Sero-molecular Epidemiology of Hepatitis E Virus in Blood Donors, Gezira State, Sudan: A Cross-sectional Study

Background: Hepatitis E virus (HEV) is a hepatotropic pathogen that causes significant morbidity and mortality in humans. It is an important causative agent of viral hepatitis outbreaks. This study investigates the serological and molecular prevalence of HEV in blood donors attending the Central Blood Bank in Wad Medani City in Gezira State, Sudan. Methods: The study adopted a cross-sectional descriptive design. A structured questionnaire was used to collect data concerning demographic information and risk factors associated with HEV transmission. All enrolled participants (N = 300) were screened for HEV IgG antibodies using commercial ELISA kits, then strong positive samples (N = 84) were selected and rescreened for HEV IgM and HEV RNA by RT PCR. SPSS version 24.0 was used for analysis. Results: Out of 300 male participants, 36.3% (109/300) were positive for HEV IgG. However, only one participant was IgM positive, while the HEV RNA was negative. The highest prevalence rates of the virus were 42 (44.6%) among the age group of 31–40 years, 20 (48.8%) in those who consumed food from outside, 13 (50%) in three to four multiple blood donations, and 5 (62.5%) in those who consumed water from the river source. A significant association of HEV IgG prevalence concerning the occupation of the participants being students or farmers was detected using univariate and multivariate analysis (P-value = 0.007). Conclusion: High prevalence of HEV IgG was demonstrated among the healthy blood donors in this study. Given the possibility of HEV transmission by transfusion from donors to recipients, we recommend that routine screening for HEV should be adopted by blood banks in Sudan

Epidemiology of strongyle nematode infections and first report of benzimidazole resistance in Haemonchus contortus in goats in South Darfur State, Sudan

Background Since pastoralists in South Darfur, Sudan, had complained about lack of albendazole (ABZ) efficacy to control nematodes in goats, the frequency of infection with gastrointestinal helminths was studied before in vivo faecal egg count reduction tests (FECRT) were conducted using ABZ orally either at the dose recommended for sheep, 5 mg/kg body weight (bw) or at 10 mg/kg bw. Experiments included goats naturally infected with gastrointestinal nematodes or experimentally infected with local Haemonchus contortus isolates. Three study areas (Nyala, Beleil and Kass) were visited in autumn or winter. Results Out of 478 screened goats, 82.4% were infected with gastrointestinal helminths and 82% were shedding eggs of strongyle nematodes with 90% of the strongyle larvae representing Haemonchus spp. A FECRT using naturally infected goats (n = 225: 71 untreated, 104 and 50 treated with 5 and 10 mg ABZ/kg bw, respectively) detected reduced ABZ efficacy in Nyala and Kass. Paired and unpaired FECRT calculations detected reductions of 72–92% with samples taken at 8 days post treatment with 5 mg ABZ/kg bw and of 85–94% with 10 mg ABZ/kg bw. The FECRT based on day 14 post treatment samples showed reductions of 69–77% with 5 mg/kg and of 75–87% with 10 mg ABZ/kg bw. In Beleil, ABZ efficacy was 95%. In the egg hatch test EC50 values for Nyala and Kass ranged from 0.12–0.24 μg thiabendazole/ml, corresponding to benzimidazole resistant phenotypes. Only Haemonchus spp. larvae were present after treatments in coprocultures. When the efficacy was evaluated experimentally using isolates of H. contortus from Nyala and Kass, the 5 mg ABZ/kg dose revealed reductions of 76–78% on day 8 and of 62–70% on day 14 with the unpaired method. Using 10 mg ABZ/kg, the FECR was still only 77–82%. Conclusions Both, in vivo and in vitro methods detected resistant H. contortus populations in goats from South Darfur State. The time point 14 days post treatment was more sensitive for detection of ABZ resistance than 8 days post treatment. This is the first report on the occurrence of anthelmintic resistance in Sudan confirming that anthelmintic resistance selection is occurring in African subsistence farming systems

Impact of Sever Plasmodium falciparum infection on Platelets Parameters among Sudanese children Living in Al-Jazira State

