Hemoglobin A1c (HbA1c) is affected by the red blood cell (RBC) lifespan. The association of HbA1c... more Hemoglobin A1c (HbA1c) is affected by the red blood cell (RBC) lifespan. The association of HbA1c with RBC indices in pregnant women is not widely investigated. In this study, we investigated the association between HbA1c and Hb/RBCs count and RBCs indices; specifically, Hb/RBCs count and indices in non- diabetic pregnant women. Across-sectional study was carried- out at the antenatal care of Saad Abu Elela Hospital, Khartoum, Sudan. Obstetrics history was gathered using questionnaire and body mass index was calculated. Fasting blood sugar, at one hour, at two hours post prandial and HbA1c were investigated. Complete blood count parameters of RBCs count was performed, including, hematocrit, Hb, RBCs indices of MCV, MCH, and MCHC. One hundred twenty three women were enrolled. The mean age of the participants was 28±5.6 years and a mean body mass index was 27.65±6.8 k/m2. There was significant positive correlation between HbA1c and Hb (r=0.174, P=0.037), Hct (r=0.174, P=0.037), and MC...
Sub-Saharan Africa suffers from a dual impact of communicable (CDs) and non-communicable diseases... more Sub-Saharan Africa suffers from a dual impact of communicable (CDs) and non-communicable diseases (NCDs). There is scarce data on causes, trends of admission, and deaths among patients in Sudan. We aimed to determine the causes, trends of admission, and mortality among adult patients admitted to Gadarif Hospital in Eastern Sudan. Patients and Methods: The medical records of adult patients admitted to Gadarif medical wards from January 2017 to December 2020 were reviewed for age, gender, causes of admission, and outcomes. Multivariate Cox regression analysis was used to analysis factors (age, sex, years, and disease) associated with the mortality. Results: Of the 7230 patients who were admitted, 2221 (34.7%) were females and 5009 (69.3%) were males. The median age (interquartile range, IQR) was 47.0 (35.0) years. Of these 7230 patients, 3167 (43.8%) and 4063 (56.2%) patients were admitted with CDs and NCDs, respectively. Cardiovascular diseases (18.4%), snakebites (12.9%), and visceral leishmaniasis (12.0%) were the most common causes of admission. The overall in-patient adult deaths were 674 (9.3%). Cardiovascular diseases (22.3%), neurological diseases (16.9%), sepsis (15.9%), renal diseases (13.9%), and snakebites (8.3%) were the most common causes of inpatient mortality. Malignancy (20.7%), sepsis (20.9%), neurological diseases (17.4%), and cardiovascular diseases (13.8%) comprised the highest case fatality rates among the admitted patients. Using a Cox regression model (adjusted), age (adjusted hazard ratio = 1.02, 95% confidence interval = 1.01-1.03) was associated with increased mortality hazard. However, the gender and years of admission were not associated with increased mortality hazard. Conclusion: Admissions and mortality rates for CDs and NCDs are high compared with other African countries. Preventive measures are required to avert the high burden of these diseases. Health care systems in Sudan need to be prepared to deal with the dual burden of the diseases.
Objectives: Severe sepsis is a major public health concern and a frequent cause of intensive care... more Objectives: Severe sepsis is a major public health concern and a frequent cause of intensive care unit (ICU) admission with a high fatality rate. Higher (Sequential Organ Failure Assessment score) SOFA score and co-morbidity of acute renal failure (ARF) are risk factors contributing to fatal outcome. This work was meant to study the epidemiology of sepsis in Buraidah central hospital. Methods: This is a descriptive study conducted in the period from January 1, 2012, to June 29, 2012 to determine the epidemiology (incidence, clinical characteristics) and the outcome of sepsis in Buraidah hospital, Saudi Arabia. Results: Out of 387 patients admitted to ICU, 62 (16%) patients had sepsis, their mean (SD) age was 62.7 (21.3) years. Three quarters of them 47 (75.8%) presented with septic shock. The median APACHE II score was 26.5 (8 to 48) and SOFA score 11 (5 to 21). The mean of duration of hospital stay was 11.95 days. The most frequent infection site was the pulmonary (69.5%). There were 37 isolated organism, gram-negative organisms (13; 35.13%) were the predominant isolates. There were 25 (40.3%) deaths; the majority of the deaths were due to septic shock 20(80%). There was a significant difference between deaths and the survivors, in the APACHI II score, SOFA score), and whether ventilated or not. Conclusions: There was a high incidence of septic shock (and higher mortality) among the patients admitted to the ICU of Buraidah central hospital, especially among the elderly patients with respiratory infections.
