East Sudan Research Articles

Breast cancer burden in eastern Sudan: seven-year retrospective study.

Breast cancer (BC) is prevalent in Sudan, yet data on its epidemiology in Eastern Sudan is limited. This study aims to provide insights into the demographic and clinicopathologic features of BC patients treated at the East Oncology Centre (EOC) in Gadarif State, Eastern Sudan. Furthermore, we aim to identify the factors that contribute to a late-stage diagnosis. This cross-sectional study included patients diagnosed with BC and treated in the EOC between 2016 and 2022. Data obtained from medical records were analysed using R software, with descriptive statistics and multiple logistic regressions applied to determine determinants of advanced-stage presentation. A p-value < 0.05 was considered statistically significant. Among the 394 patients studied, the majority were women (96%), married (66%) and from rural areas (43%). The peak years for BC diagnoses were 2018 and 2022, with a median age at diagnosis of 48 years. A family history of cancer was reported by 20% of patients. Clinical stages were distributed as follows: I (1.6%), II (17%), III (50%) and IV (32%). Twenty-five percent tested positive for human epidermal growth factor receptor 2, while 73% tested negative and 43% had triple-negative BC. Modified radical mastectomy was performed in 47% of patients, with 21% undergoing breast-conserving surgery. Treatment rates were 38% for radiotherapy, 84% for chemotherapy and 46% for hormonal therapy. Higher grade BC and lower education levels were associated with advanced-stage presentation, while a family history of cancer reduced the risk of advanced-stage disease (OR: 0.38, 95% CI: 0.18-0.78). The study found that females in East Sudan often present at a young age and advanced stage, with a significant prevalence of triple-negative BC. Notably, family cancer history exhibited a protective effect against advanced-stage presentation, while grade 3 cancer was positively associated with advanced disease.

Генезис и динамика развития этнополитического конфликта в Республике Судан

The aim of this article is to investigate the genesis and dynamics of ethno-political conflict in the Republic of Sudan focusing on three main regions: the South, the West, and the East. The study uses various scientific methods such as historical, descriptive, and cognitive approach to analyse the dynamics of ethno-political con-flict in Sudan through identifying the key elements of identity in different societies. Understanding the specificity of local conditions, motives of the conflicting parties’ actions and decision-making on conflict resolution in Su-dan, identifying common causes of ethno-political conflict in South, West and East Sudan, and developing rec-ommendations for conflict resolution in Sudan. The findings of the study highlight the politicisation of religious and ethnic factors as well as fomentation of divisions as one of the major causes of worsening conflicts in the said regions. In addition, the study revealed that conflicts in Sudan have deep historical roots and are driven by complex socio-economic and political factors.

Recurrent urethral obstruction secondary to large vulval inclusion cyst: a remote complication of female genital mutilation: a case report

BackgroundFemale genital mutilation/cutting (FGM/C) is a major public health problem, particularly in developing countries.Case presentationThe authors reported a case of 48-year old multiparous woman presented to Kassala Hospital, east Sudan, with recurrent urine retention resulting from urethral obstruction, which was caused by large vulval inclusion cyst. A traditional birth attendant circumcised her when she was 5 year old. Five years before her presentation the patient observed a painless swelling in her vulva, which was gradually increasing in size. She presented to the hospital with urine retention seeking medical care. Local examination showed a large cystic swelling originating in the circumcision line and covering the introitus. A diagnosis of inclusion cyst at the site of circumcision was made. The cyst was large enough causing bladder outlet obstruction and when the patient advised to tilt it away from the urethral orifice she passed urine without difficulties. The cyst was surgically removed by dissection along the lines of cleavage, which measured 10 × 9.2 cm and weighed 1.2 kg.ConclusionThis case report indicates that FGM is a serious public health problem and there should an urgent intervention such as planned health education campaigns to end FGM practice.

