EPIDEMIOLOGY OF MATERNAL MORTALITY AND POOR PERINATAL OUTCOMES IN DIFFERENT REGIONS OF SUDAN

Background: Both maternal mortality and poor perinatal outcomes (mainly; low birth weight, stillbirth and perinatal mortality) are health as well as obstetrics indicators. Thus, there is an urgent need to investigate epidemiology of maternal mortality and poor perinatal outcomes in the different regions of Sudan. Objectives: To investigate the epidemiology of maternal mortality and poor perinatal outcomes in the different regions of Sudan. Methods: Various cross- sectional, case -control, and Cohort studies were conducted during the last 7 years. Results:  Maternal mortality was ranged 442 (146/33034)-640 (63/9841) / 100000 birth in the different regions of Sudan, most of these were due to communicable diseases. Low birth weight was reported in 15.3% (80/524), 12.5% (260/2076), 12.6% (97/1224), 14.9% (64/430) 12.6% in New Halfa, Khartoum, Medani and Elfashir, respectively. Anaemia was risk factors for low birth weight in Elfashir and in Medani; it was risk factor for fetal anaemia in New Halfa and risk factor for stillbirth in Kassala. There were 21 (206/9841), 29 (981/34015), 35(46/1293)/ 1000 stillbirths and 33(44/1342)/1000 in Elfashir, Medani, Khartoum respectively and Kassala, respectively. There was 9.2% (46/500) perinatal death in New Halfa. Conclusion: More effort should be paid to reduce the high maternal and perinatal mortality. More care should be toward nutrition, malaria prevention and other communicable disease

Fluorescence microscope (Cyscope®) for malaria diagnosis in pregnant women in Medani Hospital, Sudan

<p>Abstract</p> <p>Background</p> <p>Accuracy of diagnosis is the core for malaria control. Although microscopy is the gold standard in malaria diagnosis, its reliability is largely dependent on user skill. We compared performance of Cyscope^®fluorescence microscope with the Giemsa stained light microscopy for the diagnosis of malaria among pregnant women at Medani Hospital in Central Sudan. The area is characterized by unstable malaria transmission.</p> <p>Methods</p> <p>Socio-demographic characteristics and obstetrics history were gathered using pre-tested questionnaires. Blood samples were collected from febrile pregnant women who were referred as malaria case following initial diagnosis by general microscopist.</p> <p>Results</p> <p>During the study period 128 febrile pregnant women presented at the hospital. Among them, <it>Plasmodium falciparum </it>malaria was detected in 82 (64.1%) and 80 (62.5%) by the Giemsa-stained light microscopy and the Cyscope^®fluorescence microscope, respectively. The sensitivity of the Cyscope^®fluorescence microscope was 97.6% (95% CI: 92.2%-99.6%). Out of 46 which were negative by Giemsa-stained light microscopy, 5 were positive by the Cyscope^®fluorescence microscope. This is translated in specificity of 89.1% (95% CI: 77.5%-95.9%). The positive and negative predictive value of Cyscope^®fluorescence microscope was 94.1% (95% CI: 87.4% -97.8%) and 95.3% (95% CI: 85.4% - 99.2%), respectively.</p> <p>Conclusion</p> <p>This study has shown that Cyscope^®fluorescence microscope is a reliable diagnostic, sensitive and specific in diagnosing <it>P. falciparum </it>malaria among pregnant women in this setting. Further studies are needed to determine effectiveness in diagnosing other <it>Plasmodium </it>species and to compare it with other diagnostic tools e.g. rapid diagnostic tests and PCR.</p