Disease In Sudan Research Articles

Bacterial Foodborne Diseases in Sudan: A Review

Objective: To determine the role of the bacteria associated with foodborne diseases in Sudan and to help health policymakers introduce strict intervention measures control. Methods: The review uses up-to-date data via manual screening of the titles and abstracts of retrieved articles using string foodborne diseases in Sudan and foodborne illnesses as keywords to obtain publications from the electronic databases PubMed and Google Scholar using the publish or perish tool. However, priority has been given to the scientific papers, reports, and literature issued within the past 5 years. Results: The review reported that many types of research revealed that foodborne infection is a critical, life-threatening health problem in Sudan and that different food pathogens are responsible for people and outbreaks of foodborne illness. Conclusion: Foodborne diseases are considered one of the main reasons for illness and death, particularly in countries that suffer from poor economic conditions, such as Sudan. The review concluded that the most bacteria that caused foodborne disease in Sudan were Escherichia coli, Salmonella spp, and Staphylococcus aureus.

A Review of Sudan’s Major Food-Borne Viral and Fungal Diseases

Objective: This review article was conducted to highlight both viral and fungal foodborne situations in Sudan and their health impacts aiming to help health policymakers in introducing strict intervention measures. Method: The review uses up-to-date data via manual screening of the titles and abstracts of retrieved articles using string foodborne diseases in Sudan and foodborne illnesses as keywords to obtain publications from the electronic databases PubMed, Scopus, and Google Scholar from the year 2000-2020 using the publish or perish tool, the databases were reviewed from January to April 2022. Results: Foodborne viruses and Mycotoxins produced by certain fungi; are considered among the top priorities and have become of great concern to the food industry over the last few years because their contamination can occur at any point in the nutritional supply chain besides their serious effects on human health both long and short term. Conclusion: The review on major food borne viral and fungal diseases in Sudan is an important issue to guard against contamination with such micro-organisms and prevent their illnesses.

Vernal Keratoconjunctivitis in Sudan and Its Impact on Visual Acuity

Purpose: Despite being a self-limiting allergy disorder, vernal keratoconjunctivitis (VKC) can potentially cause severe problems, including blindness, if not properly treated. Therefore, the objective of this study is to determine the effect of VKC on the visual acuity of patients. Materials and Methods: We conducted this prospective descriptive study between January 1, 2023, and April 20, 2024.So, all children with spring catarrh symptoms and signs were examined at Dr. Khalil's ophthalmology center (240 patients), including the cornea, bulbar, and palpebral conjunctiva, visual acuity was measured, visual impairment was classified by WHO, and structured questionnaires were completed. The study excludes children under the age of four years and those over the age of eighteen years. Findings: A total of 240 patients participated in this assessment, with an average age of 10 years. The male to female ratio for the age of disease beginning was 2.10:100. The mean age of onset was 5 years. The occurrence of this phenomenon is more prevalent in the younger age group compared to the older age group, with a ratio of 1.40 to 1.00. We have observed that a condition recurs in 85% of patients. The illness affects both eyes in 97% of the individuals. Regarding visual acuity, the majority of patients exhibit normal or reduced visual acuity, accounting for 81.6%, while the remaining 15% experience substantial visual impairment. 2.1% of patients were found to have severe visual impairment, while 1.3% were diagnosed Implications to Theory, Practice and Policy: VKC, is a prevalent disease in Sudan. It often affects both eyes and is more common in males than females. VKC tends to occur at a young age and often recurs in patients. Additionally, it can lead to severe consequences that result in a decline in visual acuity in over 18% of patients. Children with VKD should undergo continuous screening for their visual acuity.

Case Report: Entamoeba Histolytica and Candida Impair Artemisinin-Based Combination Therapy Effect in Malaria Patient

Malaria is an endemic disease in Sudan, and the emergence of antimalarial drugs resistance represent a serious problem affecting the Sudanese population. Acidity reduces absorption of antimalarial drugs and allows for malaria parasites to survive and multiply. Enteric pathogens such as Entamoeba histolytica, candida and Helicobacter pylori may support the growth of Plasmodium falciparum, through inhibition of the absorption of antimalarial agent, such as artemisinin-based combination therapy (ACT).