Introduction: The association between Iron Deficiency Anaemia (IDA) and Haemoglobin A1c (HbA1c) l... more Introduction: The association between Iron Deficiency Anaemia (IDA) and Haemoglobin A1c (HbA1c) levels is not yet fully investigated. It is suggested that iron-deficiency anaemia may increase concentrations of HbA1c during pregnancy. Aim: To assess the association between serum ferritin (S-ferritin), IDA and HbA1c among non-diabetic pregnant women. Materials and Methods: A cross-sectional study was carried out at Saad Abuelela hospital (Khartoum) during the period from February 2017 to August 2017. Data were gathered using a questionnaire. A 75-gram oral glucose tolerance test was performed. HbA1c and S-ferritin were measured. t-test, Mann−Whitney U test and linear regression were performed. Results: One hundred and fifty-four non-diabetic pregnant women were enrolled. The mean (SD) of age, parity and gestational age were 27.8 (4.7) years, 0.9 (1.0) and 26.8 (1.0) weeks, respectively. The median (interquartile) of HbA1c and S-ferritin were 4.4 (3.8-5.0)% and 20.7 (10.1-35.7) µg/L respectively. Of the 154 women, 103 (66.9%) had anaemia, 56 (36.4%) had iron deficiency (ID) and 38 (24.7%) had IDA. There was no significant difference in the level of HbA1c {4.4 (3.6-5.2)% vs. 4.4 (3.9-4.9)%, p=0.726} between women with IDA and women with no IDA. Likewise, there was no significant difference in the median (interquartile) of HbA1c level in anaemic women {4.5 (4.0-5.0)% vs. 4.4 (3.8-5.1)%, p=0.496}, ID {4.4(3.9−5.0)% 4.4 (3.8-4.9)%, p=0.562} compared with non-anaemic women. There was no association between haemoglobin, S-ferritin, IDA and log of HbA1c in linear regression. Conclusion: This study found no association between IDA and HbA1c in non-diabetic Sudanese pregnant women. www.jcdr.net Omar E Fadlelseed et al., Serum Ferritin, Iron Deficiency Anemia and Hemoglobin A1c in Non-diabetic Pregnant Women
Objectives: To assess the association between Helicobacter pylori (H. pylori) infection and insul... more Objectives: To assess the association between Helicobacter pylori (H. pylori) infection and insulin resistance among pregnant Sudanese women attending Saad Abuelela hospital (Khartoum). A cross-sectional study was conducted from 1st July 2017 to 31st January 2018. One hundred and sixty-six women were enrolled and underwent testing for H. pylori IgG antibodies using specific ELISA kits. The Quantitative insulin sensitivity check index (QUICKI) was computed from the fasting insulin and glucose levels. Results: Median age, gravidity and gestational age were 27 years, 2 and 26 weeks, respectively. Twenty (12%) women were found to have gestational diabetes mellitus (GDM). H. pylori IgG seroprevalence was 66.0% among the study population. Univariate analysis showed that H. pylori-seropositivity was significantly higher among women who have GDM while Log (Homeostatic Model Assessment-β) HOMA-B% was lower (P value = 0.038, and 0.028) respectively. There was no difference between the GDM group and the other group in terms of demographics, body mass index, haemoglobin and QUICKI index results. In multivariate analysis, a higher prevalence of H. pylori was associated with GDM (OR = 2.8, 95% CI 1.1-7.5, P = 0.036). The current study concludes that an increased prevalence of H. pylori is a risk factor for the development of GDM.
Diarrheal diseases are a big public health problem worldwide, particularly among developing count... more Diarrheal diseases are a big public health problem worldwide, particularly among developing countries. The current study was conducted to detect and characterize group A rotavirus among admitted children with gastroenteritis to the pediatric hospitals, Sudan. A total of 755 stool samples were collected from Sudanese children with less than 5 years of age presenting with acute gastroenteritis during the period from April to September 2010. Enzyme-linked immunosorbent assay (ELISA) was used to Detection of Rotavirus antigens. Ribonucleic acid (RNAs) were extracted from rotavirus-positive stool samples using (QIAamp Viral RNA Mini Kit). (Omniscript Reverse Transcription kit) was used to convert RNA to complementary Deoxyribonucleic acid (cDNA). The cDNAs were used as template for detection of VP4-P (P for Protease-sensitive) and VP7-G (G for Glycoprotein) genotyping of Rotavirus using nested PCR and sequencing. Out of the 755 stool samples from children with acute gastroenteritis, 121 ...
The objective was to investigate the prevalence and the association between blood groups and Heli... more The objective was to investigate the prevalence and the association between blood groups and Helicobacter pylori IgG seropositivity among pregnant Sudanese women. A cross-sectional survey was carried-out at Saad Abul Ela Maternity Hospital, Khartoum, Sudan during the period of July 2014 through December 2015. Questionnaires covering socio-demographic and obstetrics information were administered. Specific H. pylori IgG antibody was analysed using ELISA. One hundred eighty six pregnant women were enrolled. The mean (SD) of the age, parity was 28.3 (2.6) years and 2.6 (3.5), respectively. Of the 186 women, 42 (22.6%), 24 (12.9%), 11(5.9%) and 109 (58.6%) had blood group A, B, AB and O, respectively. H. pylori IgG seropositivity rate was 132/186 (71.0%). There was no significant difference in age and parity between women with H. pylori IgG seropositive and seronegative. Compared with the women with H. pylori IgG seronegative, significantly higher numbers of women with H. pylori IgG sero...