Chemical Composition and Screening of Aflatoxin in Cows’ Milk in Gadarif town, Sudan

Objectives: This study was conducted to analyze milk samples, for chemical composition and detection of aflatoxins M1 in Gedarif town, East Sudan. Methods: One hundred milk samples were collected randomly; 35 samples from farms, 35 samples from sale points and 30 samples from groceries in Gedarif town. Milk-Kana was used for determination of fat, solids not fat, lactose and protein, freezing point, density and added water and Unisensor kits were used as screening method for detection of aflatoxin M1. Results: The collected milk samples showed lower content of fat (3.4 +- 1.3%, 3.4 +- 1.3% and 3.5 +- 1.25%), solids not fat (7.7 +-1.1%, 8.1+-1.7% and 8+-1%), lactose (4.2+-0.6%, 4.4+-0.8% and 4.3+-0.5%) and protein (3+-0.4%, 3+-0.5% and 3+-0.4%). Relatively, the freezing point and density of milk revealed few variations in the examined samples. Moreover, the added water was high in the samples collected from the farms and sale points compared to those from the groceries. The occurrence of aflatoxin M1 was found in 22 (27.50%) of the milk samples. The presence of aflatoxin contamination was high in milk samples collected from sales points (15.0%) followed by farms (11.25%) compared to those obtained from groceries (1.25%). Conclusions: The presences of aflatoxin in the milk samples might indicate that the cow milk was contaminated with aflatoxins through feed. Hence this study recommended that good hygienic practices should be considered in Gadarif town. Similarly, regulations and lows for selling the milk should be implemented by the official authorities.

Incidence of Head and Neck Cancer in East Sudan

This review aims to provide an updated and detailed overview of the incidence of head and neck cancer in the eastern region of Sudan, focusing on studies conducted between 2018 and 2023. It aims to shed light on changes in incidence rates, emerging risk factors, advancements in diagnostic techniques, treatment modalities, and preventive strategies. Accurate knowledge of the latest trends and developments in head and neck cancer incidence is essential for effective public health planning and intervention. One significant aspect that the review highlights is the limited number of head and neck surgeons in East Sudan. It emphasizes the need for specialized training in staging malignancies using head and neck anatomy, as this information is vital for determining appropriate treatment approaches. With a shortage of trained professionals, it becomes even more critical to enhance the anatomic understanding and staging capabilities in order to improve patient outcomes and optimize treatment plans. The review underscores the urgency of addressing this gap in healthcare infrastructure. By increasing the number of head and neck surgeons in East Sudan and providing them with the necessary training, the region can improve its capacity to accurately stage head and neck cancers, leading to more effective treatment decisions and improved patient care. This review provides a comprehensive resource for understanding the current landscape of head and neck cancer incidence in the eastern region of Sudan. It addresses recent trends, emerging risk factors, and the need for improved anatomic understanding and staging capabilities. The findings can guide policymakers, healthcare providers, and researchers in implementing targeted strategies to reduce the burden of head and neck cancer in East Sudan and improve patient outcomes.

Effect of urbanization on East African climate as simulated by coupled urban-climate model

This study examines the effect of urbanization on climate variability over East Africa. Seasonal trend of rainfall and temperature was analyzed using Mann-Kendall trend test and statistically significant rainfall trend is observed during spring (February-May) and summer (June-September) over northeast and spring/“bega”(October-January) seasons in southeastern regions of Ethiopia, thereby suggesting a seasonal shift of rainfall distribution. The temperature trend showed significant warming in the simulated field, except in central East Sudan, where there has been a significant decline. A numbers of idealized sensitivity experiments have been conducted with the Regional Climate Model (RegCM4.6) to investigate the contribution of urbanization to the East African region climate variability and trend. Model assessment against observed climate variables showed good performance in the simulation of spatial and temporal variability of regional climate variables. The results of the sensitivity experiment by prescribing different urban environments (tall building district (TBD), high density (HD), medium density (MD) and original land use) for the surface scheme (CLM4.5) reveal statistically significant impacts of urbanized surfaces on surface temperatures and precipitation due to variations in energy budget, local circulation and disturbance of hydro meteorological variables. It is noted that TBD urban environment has a higher impact on the local climate than other urban environments. Patterns of seasonal rainfall variability simulated using artificially urbanized land cover suggests involvement of complex interactions and is less similar to the observed rainfall trend, while surface temperature variability is significantly affected by local land-cover change and is very similar to the observed surface temperature trend.

Tokens of Peace? Women’s Representation in the Juba Peace Process

This article evaluates women’s representation in the 2019–20 peace negotiations and the extent to which their interests are reflected in the Juba Peace Agreement. With East Sudan as a case study, this article explores women peacebuilders’ experiences at and around the peace table in Juba. Building on interviews conducted in 2021, this article argues that women’s inroads to the peace negotiations were tokenistic. Women’s substantive representation was hampered by the structure of the peace talks, which were divided into different geographical tracks. In a patriarchal context such as the East, this track model did not provide a de facto political space for women to exercise meaningful influence. As cultural norms in this region domesticate women, the women from the East did not enter the talks with a political track record and they were isolated from important support networks. Added to that, the article suggests further that tokenistic inclusion may even lead to backlash effects as female negotiators have to bear the responsibility for a peace agreement that resulted in tribally charged conflict.

