudan People’s Liberation Movement (SPLM) on the Resolution of Conflict in Southern Kordofan/Nuba Mountains and Blue Nile States

Protocol between the Government of Sudan (GOS) and the Sudan People’s Liberation Movement (SPLM) on the Resolution of Conflict in Southern Kordofan/Nuba Mountains and Blue Nile States

NATURAL VARIATION IN FRUIT TRAITS OF WILD BAOBAB (Adansonia digitata L.) IN BLUE NILE STATE: AWAY FORWARD FOR SPECIES DOMESTICATION AND CONSERVATION IN SUDAN

The overall objective of this study was to distinguish and evaluate morphological variations in relation to locations of baobab fruits traits. The study was conducted in Blue Nile states Sudan 2015/2016. The morphological variation in fruits was evaluated by sampling fruits and assessing their characteristics. Five to twenty single trees were checking out randomly inside baobab location for the morphometric quantities (fruits) at different distances. Our first results point to there was high variety in fruit phenotypes. obovate, ovate, globose, fusiform, oblong, ellipsoid pointed, ellipsoid and spheroid emarginated fruit types were identified. Fruit shape was constant within each individual tree but was varied between trees. Results presented highly important differences (P?0.05) in fruit traits. The study findings revealed that spheroid emarginated fruit shape from Tolaba location was highly significant in term of fruit, seed and pulp weight, 407.00 ± 35.17 g, 187.07 ± 23.94g and 70.18 ± 6.23g respectively. Ovate fruit type was the most abundant (21 %), whereas spheroid emarginated and ellipsoid pointed shape was the least frequent (3%). The highly diversity found between locations is vital for domestication devotions and tree development through assortment and breeding candidate plus trees. Founded on the results documented, development of study doings on the practically unstudied baobabs in Blue Nile state, Sudan is greatly recommended.

Lifestyle Patterns and the Awareness of the Risks of Non-Communicable Diseases in Sudan : A Community Study = أنماط الحياة و الوعي بمخاطر الأمراض غير السارية في السودان : دراسة مجتمع

Objectives The objective of this study was to explore the knowledge and practices regarding lifestyle (healthy diet, physical activity and tobacco use) in relation to awareness of the risks of NCDs in Sudan. Methods It was a qualitative study conducted in three states in Sudan (Northern state, Blue Nile State and Red Sea State) in May 2011, as part of the Risk Behavior Survey. The fifteen states of Northern Sudan were ranked into four zonal groups. Each zonal group was given scores according to health indicators that are based on data from representative national health surveys. Twenty-four focus group discussions were conducted; eight in each state, four in rural areas and four in urban areas. Results The results revealed that the respondents were aware of the benefits of all lifestyle habits that are related to NCDs; such as the effect of physical exercise and the negative effect of obesity. However, only few respondents were engaged in regular physical activity with the purpose of exercise. Consumption of cooked vegetables occurred on daily basis in all states; however, fruit consumption was much less depending on accessibility and prices. Respondents identified white meat as a healthier option; however, they consumed red meat much more. There were also high consumption rates of both white sugar and salt. All tobacco users were aware of tobacco health-related hazards. The respondents showed their desire to quit tobacco use but lack of support and resources were the main barriers. Conclusion Knowledge of the Sudanese community with regards to healthy diet, physical activity and tobacco was found to be quiet adequate. However, the daily lifestyle practices are almost unhealthy and contradict their knowledge. Behavioral interventions are needed to improve the lifestyle of the Sudanese community.