Background: Falciparum malaria remains one of the most global infection among children particularly in communities with poor resources. Falciparum malaria associated with several hematological changes that affect the major blood cell lines such as platelets lead to platelets parameters (platelets count and indices) abnormalities. Objectives: The aim of this study was to evaluate the effects of falciparum malaria on platelets parameters (platelets count and indices) among Sudanese children. In addition to study relationships and correlation between platelets parameters and malaria parasitemia and parasite count. Materials and Methods: A case control study was conducted in Wad Medani Pediatric Hospital in collaboration with Faculty of Medical laboratory Sciences, University of Gezira, Sudan among 100 children with severe falciparum malaria (mean age 8.63 ± 3.40 years; 61% males), 100 children with uncomplicated falciparum malaria (mean age 8.83 ± 4.20 years; 45% males) and 100 children with normal healthy children controls (mean age 10.08 ± 3.58 years; 50% males). Parasitemia and parasite count (%) was determined directly from thick and thin blood films respectively. The platelets parameters (platelets count and indices) measured by using Sysmex XP 300 N automated analyzer, and platelets count was confirmed and assessed using stained thin blood film. SPSS software (V 20.0) and Stat disk software (V 13.0) were used for data analysis. Results: 72 % of severe falciparum malaria (SM) have hyperparasitemia, while 18 % among uncomplicated falciparum malaria (UM). The thrombocytopenia account for 43 % (SM: 30.5 %; UM: 12.5 %), low PCT account for 35.5 % (SM: 27 %; UM: 8.5 %) and high PDW account for 46.5 % (SM: 23.5 %; UM: 23 %) in falciparum malaria cases. The mean PLTs count and PDW were statistically significantly differences between falciparum malaria cases and normal healthy control (P value 0.000 and 0.008 respectively). The mean PLTs count and PCT in severe falciparum malaria cases were lower than uncomplicated falciparum malaria cases (P value 0.005 and 0.000 respectively). The PLTs count and PCT had significant negative correlation within malaria parasitemia (P value 0.000; r -0.286; P value 0.004; r -0.205 respectively) and malaria parasite count (P value 0.000; r -0.450; P value 0.000; r -0.270 respectively). Conclusion: The study concluded that thrombocytopenia, low PCT and high PDW were observed as most platelets parameters changes in falciparum malaria. PLTs count along with PCT to be recommended as hematological diagnostic markers and prognostic tool to assess the disease severity and to improve the management of falciparum malaria among patients

Direct Extraction and Assessment of Genomic DNA of Mycetoma Fungi from Black-grains Specimen

Background: Direct isolation of genomic DNA of mycetoma fungi from black-grains achieve rapid diagnosis and may overcome culture disadvantages. Objectives: This study aimed to isolate and assess the DNA of mycetoma fungi using black-grains and to apply amplification of ITS region and nucleotide sequences. Methods: CTAB method was followed by manual homogenization alternatively to liquid nitrogen and glass beads disruption to obtain the genomic DNA. Results: Yielded DNA concentrations vary from 1.50 to 47.97 μg/ml (mean 10.09 μg/ml) while the optimum DNA purity recorded with 75.8% of specimens (n=69/91).Successful amplification of ITS region was done using pan-fungal primers (ITS4/5) with 90.1 (n=82/91)percentage. Species nucleotide sequences were detected with 67 (94.4%) amplicons from a total of 71.Conclusion: The study recommended using of black-grain specimens for DNA extraction of mycetoma fungi parallel with culture to insure rabid diagnosis and identification

Procjena anthelmintičke učinkovitosti pripravaka albendazola i ivermektina u magaraca u Darfuru u Sudanu