Population Genetic Analysis of Aedes aegypti Mosquitoes From Sudan Revealed Recent Independent Colonization Events by the Two Subspecies.

Increases in arbovirus outbreaks in Sudan are vectored by Aedes aegypti, raising the medical importance of this mosquito. We genotyped 12 microsatellite loci in four populations of Ae. aegypti from Sudan, two from the East and two from the West, and analyzed them together with a previously published database of 31 worldwide populations to infer population structure and investigate the demographic history of this species in Sudan. Our results revealed the presence of two genetically distinct subspecies of Ae. aegypti in Sudan. These are Ae. aegypti aegypti in Eastern Sudan and Ae. aegypti formosus in Western Sudan. Clustering analysis showed that mosquitoes from East Sudan are genetically homogeneous, while we found population substructure in West Sudan. In the global context our results indicate that Eastern Sudan populations are genetically closer to Asian and American populations, while Western Sudan populations are related to East and West African populations. Approximate Bayesian Computation Analysis supports a scenario in which Ae. aegypti entered Sudan in at least two independent occasions nearly 70–80 years ago. This study provides a baseline database that can be used to determine the likely origin of new introductions for this invasive species into Sudan. The presence of the two subspecies in the country should be consider when designing interventions, since they display different behaviors regarding epidemiologically relevant parameters, such as blood feeding preferences and ability to transmit disease.

Assessment of the Genetic Diversity of Some Female Jojoba (Simmondsia chinensis (Link) Schneider) Genotypes Growing in the Semi-arid Highlands of Sudan using ISSR Markers

The knowledge of genetic diversity of a crop like Jojoba, a commercially grown plant to produce unique liquid oil from its seed, is essential in a breeding program aiming to the development of elite genotypesfor large-scale production. This study was carried out to evaluate the genetic diversity of 25 female jojoba genotypes growing in Arkaweet Area, East Sudan, using ISSR Markers. Genomic DNA was extracted from leaves of thestudied genotypes and quantified for PCR amplification. Five ISSR primers were used for PCR amplification to investigate the genetic diversity among the female jojoba genotypes. ISSR primers showed high polymorphic pattern and produced a total of 54 polymorphic bands with an average of 10.8 polymorphic bands per primer. The average of polymorphic information content (PIC) value of 0.37 indicates moderate polymorphism. The geneticdiversity ranged from 0.01 to 0.85. The results indicate the effectiveness of using ISSR molecular markers to reveal genetic variability among the studied female jojoba genotypes, a finding that could be used for development ofelite jojoba genotypes, which provide potential for large-scale jojoba production in Sudan.

The impacts of climate change on displaced populations: A call for action

Climate change is impacting the life, health, and security of people worldwide with poor communities and displaced populations at particular risk due to lack of awareness and mitigation plans. The Tigray war in Ethiopia has forced thousands of refugees to flee and seek safety and shelter in Sudan. We investigated the impacts of climate change on this displaced population with a focus on the conditions experienced by Ethiopian humanitarian refugees who fled from the Tigray war in Ethiopia and settled in the Gedaref state, East Sudan. We analyzed data regarding the displaced population and climate-related weather effects in Sudan. Sudan is currently hosting over 63 thousand Ethiopian refugees who arrived between November 2020 and April 2021. These refugees were exposed to severe weather conditions including heavy rains, strong storms, severe floods, and heat waves which resulted in over 50% loss of their shelters and belongings, and around two thousand latrines were destroyed. Furthermore, an outbreak of Hepatitis E virus is ongoing among refugees with nearly one thousand cases reported. Massive and routine vaccination campaigns were launched to avoid the spread of locally transmitted diseases among the refugees including COVID-19, polio, cholera, and measles. The living conditions and lack of reliability of essential services among the displaced populations are increasing their vulnerability to the negative impacts of climate change on their life, health, and security. We recommend incorporating a mitigation and adaptation plan to climate change into humanitarian response plan and strategies, including raising awareness and training, in order to prepare a well-developed contingency plan that takes these factors into account.