Case Report: Intestinal Candidaisis Impair Artemether/Lumefantrine (Coartem) Effect in Malaria Patient

Malaria is an endemic disease in Sudan as well as in many developing countries. The emergence of antimalarial drugs resistance represents a serious problem disturbing the health community throughout the world. Acidity reduces absorption of antimalarial drugs and allows for malaria parasites to survive and multiply. Gastrointestinal pathogens such as Entamoeba histolytica, candida and Helicobacter pylori may support the growth of Plasmodium falciparum, through inhibition of the absorption of Artemether/lumefantrine and offer resistance of interest to malaria parasites. Antimicrobial agents such as tinidazole in case of acidity of microbial origin and antiacids in case of anxiety the resulting acidity may support the action of Artemether/lumefantrine in addition to other antimalarial agent to overcome their absorption defect.

Molecular Detection of Hemoglobin O-Arab in the Sudanese Population.

Sickle cell disease (SCD) is an inherited hemoglobin disease affecting the red cells and causing hemolytic anemia. It is a very common, endemic disease in Sudan, particularly in the central and western areas of Sudan. Sickle cell anemia (SCA) is when the patient has beta-globin gene variant (Hb S variant). In this study, we screened the co-inheritance of hemoglobin O-Arab mutation among Sudanese sickle cell disease patients. This cross-sectional study was conducted in the Sudan-Khartoum state from November 2016 to December 2021. Blood samples were collected from a random sample of the known sickle cell disease patients of Kordofan-central Sudan origin. Study-appropriate blood samples were subjected to complete blood count (CBC), hemoglobin capillary electrophoresis (CE) and molecular laboratory investigations. Initial laboratory investigations were done in Sudan, where the DNA sequencing technique was carried out at the Egyptian National Research Center (NRC)-Cairo-Egypt. The final study's main results revealed the presence of HB O-Arab genetic mutations among Sudanese Sickle cell disease patients, which estimated to be (5%) co-inherited mutations among our study population (Hb-O Arab; (HBB):c.364G>A (p.Glu122Lys)). The frequency of Hb-O Arab gene mutations was determined among Sudanese sickle cell disease patients, and the results have shown a (5%) frequency of Hb-O Arab mutation. The study result is the first molecular confirmation of co-inherited Hb-O Arab/sickle cell disease clinical condition in Sudan. The results raise the importance of extended studies of other sickle variant conditions.

Spontaneous Rupture of the Spleen Due To Malaria A Case Report

Malaria is of the commonest diseases in Sudan and a major cause of morbidity and mortality. Its transmitted by Anopheles mosquito bite. It has well described and common complications that most of the clinicians in Sudan are familiar with its presentation and how to deal with it. However, Malarial splenic rupture (MSR) is uncommon even in highly endemic areas Malaria and is a dramatic complication demanding prompt recognitions and surgical treatment.

Intrafamilial and interfamilial heterogeneity of PINK1-associated Parkinson's disease in Sudan

PINK1 is the second most predominant gene associated with autosomal recessive Parkinson's disease. Homozygous mutations in this gene are associated with an early onset of symptoms. Bradykinesia, tremors, and rigidity are common features, while dystonia, motor fluctuation, and non-motor symptoms occur in a lower percentage of cases and usually respond well to levodopa. We investigated 14 individuals with parkinsonism and eleven symptom-free siblings from three consanguineous Sudanese families, two of them multigenerational, using a custom gene panel screening 34 genes, 27 risk variants, and 8 candidate genes associated with parkinsonism. We found a known pathogenic nonsense PINK1 variant (NM_032409.3:c.1366C>T; p.(Gln456*)), a novel pathogenic single base duplication (NM_032409.3:c.1597dup; p.(Gln533Profs*29)), and another novel pathogenic insertion (NM_032409.3:c.1448_1449ins[1429_1443; TTGAG]; p.(Arg483Serfs*7)). All variants were homozygous and co-segregated in all affected family members. We also identified intrafamilial and interfamilial phenotypic heterogeneity associated with PINK1 mutations in these Sudanese cases, possibly reflecting the nature of the Sudanese population that has a large effective population size, which suggests a higher possibility of novel findings in monogenic and polygenic diseases in Sudan.