The therapeutic efficacies of albendazole and ivermectin drench formulation at the manufacturer’s recommended dose were evaluated in a controlled trial in Nyala town, South Darfur State, Sudan. The study involved 24 donkeys naturally infected with gastrointestinal nematodes; they were divided into four groups of equal size. Albendazole was administered orally once at a dose rate of 10 mg/kg body mass, or twice, 14 days apart at dose rate of 10 mg/kg body mass. Ivermectin was administered orally as a single dose at 200 μg/kg body mass. Treatment efficacy was based on the mean faecal egg count reduction 14 days post treatment. A faecal egg count reduction of 100% was found after treatment with albendazole and ivermectin. In addition efficacy percentages of albendazole and ivermectin against immature and adult nematodes were as follows: Trichostrongylus axei 67.09% and 100%, Parascaris equorum 100% and 100%, Oxyuris equi 100% and 100%, Strongylus sp. 98.4% and 100%; and small strongyles 100% and 100%. Albendazole single and twice and ivermectin with the single dose showed moderate efficacy (33%, 59.08% and 62.71%, respectively) against larvae found in the cranial mesenteric artery aneurisms. No adverse reactions were observed in treated donkeys during the experiment period.Učinkovitost pripravaka albendazola i ivermektina u preporučenoj dozi istražena je u kontroliranom pokusu provedenom na magarcima u gradu Nyala u južnom Darfuru u Sudanu. Istraživanje je obuhvatilo 24 magarca prirodno invadirana želučanocrijevnim oblićima. Magarci su bili ravnomjerno raspoređeni u četiri skupine te peroralno liječeni albendazolom u dozi od 10 mg/kg tjelesne mase jednokratno ili dvokratno u razmaku od dva tjedna. Ivermektinom su liječeni peroralno i to jednokratno u dozi od 200 mg/kg tjelesne mase. Ljekovit učinak bio je određen na temelju smanjenja broja jaja u izmetu dva tjedna nakon liječenja. Dokazano je bilo 100%-tno smanjenje broja jaja nakon liječenja obama pripravcima. Učinkovitost je bila dokazana i postmortalnom parazitološkom pretragom i to prebrojavanjem nezrelih i odraslih oblića. U liječenih životinja ustanovljeno je 67,9% manje nezrelih te 100% manje odraslih oblića Trichostrongylus axei. Stopostotna učinkovitost bila je dokazana za nezrele i za zrele obliće Parascaris equorum, Oxyuris equi te male strongilide. Nešto manja učinkovitost (98,4%) bila je dokazana za nezrele obliće Strongylus sp. Kombinacija jednokratnoga i dvokratnoga davanja albendazola s jednokratnim davanjem ivermektina pokazala je prosječno dobru učinkovitost (33%, 59,08% i 62,71%) protiv ličinki u aneurizmama na području kranijalne mezenterijske arterije. U magaraca nisu bile primijećene nikakve nuspojave nakon primjene lijekova

Impact of Sever Plasmodium falciparum infection on Platelets Parameters among Sudanese children Living in Al-Jazira State

Background: Falciparum malaria remains one of the most global infection among children particularly in communities with poor resources. Falciparum malaria associated with several hematological changes that affect the major blood cell lines such as platelets lead to platelets parameters (platelets count and indices) abnormalities. Objectives: The aim of this study was to evaluate the effects of falciparum malaria on platelets parameters (platelets count and indices) among Sudanese children. In addition to study relationships and correlation between platelets parameters and malaria parasitemia and parasite count. Materials and Methods: A case control study was conducted in Wad Medani Pediatric Hospital in collaboration with Faculty of Medical laboratory Sciences, University of Gezira, Sudan among 100 children with severe falciparum malaria (mean age 8.63 ± 3.40 years; 61% males), 100 children with uncomplicated falciparum malaria (mean age 8.83 ± 4.20 years; 45% males) and 100 children with normal healthy children controls (mean age 10.08 ± 3.58 years; 50% males). Parasitemia and parasite count (%) was determined directly from thick and thin blood films respectively. The platelets parameters (platelets count and indices) measured by using Sysmex XP 300 N automated analyzer, and platelets count was confirmed and assessed using stained thin blood film. SPSS software (V 20.0) and Stat disk software (V 13.0) were used for data analysis. Results: 72 % of severe falciparum malaria (SM) have hyperparasitemia, while 18 % among uncomplicated falciparum malaria (UM). The thrombocytopenia account for 43 % (SM: 30.5 %; UM: 12.5 %), low PCT account for 35.5 % (SM: 27 %; UM: 8.5 %) and high PDW account for 46.5 % (SM: 23.5 %; UM: 23 %) in falciparum malaria cases. The mean PLTs count and PDW were statistically significantly differences between falciparum malaria cases and normal healthy control (P value 0.000 and 0.008 respectively). The mean PLTs count and PCT in severe falciparum malaria cases were lower than uncomplicated falciparum malaria cases (P value 0.005 and 0.000 respectively). The PLTs count and PCT had significant negative correlation within malaria parasitemia (P value 0.000; r -0.286; P value 0.004; r -0.205 respectively) and malaria parasite count (P value 0.000; r -0.450; P value 0.000; r -0.270 respectively). Conclusion: The study concluded that thrombocytopenia, low PCT and high PDW were observed as most platelets parameters changes in falciparum malaria. PLTs count along with PCT to be recommended as hematological diagnostic markers and prognostic tool to assess the disease severity and to improve the management of falciparum malaria among patients