Price Adjustments in the Sudanese Construction Industry for Public-funded projects

In recent years Sudan suffers from deterioration in the economy. There are three financial legislations issued from the Government of Sudan between Nov 2016 and Oct 2018. These legislations have led to increase in prices of all goods and materials especially construction materials that lead many contracting companies to submit claims demanding for adjustment of prices. This paper documents effort by the Government of Sudan (GoS) to address price adjustments for public-funded projects affected by the mentioned legislations. It also validates some data submitted by the contractors to examine the adjustment through a technical committee established for that purpose. Furthermore, the GoS has introduced a program to build the capacity of all involved parties in the construction industry to calculate price adjustments. This paper compares some data submitted by some contractors for three projects in east Sudan (Qadarif), West Sudan (Zalingei) and central Sudan (Khartoum) that have been approved by consultants with prices of materials obtained from an independent third party the in Khartoum. The results of the comparison are found that some increase in material follows the prices of the (USD) dollar as reinforcement and some local material increase in price due to other reasons like fees of transportation. Also, when comparing prices in different states in Sudan, there are differences in some material depending on the distance from Khartoum and the availability of the materials in the states like local materials as aggregates and red bricks.

Outbreak of kala azar: our experience in South Sudan

Background: Worldwide kala azar affects around 500,000 people every year with at least 50,000 deaths annually. Gedaref state in east Sudan is the epicentre of visceral leishmaniasis in east Africa. Objectives of this study were to describe the outbreak of kala azar in South Sudan, from August 2009 to July 2010, in terms of person and time distribution and to describe the outbreak of kala azar in South Sudan, from August 2009 to Jul 2010, in terms of frequency of various clinical features and outcomeMethods: A prospective cross-sectional descriptive study conducted at South Sudan with cases of kala azar affected during an outbreak in South Sudan from August 2009 to July 2010. Statistical analysis was percentage.Results: This outbreak indicates the emergence or re-emergence of kala azar in South Sudan. Within the restrictions on movement because of the civil war, further research is needed to investigate the extent of the transmission zone and whether other populations in South Sudan have been infected and have no access to treatment.Conclusions: There is lack of awareness regarding dog bite and its management among the rural population.

Leishmania donovani infection in Eastern Sudan: Comparing direct agglutination and rK39 rapid test for diagnosis-a retrospective study

Objective: To compare diagnostic accuracy and agreement between direct agglutination test and rK39 rapid tests for diagnosis of visceral leishmaniasis in an endemic area, the Doka area in Eastern Sudan. Methods: Stored sera of confirmed visceral leishmaniasis cases, unconfirmed visceral leishmaniasis-suspects and negative controls were tested by direct agglutination test and rK39 rapid test. The sera were collected from the Doka area in Eastern Sudan. Diagnostic accuracy of direct agglutination test and rK39 rapid test was assessed in terms of sensitivity, specificity, positive predictive value and negative predictive value, estimated at 95% confidence interval (CI). Agreement between the two tests was determined by the kappa (κ) value. Results: Taking lymph node aspiration of Leishmania as a gold standard, direct agglutination test showed 91.0% sensitivity, 99.3% specificity, resulting in a positive and negative predictive value of 99.3% and 91.0%, respectively. In contrast, the sensitivity of rK39 rapid test was 85.2% and specificity 98.6%, resulting in a positive and negative predictive value of 98.5% and 85.9%, respectively. Most (81.3%) of the confirmed visceral leishmaniasis sera revealed strong antibody titers (≥1:6 400). Some sera (n=5) that were positively tested with rK39 rapid test were negative in direct agglutination test (≤1:800); in contrast, direct agglutination test was positive in 12 confirmed visceral leishmaniasis sera that were negatively tested with rK39 rapid test. There was moderate to good agreement between direct agglutination test and rK39 rapid test for confirmed visceral leishmaniasis patients (κ=0.42, 95% CI=0.21-0.63) and control sera (κ=0.80, 95% CI=0.41-1.00). Conclusions: Both direct agglutination test and rK39 rapid test are satisfactory test systems for visceral leishmaniasis diagnosis in East Sudan. Their simplicity makes them ideal for first healthcare in rural areas. These data are relevant also for other East African endemic countries because of the geographical and overlapping distribution of the Leishmania parasite.