“Honestly, this problem has affected me a lot”: a qualitative exploration of the lived experiences of people with chronic respiratory disease in Sudan and Tanzania

BackgroundOver 500 million people live with chronic respiratory diseases globally and approximately 4 million of these, mostly from the low- and middle-income countries including sub-Saharan Africa, die prematurely every year. Despite high CRD morbidity and mortality, only very few studies describe CRDs and little is known about the economic, social and psychological dimensions of living with CRDs in sub-Saharan Africa. We aimed to gain an in-depth understanding of the social, livelihood and psychological dimensions of living with CRD to inform management of CRDs in Sudan and Tanzania.MethodWe conducted 12 in-depth interviews in 2019 with people with known or suspected CRD and 14 focus group discussions with community members in Gezira state, Sudan and Dodoma region, Tanzania, to share their understanding and experience with CRD. The data was analysed using thematic framework analysis.ResultsPeople with CRD in both contexts reported experiences under two broad themes: impact on economic wellbeing and impact on social and psychological wellbeing. Capacity to do hard physical work was significantly diminished, resulting in direct and indirect economic impacts for them and their families. Direct costs were incurred while seeking healthcare, including expenditures on transportation to health facility and procurement of diagnostic tests and treatments, whilst loss of working hours and jobs resulted in substantial indirect costs. Enacted and internalised stigma leading to withdrawal and social exclusion was described by participants and resulted partly from association of chronic cough with tuberculosis and HIV/AIDS. In Sudan, asthma was described as having negative impact on marital prospects for young women and non-disclosure related to stigma was a particular issue for young people. Impaired community participation and restrictions on social activity led to psychological stress for both people with CRD and their families.ConclusionChronic respiratory diseases have substantial social and economic impacts among people with CRD and their families in Sudan and Tanzania. Stigma is particularly strong and appears to be driven partly by association of chronic cough with infectiousness. Context-appropriate measures to address economic impacts and chronic cough stigma are urgently needed as part of interventions for chronic respiratory diseases in these sub-Saharan African contexts.

Parasitic and Chemical Foodborne Diseases in Sudan

The interest in parasitic and chemical foodborne diseases has increased due to its increased danger, as chemical poisoning of food often occurs within minutes. This pollution occurs in restaurants or when preparing food at home, in food laboratories and in factories that produce food and drink in large quantities. In developing countries, intestinal parasites are one of the dangerous problems that affect health and lead to an increase in illness and death because of poor economic, social, and health conditions. Chemical hazards are both natural and unnatural toxins and contaminants in food. Some toxins come from the food source, either naturally or due to mishandling. Safe food provides health to the individual and the community and protects it from the risks of diseases that may cause by eating these contaminated foods. This review aims to report information and published data of foodborne diseases acquired in Sudan. The review showed that, there are many risks, to varying degrees, in a wide range of food consumed in Sudan, which raises concern about the potential threat to the public health of the people and requires more attention by the responsible authorities in the state such as the Sudanese Standards and Metrology Organization and the judicial authorities to establish laws that regulate and follow up on this.

Seroepidemiological Survey of Lumpy Skin Disease among Cattle in El Gezira State (Central Sudan)

Lumpy skin disease (LSD) is an infectious viral disease that affects cattle, buffalos and selected wild animals. A cross-sectional study was conducted in El Gezira State, Central Sudan to determine the seroprevalence and risk factors of LSD in cattle in seven localities. A total of 197 serum samples were collected randomly from apparently healthy cattle during the period between April – May, 2021 and tested serologically with a commercial ELISA kit. The overall true seroprevalence of lumpy skin disease virus (LSDV) was 24.6% (50/198). Univariate analysis showed that there was a significant difference (p < 0.05) in seropositivity to LSD between age groups, sex as well as breed. Multivariate analysis revealed that only two independent risk factors (age and breed) were statistically significant (p < 0.05). It is apparent from the present study that LSDV infection is quite prevalent among cattle in El Gezira State, Central Sudan. To the best of the author’s knowledge, this is the first seroepidemiological study of LSDV infection in Central Sudan. The authors recommend that the concerned authorities expend more efforts to control this economically important disease in Sudan.

Head and neck mycetoma: Clinical findings, investigations, and predictors for recurrence of the disease in Sudan: A retrospective study.