Procjena anthelmintičke učinkovitosti pripravaka albendazola i ivermektina u magaraca u Darfuru u Sudanu

The therapeutic efficacies of albendazole and ivermectin drench formulation at the manufacturer’s recommended dose were evaluated in a controlled trial in Nyala town, South Darfur State, Sudan. The study involved 24 donkeys naturally infected with gastrointestinal nematodes; they were divided into four groups of equal size. Albendazole was administered orally once at a dose rate of 10 mg/kg body mass, or twice, 14 days apart at dose rate of 10 mg/kg body mass. Ivermectin was administered orally as a single dose at 200 μg/kg body mass. Treatment efficacy was based on the mean faecal egg count reduction 14 days post treatment. A faecal egg count reduction of 100% was found after treatment with albendazole and ivermectin. In addition efficacy percentages of albendazole and ivermectin against immature and adult nematodes were as follows: Trichostrongylus axei 67.09% and 100%, Parascaris equorum 100% and 100%, Oxyuris equi 100% and 100%, Strongylus sp. 98.4% and 100%; and small strongyles 100% and 100%. Albendazole single and twice and ivermectin with the single dose showed moderate efficacy (33%, 59.08% and 62.71%, respectively) against larvae found in the cranial mesenteric artery aneurisms. No adverse reactions were observed in treated donkeys during the experiment period.Učinkovitost pripravaka albendazola i ivermektina u preporučenoj dozi istražena je u kontroliranom pokusu provedenom na magarcima u gradu Nyala u južnom Darfuru u Sudanu. Istraživanje je obuhvatilo 24 magarca prirodno invadirana želučanocrijevnim oblićima. Magarci su bili ravnomjerno raspoređeni u četiri skupine te peroralno liječeni albendazolom u dozi od 10 mg/kg tjelesne mase jednokratno ili dvokratno u razmaku od dva tjedna. Ivermektinom su liječeni peroralno i to jednokratno u dozi od 200 mg/kg tjelesne mase. Ljekovit učinak bio je određen na temelju smanjenja broja jaja u izmetu dva tjedna nakon liječenja. Dokazano je bilo 100%-tno smanjenje broja jaja nakon liječenja obama pripravcima. Učinkovitost je bila dokazana i postmortalnom parazitološkom pretragom i to prebrojavanjem nezrelih i odraslih oblića. U liječenih životinja ustanovljeno je 67,9% manje nezrelih te 100% manje odraslih oblića Trichostrongylus axei. Stopostotna učinkovitost bila je dokazana za nezrele i za zrele obliće Parascaris equorum, Oxyuris equi te male strongilide. Nešto manja učinkovitost (98,4%) bila je dokazana za nezrele obliće Strongylus sp. Kombinacija jednokratnoga i dvokratnoga davanja albendazola s jednokratnim davanjem ivermektina pokazala je prosječno dobru učinkovitost (33%, 59,08% i 62,71%) protiv ličinki u aneurizmama na području kranijalne mezenterijske arterije. U magaraca nisu bile primijećene nikakve nuspojave nakon primjene lijekova

Djelotvornost ivermektina kao injekcijske otopine protiv želučano-crijevnih oblića magaraca (Equus asinus).

The efficacy of Ivermectin was evaluated under field conditions at Nyala town, South Darfur State, Sudan. The study involved 16 donkeys. Ivermectin was administered by intramuscular injection at dose of 0.2 mg/kg in the lateral mid- line of the neck. Treatment efficacy was based on the mean faecal egg count reduction 14 days post treatment. A faecal egg count reduction of 100% was found after treatment with Ivermectin. In addition efficacy percentages of Ivermectin against immature and adult nematodes were as follows: Trichostrongylus axei 100%, Parascaris equorum 100%, Oxyuris equi 100%, Triodontophorus sp. 100%, Strongylus sp. 100%, and small strongyles 100%. Two of the control donkeys were infected with Strongylus vulgaris larvae. Ivermectin showed moderate efficacy (69.23%) against larvae found in the mesenteric artery aneurisms. No adverse reactions were observed during the experimental period.Procjenjivana je djelotvornost ivermektina u terenskim uvjetima u gradu Nyala, Južni Darfur, Sudan. Istraživanje je provedeno na 16 magaraca. Ivermektin je bio primijenjen intramuskularnim injekcijama u dozi od 0,2 mg/kg u lateralnu stranu vrata. Ocjena učinkovitosti lijeka provedena je na temelju smanjenja ukupnog broja jaja u fecesu 14 dana poslije liječenja. Ukupni broj jaja u fecesu smanjio se za 100% poslije primjene ivermektina. Nadalje, postotci djelotvornosti ivermektina protiv nezrelih i adultnih stadija oblića bili su: Trichostrongylus axei 100%, Parascaris equorum 100%, Oxyuris equi 100%, Triodontophorus sp. 100%, Strongylus sp. 100% i mali strongilidi 100%. Dva kontrolna magarca bila su invadirana ličinkama Strongylus vulgaris. Ivermektin je bio umjereno djelotvoran (69,23%) protiv ličinki nađenih u aneurizmama mezenterijalnih arterija. Tijekom pokusa nisu zamijećene štetne posljedice liječenja