Prevalence and identification of arthropod-transmitted viruses in Kassala state, Eastern Sudan

ABSTRACTVector-borne diseases are responsible for more than 20% of the infectious diseases worldwide. The prevalence of arboviruses transmit diseases to humans in Sudan has not been investigated. Mosquito-borne viral diseases increase globally incidence, including the Sudan. Frequent unknown fever outbreaks have been reported in eastern region, Sudan. However, diagnosis was based exclusively on clinical signs and symptoms without confirmatory laboratory investigations. However, for accurate detection of these viruses in outbreaks, molecular technique is considered. The objective of this study was to determine the prevalence of six arboviruses in the Kassala state of east Sudan during unknown fever outbreak. A cross sectional hospital-based study was conducted in the Kassala, Teaching Hospital. Blood samples from 119 patients suffering from unknown fever were used for screening of six arboviruses, hepatitis E virus and malarial using molecular techniques and serology. The overall arboviruses seroprevelance was 61.3% (73/119). The highest positivity rate was 73.1% (52/73) chikungunya virus; 29 males and 20 females patients were chikungunya positive. Other arboviruses were circulating in low rate 20.5% (15/73), and 6.8% (5/73) for sindbis and rift valley fever viruses respectively. Hepatitis E virus was negative in all cases and malaria positivity rate 13.4% (16/119). The prevalence of arboviruses among unknown fever patients present to Kassala teaching hospital of eastern region in Sudan is significantly high (61.3%). The chikungunya virus is the predominant causative agent of arboviruses. Molecular techniques such as PCR are important for accurate and rapid diagnosis of this viral outbreak.

Archaeobotanical Investigation of Charred and Desiccated Fruit Stones and Seeds from Late Holocene Contexts in Kassala and its Environs: Window to Past Ecology and Subsistence

With the aim of reconstructing the Late Holocene palaeoenvironment and vegetation history of Kassala and its environs, archaeobotanical investigation was conducted on charred and desiccated fruit stones and seeds. These botanical remains were recovered by dry screening from various contexts in three excavation squares. The excavations were conducted by the Italian Archaeological Expedition in East Sudan (IAEES) at the site of Mahal Teglinos, Kassala, northeast Sudan in the years 1991, 2013 and 2014. Identification and comparative study was conducted in the laboratories of Addis Ababa University and the Bio-archaeological Research Center of the National Museum of Oriental Art, Rome. A total of 1771 (n=1771) charred and desiccated fruit stones and seeds are identified belonging mainly to five species: Adansonia digitata, Ziziphus spina-christi, Celtis integrifolia, Vigna unguiculata and Grewia bicolor. The botanical remains are dated to the early second millennium BC when the area was populated by several Gash Groups (along the Mereb river). The identification of the macrobotanical remains indicated that the site of Kassala and the Ethio-Eritrean and Sudanese low-lying border region was characterized by semi-arid and sub-humid tropical environmental conditions by the Late Holocene. Keywords: fruit stones, seeds, semi-arid, Late Holocene, Eritrea-Sudanese border

Adaptive migration: pluralising the debate on climate change and migration

The interaction between environmental change and human mobility is attracting global attention, both in policy circles and in the contemporary literature. This introductory essay proposes using the concept of pluralism to explore the multi‐dimensional relationship between climate change and migration and to advance new perspectives and concepts to interpret the emerging theory of adaptive migration. The papers included in this themed section cover diverse issues in this area of research by focusing on the contemporary debate about the ‘migration‐as‐adaptation strategy’. The papers address six key areas: the role of law in dealing with climate‐induced migration, the category of place related to the community of origin and destination, the theme of climate justice and rights, the contribution of international organisations in framing the migration‐as‐adaptation strategy, adaptive measures developed in the Maldives, and seasonal nomadism in the East Sudan. All are quite different, but all converge in their emphasis on the role of the individual, the migrant, and on whether and how state responses are adequate in the progressive concordance between adaptation and individual capability. This introduction raises a set of salient questions that might catalyse multiple new research trajectories over the coming years.