IntroductionMycetoma is a unique neglected tropical disease which is found endemic in areas known as the “mycetoma belt”. Head and neck mycetoma is a rarity and it has many devastating impacts on patients and communities. In this study, we assessed clinical findings, investigations, and predictors for recurrence of head and neck mycetoma in Sudan.MethodologyA retrospective study was conducted at Mycetoma Research Center in Khartoum between January 1999 and December 2020 for all patients with head and neck mycetoma. Data were analyzed using R software version 4.0.2.ResultsWe included 107 patients with head and neck mycetoma. 65.4% were young adult males from mycetoma endemic areas in Sudan, and most of them were students (33.6%). Most of patients (64.4%) had actinomycetoma. Before presenting with head and neck mycetoma, majority (75.7%) had a long duration with mycetoma, and 30.8% had a history of trauma. The commonest invaded site was the parietal region (30.8%). The lesion started gradually in most of the patients (96.3%). 53.3% of the patients had large size lesions with no sweating, regional lymph nodes involvement, or distal vein involvement. CT scan was the most accurate diagnostic tool while 8.4% of patients were diagnosed by clinical examinations only. Laboratory investigations confirmed that 24/45 (44.4%) of actinomycetoma was caused by Streptomyces somaliensis while 13/28 (46.4%) of eumycetoma was caused by Madurella mycetomatis. All patients with recurrence of head and neck mycetoma underwent surgical excision of the lesion (n = 41/41 {100%}, p < 0.001).ConclusionIn head and neck mycetoma, the most common type was actinomycetes in Sudan. Majority had a long course of mycetoma and the commonest causative organism was Streptomyces somaliensis. The treatment outcome was poor and characterized by a low cure rate.

A232 Assessment of Bariatric Surgery Effects on Body Mass Index, Type 2 Diabetes, Hypertension, and Risks for Cardiovascular Diseases in Sudan

A232 Assessment of Bariatric Surgery Effects on Body Mass Index, Type 2 Diabetes, Hypertension, and Risks for Cardiovascular Diseases in Sudan

Pediatric Sickle Cell Disease in Sudan: Complications and Management.

Background Sickle cell disease (SCD) is a life-threatening genetic disorder due to the formation of sickle hemoglobin molecule (HbS) that polymerizes in hypoxic conditions leading to SCD-related complications. Different approaches have been used in the management of SCD including symptomatic management, supportive management, and preventive management. Objectives To assess the management of SCD in pediatric patients in Gaafar Ibnauf Referral Hospital in Khartoum locality, Sudan. Method A descriptive, retrospective, hospital-based study was conducted in Gaafar Ibnauf Hospital using a data collection sheet. The study included all medical files of pediatric patients with SCD attending the hospital during the period from the first of April 2018 to the first of July 2018. The data were analyzed using descriptive statistics and the chi-square test. P < 0.05 was considered statistically significant. Results Out of 207 pediatric patients, 53.1% were females (mean age of 7.5 ± 3.1 years), with a 1.1 : 1 female:male ratio and low socioeconomic status. Only 4.3% of participants had health insurance. The Messeryia tribe in western Sudan had the highest prevalence of the disease among the Sudanese tribes (11.1%). Vaso-occlusive crisis (33.3%), infections (13.5%), and neurological complications (10.6%) were the most frequent complications reported during routine visits. After initiation of management, only 3.4% of pediatric patients had hemolytic crises, and 1.4% of the anemic patients had splenomegaly. 100% of patients received folic acid, 73.9% used hydroxyurea, and 69.6% underwent blood transfusion for the management of SCD. Prophylactic penicillin was prescribed for 15% of patients, and 41.1% were immunized with pneumococcal vaccine (PPSV23). Most patients had been scheduled for planned follow-up visits every 3–6 months (93.2%). Hydroxyurea and blood transfusion significantly reduced fever and vaso-occlusive crisis. Conclusion The SCD treatment protocol in Gaafar Ibnauf Children's Hospital, involving preventive and symptomatic therapy, is consistent with the internationally implemented protocols for SCD management. However, immunization and prophylactic penicillin approaches are deficient.

