Effect of Plasmodium vivax malaria and their density on some Haematological parameters in infected patients admitted to Wad Medani teaching hospital in Gezira state, Sudan

Background: Despite the great effort of the malaria control program in Sudan, Plasmodium vivax malaria has remained a major challenge recently, causing significant morbidity with a variety of haematological changes. Objective: This study aims to investigate the effect of Plasmodium vivax malaria and their density on some haematological parameters in patients admitted to Wad Medani teaching hospital in Gezira state, Sudan. Methods: Some haematological parameters of 160 participants, 80 infected with vivax malaria (47 male and 33 female) and 80 non-infected with malaria, who were admitted to Wad Medani teaching hospital in Gezira state, Sudan during high transmission season between August and November 2018, were evaluated for some haematological parameters. Results: The parameters (haemoglobin, haematocrit, counts of red blood cells, platelets, white blood cells, lymphocytes, monocytes and eosinophils) were significantly lower in infected patients than malaria negatives. The platelets and haemoglobin were inversely correlated to parasite density in positive cases. Conclusion: The exhibition of some haematological parameters changes was closely related to patients infected with vivax malaria versus non-infected, and these changes could be used as a diagnostic criterion for vivax malaria diagnosis in endemic regions

Effect of Plasmodium Vivax Malaria and Their Density on Some Haematological Parameters in Infected Patients Admitted to Wad Medani Teaching Hospital in Gezira State, Sudan

Background: Despite the great effort of the malaria control program in Sudan, Plasmodium vivax malaria has remained a major challenge recently, causing significant morbidity with a variety of haematological changes. Objective: This study aims to investigate the effect of Plasmodium vivax malaria and their density on some haematological parameters in patients admitted to Wad Medani teaching hospital in Gezira state, Sudan. Methods: Some haematological parameters of 160 participants, 80 infected with vivax malaria (47 male and 33 female) and 80 non-infected with malaria, who were admitted to Wad Medani teaching hospital in Gezira state, Sudan during high transmission season between August and November 2018, were evaluated for some haematological parameters. Results: The parameters (haemoglobin, haematocrit, counts of red blood cells, platelets, white blood cells, lymphocytes, monocytes and eosinophils) were significantly lower in infected patients than malaria negatives. The platelets and haemoglobin were inversely correlated to parasite density in positive cases. Conclusion: The exhibition of some haematological parameters changes was closely related to patients infected with vivax malaria versus non-infected, and these changes could be used as a diagnostic criterion for vivax malaria diagnosis in endemic regions

Frequency Distribution of Antimalarial Drug Resistance Alleles among Plasmodium falciparum Isolates from Gezira State, Central Sudan, and Gedarif State, Eastern Sudan

In 2004, Sudan adopted artesunate + sulfadoxine/pyrimethamine (SP) combination as the first-line drug, in response to the high level of falciparum resistance to antimalarials. In 2007, a molecular study on antimalarial resistance linked genes, pfcrt, pfmdr1, pfdhfr, pfdhps, and pfATPase6, was conducted on 198 isolates from central and eastern Sudan. We observed a high frequency of point mutations at almost all loci analyzed, mainly of pfcrt 76T (72.7%), pfdhfr 51I (75.3%), and pfdhfr 108N (72.7%) alleles. The MARK III in vitro test for chloroquine sensitivity in 45 P. falciparum isolates showed that 37.8% of the isolates were low resistant and 6.7% were fully resistant. This study represents the most recent molecular investigation on antimalarial resistance in this area after the adoption of artemisinin-based combination therapy (ACT), and underlines the importance of the analysis of SP resistance evolution to monitor the efficacy of ACT therapy in endemic areas

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population