Mapping the pastoral migratory patterns under land appropriation in East Sudan: the case of the Lahaween Ethnic Group

The loss of about 4 million ha of land in East Sudan to mechanised rain‐fed agriculture severely restricts pastoral mobility, as much of this land is the traditional rangeland for different transhumant pastoralists and smallholder farmers in the area. The aim of this paper is to map the current transformations of the migration patterns of transhumant pastoralists in East Sudan as a result of the land appropriation, by taking the Lahaween ethic group as an example. The paper followed a mixed approach of mapping, geo‐coded field trips using GPS device, focus group discussion and key informant interviews. The findings showed that the annual movement of the Lahaween covers approximately 350 km. They spend 77% of their annual cycle in the summer areas. Frequent and rapid herd movement is a principal strategy in the process of coping with land appropriation. Other coping and adaptation mechanisms taken by the Lahaween included separation of animal types; separation of herds from households; fragmentation of households; use of vehicles and mobile phones in managing herds; entering the national game park; and crossing the international border. The need to promote and facilitate livestock mobility is a longstanding claim in the region. However, the continued neglect of livestock movement territories by state planners is a contested issue which might add a new dilemma of conflict to the country. The mapping exercise presented in this paper is expected to offer a technical guide for solving the problem of congested mobility. It also provides decision‐makers with the current territories of pastoralists' movements.

The Effect of Breed on Skin/Leather Quality of Sudan Desert Sheep

This study was carried out to estimate the effect of Sudan Desert sheep breed variations on skin\leather quality. Five Sudan desert sheep breeds on an average age of 1-1.2 years were selected for the study. One hundred and fifty (150) pieces of fresh skins from five non-castrated male of Sudan desert breeds were collected from west Sudan (Kordofan state) and east Sudan (Gezira and Butana). The results showed that, Fresh skin weight, elongation, tensile strength , flexibility, cracking and tear load results were significantly affected (P ≥ 0.05) by breed variations. Thickness findings were not significantly affected (P ≥ 0.05) by breed. Moisture, fat and chrome oxide contents findings were significantly affected (P ≥ 0.05) by breed. Whereas, Ash content values were not significantly affected (P ≥ 0.05) by breed variations.

Maternal and perinatal outcomes of uterine rupture in the Kassala Hospital, east Sudan: 2006–2009

Medical files of patients with ruptured uterus during 2006–2009 at the Kassala Hospital, east Sudan were reviewed. Of 13,569 deliveries, there were 28 cases of ruptured uterus (two per 1,000 deliveries). The majority of these patients had parity ≥5 (53.5%), were illiterate (82.1%), rural residence (75%) and unbooked (92.8%). The identified causes of ruptured uterus were: obstructed labour (50%), previous caesarean section (32.1%). Caesarean hysterectomy was carried out in (39.3%), repair in (32.2%) and repair with tubal ligation in (28.5%). There was 14.3% and 92.8% maternal and perinatal mortality, respectively. A total of 21.4% and 7.14% developed sepsis and vesicovaginal fistulae, respectively.

Cardiac Autonomic Dysfunction in Children and Adolescents with Type 1 Diabetes Mellitus

Introduction: Autonomic neuropathy is less well documented in children with type 1 diabetes mellitus and has received less attention than other diabetic complications. Sudden death and cardio-respiratory arrest in patients with type 1 and type 2 diabetes mellitus have been attributed to cardiac autonomic dysfunction. Aim: The aim of this study was to determine the prevalence of autonomic neuropathy in a cohort of children and adolescents with type I diabetes and to examine the relationship between this complication, and duration of diabetes and degree of glycemic control. Material and Methods: Seventy-six type 1 diabetic children and adolescents below age 18 years of age, and 76 nondiabetic school children, matched for age and sex, had their cardiac autonomic nerve function assessed using four autonomic function tests. Namely the respiratory sinus arrhythmia test ; the Valsalva ratio test; the heart rate response to standing, and the blood pressure response to standing. The first three are tests of parasympathetic function, while the last one is a sympathetic function test. Results: The diabetic patients had a median age of 12 years and their median duration of diabetes mellitus was 43 months. They showed a significantly higher resting heart rate and a significant drop in systolic and diastolic blood pressures upon standing compared to the control group. The duration of diabetes mellitus showed linear correlation to the symptoms of autonomic dysfunction. Conclusion: We conclude that cardiac autonomic neuropathy is not rare in young diabetic patients of relatively short duration of illness where glycemic control is less than optimal. Such tests may serve as long-term prognostic indicators in diabetic patients.Keywords:autonomic neuropathy, peripheral neuropathy, glycemic control, Middle East Sudan Journal of Medical Sciences Vol. 2 (2) 2007: pp. 95-100