Assessing the Psychological Impact of the Pandemic COVID -19 in Uninfected High-Risk Population

PurposeTo assess the impact of the COVID-19 pandemic on the psyche of uninfected people with chronic diseases in the Elduim community, White Nile State, Sudan, during the COVID -19 pandemic.MethodsWe used a generalized anxiety disorder scale (GAD -7) and a patient health questionnaire (PHQ-9) for psychological assessment. The study included two hundred thirty-four participants; all participants with a chronic disease but not infected with COVID -19 were between 24 and 65 years of age. Residents of the study area were randomly selected. Descriptive statistics and a t-test were used for associations with a p-value of 0.05 or less.ResultsThis study found that anxiety rated by GAD 7 was either mild (18, 7.7%), moderate (98, 41.9%), or severe (41, 17.5%) among participants. PHQ 9-rated depression showed 22 (9.4%) mild depression, most of them in participants aged 36–44 years. Participants with kidney disease showed major depression 11 (42.31%). Factors that significantly affected anxiety scores were age 24–35 years (P =0.002), university graduates (P < 0.000), married (P < 0.000), those with diabetes and hypertension (P =0.041), and urban residents (P < 0.023). Those who had secondary education were married and smoked were significantly more likely to have major depression than those with another educational status (p < 0.05).ConclusionCOVID 19 pandemic had a significant impact on the psyche of uninfected people with chronic diseases in Sudan, and significant associated factors were identified. Unique interventions are strongly recommended to reduce the psychological impact of the COVID 19 pandemic.

Epidemiology and laboratory diagnosis of very virulent infectious bursal disease virus in vaccinated chickens in Khartoum, Sudan.

Background:Infectious Bursal Disease (IBD, Gumboro disease) has become more severe than in early outbreaks in the 1980s. The present research aims to study the epidemiology of IBD in Khartoum state and compare some commonly used laboratory techniques for diagnosis.Method:We collected epidemiological data from 30 farms that showed signs suggestive of IBD, estimated the morbidity and mortality rates, and interviewed the owners about the type and the doses of the used vaccines. We collected bursas of Fabricius for virus assays and histopathology. Samples positive in the agar gel immunodiffusion (AGID) test were inoculated onto chicken embryo fibroblast cell culture and embryonated chicken eggs. Twenty-two-day-old chicks were infected experimentally with three selected isolates, and morbidity and mortality rates were compared.Results:The results showed that 70% of outbreaks occurred between 6 and 8 weeks of age, and the mean mortality rate was 51%. Epidemiologic, clinical, gross, and histopathological findings were characteristic of the severe disease caused by the very virulent IBDvirus (vvIBDV). The farms that used intermediate or the intermediate plus vaccines had lowered mortality compared with the farms that used intermediate vaccines. The AGID was found more sensitive than the counter-immuno-electrophoresis (CIEP) since it detected 83.4% of the IBDV antigen in the samples while the CIEP detected 66.7% of the samples. The reverse transcriptase polymerase chain reaction (RT-PCR) was found to be rapid, specific, and was more sensitive detecting 100% of the tested samples. Virus isolation in embryonated eggs and cell culture was not successful.Conclusion:A vvIBDV is responsible for the recent outbreaks of the disease in Sudan, resulting in a mean high mortality rate of 51%, even in vaccinated flocks. The RT-PCR and AGID are the best methods for laboratory confirmation.

Assessment of Bariatric Surgery Effects on Body Mass Index, Type 2 Diabetes, Hypertension, and Risks for Cardiovascular Diseases in Sudan

Assessment of Bariatric Surgery Effects on Body Mass Index, Type 2 Diabetes, Hypertension, and Risks for Cardiovascular Diseases in Sudan

Role of Leishmanin Skin Test (LST) as Epidemiological Indicator for Cutaneous Leishmaniasis in Al-tragma Village, River Nile State, Sudan