Evaluation of Imprint Cytology of Endoscopic Gastric Mucosa Biopsy in the Diagnosis of Helicobacter pylori Infection

Background:Helicobacter pylori colonization of the gastric mucosa is associated with the pathogenesis of gastritis, peptic ulcer disease, and gastric malignancy. There are several methods to detect the presence of Helicobacter pylori.These tests include noninvasive method (serology, urea breath test, or stool antigen test) and invasive methods, such as, culture, histological examination, and rapid urease test. Method:This descriptive prospective cross sectional study was conducted in Gezira state in Wad Madeni from March - August 2016;it aimed to determine the sensitivity, specificity, positive (PPV), and negative predictive values (NPV) of imprint cytology in the detection of H. pylori compared with stool Ag test. H.pylori stool Ag test was done for 50 clinically suspected patients for H.pylori infection and one gastric biopsy from each patient was collected during endoscopy. Air-dried imprint smears of gastric biopsies were stained by the Diff-Quik method and examined for H.pylori. The presence of inflammation and intestinal metaplasia were documented. Results: The H. pylori prevalence was 38% by stool Ag test and 42% by imprint cytology. The sensitivity and specificity of imprint cytology in the detection of H. pylori were 89.5% and 87.1% respectively. The PPV and NPV were 80.1% and 93.1%, respectively. The accuracy of the test was 88.0%. Conclusion:This study concludes that gastric imprint smears stained with Diff-Quik method is a rapid, cheap, and reliable method for the detection of H.pylori infection.It recommends the use of Imprint cytology for detection of Helicobacter pylori inpatients undergoing upper gastrointestinal endoscopy

Evaluation of the Efficiency of N-terminal Pro-B-type Natriuretic Peptide for Diagnosis of Acute Myocardial Infarction

Background: Cardiac diseases are one of the major causes of death worldwide with increasing incidence rate per year, particularly in developing countries such as Sudan owing to urbanization and changing lifestyle. Myocardial infarction is a consequence of the imbalance between the heart blood supply and the required heart cell; this disorder leads to necrosis of myocardium and may cause death. It could be diagnosed by at least two of the following criteria: chest pain, electrocardiography (ECG) elevation, and levels on cardiac biomarkers. This study aimed to evaluate the efficiency of N-terminal pro-B-type natriuretic peptide (NTproBNP) for the diagnosis of acute myocardial infarction (AMI).  Methods: This analytical case–control hospital-based study was conducted on a total of 70 individuals, of which 40 participants were suspected of or diagnosed with AMI, while 30 healthy subjects  were included as a control group. Three ml of venous blood were collected in lithium heparin containers. Troponin I (TnI) as a cardiac biomarker was measured by TOSOH AIA-360, while the NTproBNP level was detected using I-Chroma II. Personal and clinical data were collected directly from each participant using a predesigned questionnaire. Results: A significant increase in the TnI level (mean: 13.13 ± 18.9 ng/ml) and NTproBNP (mean: 5756.5 ± 8378.2 pg/mL) in AMI patients were detected when compared with control mean (0.02 ± 0.00 ng/ml and 57.8 ± 42.32 pg/mL, respectively). Conclusions: NTproBNP gave a high sensitivity (87.5%), specificity (100%), positive predictive value (100%), and negative predictive value (85.7%) in the diagnosis of AMI when compared with another cardiac biomarker such as TnI. Keywords: acute myocardial infarction, NTproBNP, troponin I, Medani Heart Center, Suda