Introduction: Cutaneous leishmaniasis (CL) is a common health problem in the world and its zoonotic form has been reported to occur in Sudan. Leishmaniasis has been considered the second most important parasitic disease after malaria. Therefore, the role of leishmanin skin test (LST) as an epidemiological indicator for CL infection was determined in Al-tragma village, one of the endemic areas for the disease in Sudan. Materials and Methods: In this cross-sectional study, 410 individuals inhabiting Al-tragma village were enrolled. Two methods of data collection were used in this study, a structured questionnaire and LST. A structured questionnaire was designed to collect and test socio-demographic characteristics. The LST was performed by intradermal injection of 0.1 mL of LST antigen on the volar surface of the left forearm. The result of LST was read after 48-72 hours using the ballpoint pen technique. SPSS version 20.0 was used for data analysis. Results: LST results showed that 70.7% of respondents were positive and 29.3% were negative. The most infected age groups were 31–40 years (80%) and more than 40 years (82%). The results showed there was a significant difference in LTS results based on age groups, occupations, domestic animals and pets found in and around the houses, and previous experience of the disease (P &lt; 0.05). Conclusion: The overall positive rate for LST was 70.7%. The exposure duration had no effect on LST results. It seems that the patients acquired long-lasting immunity. LST is still a promising tool for evaluating the epidemiological status of Leishmaniasis in endemic areas.

Management of chronic lung diseases in Sudan and Tanzania: how ready are the country health systems?

BackgroundChronic lung diseases (CLDs), responsible for 4 million deaths globally every year, are increasingly important in low- and middle-income countries where most of the global mortality due to CLDs currently occurs. As existing health systems in resource-poor contexts, especially sub-Saharan Africa (SSA), are not generally oriented to provide quality care for chronic diseases, a first step in re-imagining them is to critically consider readiness for service delivery across all aspects of the existing system.MethodsWe conducted a mixed-methods assessment of CLD service readiness in 18 purposively selected health facilities in two differing SSA health system contexts, Tanzania and Sudan. We used the World Health Organization’s (WHO) Service Availability and Readiness Assessment checklist, qualitative interviews of key health system stakeholders, health facility registers review and assessed clinicians’ capacity to manage CLD using patient vignettes. CLD service readiness was scored as a composite of availability of service-specific tracer items from the WHO service availability checklist in three domains: staff training and guidelines, diagnostics and equipment, and basic medicines. Qualitative data were analysed using the same domains.ResultsOne health facility in Tanzania and five in Sudan, attained a CLD readiness score of ≥ 50 % for CLD care. Scores ranged from 14.9 % in a dispensary to 53.3 % in a health center in Tanzania, and from 36.4 to 86.4 % in Sudan. The least available tracer items across both countries were trained human resources and guidelines, and peak flow meters. Only two facilities had COPD guidelines. Patient vignette analysis revealed significant gaps in clinicians’ capacity to manage CLD. Key informants identified low prioritization as key barrier to CLD care.ConclusionsGaps in service availability and readiness for CLD care in Tanzania and Sudan threaten attainment of universal health coverage in these settings. Detailed assessments by health systems researchers in discussion with stakeholders at all levels of the health system can identify critical blockages to reimagining CLD service provision with people-centered, integrated approaches at its heart.

The epidemiology of autoimmune bullous diseases in Sudan between 2000 and 2016.

Autoimmune bullous diseases vary in their clinico-epidemiological features and burden across populations. Data about these diseases was lacking in Sudan. We aimed to describe the epidemiological profile and to estimate the burden of autoimmune bullous diseases in Sudan. This was a retrospective cross-sectional study conducted at Khartoum Dermatological and Venereal Diseases Teaching Hospital. We used routinely collected health care data, and included all patients with an autoimmune bullous disease who presented to the hospital between 2001 and 2016. Out of the 4736 patients who were admitted to the hospital during the study period, 923 (19.5%) had an autoimmune bullous disease. The average rate of patients at the hospital was 57.7 per year representing 1.3 per 100,000 population per year. After exclusion of patients where the final diagnosis was missing, 585 were included in the further analysis. Pemphigus vulgaris was the most common disease (50.9%), followed by bullous pemphigoid (28.2%), linear IgA disease/chronic bullous disease of childhood (8.4%), and pemphigus foliaceous (8.2%). Pemphigoid gestationis and IgA pemphigus constituted 1.4% and 1.2% of the cohort, respectively. Paraneoplastic pemphigus, mucous membrane pemphigoid, lichen planus pemphigoidis, bullous systemic lupus erythematosus, and dermatitis herpetiformis were rare. None of the patients had epidermolysis bullosa acquisita. The clinico-epidemiological characteristics vary among the types of autoimmune bullous diseases. Females were more predominant in most of them. Sudanese patients tended in general to present at a younger age than other populations. The pool of Sudanese patients with autoimmune bullous diseases is large which requires investigation for the local risk factors and presents a field for future trials.