Aim: To investigate the association between obesity and anemia/hemoglobin levels. Material & meth... more Aim: To investigate the association between obesity and anemia/hemoglobin levels. Material & methods: A cross-sectional study was conducted at Khartoum, Sudan. Obstetric data were collected from 388 pregnant women at mean (standard deviation) of 10.5 (3.1) weeks of gestation using questionnaires. Weight and height were determined, and BMI was calculated. Results: There were 15 (4.4%), 95 (28.1%), 127 (37.6) and 101 (29.9%) women who were underweight, normal weight, (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2) and obese (≥30 kg/m2), respectively. Hemoglobin levels and white blood cell counts were significantly higher in obese than nonobese groups. Compared with normal BMI, overweight and obesity were associated with higher hemoglobin level. Conclusion: Obese women had higher white blood cell count and hemoglobin level.
Open Access Macedonian Journal of Medical Sciences, 2017
AIM: The aim was to investigate serum vitamin D (25-OH) level among females with hypothyroidism.M... more AIM: The aim was to investigate serum vitamin D (25-OH) level among females with hypothyroidism.MATERIALS AND METHODS: A case-control study (58 in each arm) was conducted in Arar Central Hospital, Kingdom Saudi Arabia. The cases were females with hypothyroidism, and healthy females were controls. TSH, thyroid hormones: Free T3 (FT3) and Free T4 (FT4) and haemoglobin levels were measured in all participants. Serum vitamin D (25-OH) level was measured using the spectrophotometry.RESULTS: While there was no significant difference in the age and haemoglobin level, body mass index (BMI) was significantly higher in the cases. Compared with the controls, cases had significantly higher TSH, had significantly lower T4, and there was no significant difference in FT3 and 25 (OH) vitamin D, [16.1 (8.8-26.7) vs. 14.0 (9.5-20.3 ng/ml; P = 0.577]. Linear regression showed no association between, age, BMI, haemoglobin, TSH, FT3, FT4 and the log of 25 (OH) vitamin D levels.CONCLUSION: There was no s...
Parasitic infections (e.g., malaria and helminthiases) have a huge impact on public health in end... more Parasitic infections (e.g., malaria and helminthiases) have a huge impact on public health in endemic areas. Moreover, parasitic infestations are prominent causes of anemia in the tropics and subtropics, further perpetuated by malnutrition, inflammatory, and genetic diseases. Anemia-associating parasitic infections vary depending on the requirements and pathophysiology of the parasites. There is an interplay between different factors that can be segregated as host and parasite factors, resulting in severe anemia accompanying these parasitic infestations. The pathophysiological mechanisms leading to anemia associated with the different parasites vary greatly, including hemolysis, anemia of inflammation, bone marrow suppression, and micronutrients deficiency. The major means to deal with this anemia include prevention and treatment of such infestations.
Estimating malaria parasite count is needed for estimating the severity of the disease and during... more Estimating malaria parasite count is needed for estimating the severity of the disease and during the follow-up. This study was conducted to determine the malaria parasite density among children using actual white blood cell (WBC) and the assumed WBC counts (8.0 × 10(9)/l). A cross-sectional study was conducted at New Halfa Hospital, Sudan. WBC count and count of asexual malaria parasite were performed on blood films. One hundred and three children were enrolled. The mean (SD) WBCs was 6.2 (2.9) cells × 10(9)/l. The geometric mean (SD) of the parasite count using the assumed WBCs (8.0 × 10(9)/l cells/μl) was significantly higher than that estimated using the actual WBC count [7345.76 (31 038.56) vs. 5965 (28 061.57) rings/μl, p = 0.042]. Malaria parasitemia based on assumed (8.0 × 10(9)/) WBCs is higher than parasitemia based on actual WBCs.
Hepatitis E virus (HEV) infection can lead to adverse maternal and perinatal outcomes and is a ri... more Hepatitis E virus (HEV) infection can lead to adverse maternal and perinatal outcomes and is a risk for mortality in pregnant women. There are few published data on the seroepidemiology of HEV infection in pregnant women and none are available from Sudan specifically. A cross-sectional study was conducted to investigate the seroepidemiology of anti-HEV Immunoglobulin G (IgG) antibodies in mothers and newborns in Medani Hospital, Sudan. Socio-demographic, clinical and obstetric characteristics of the women were gathered using questionnaires. Anti-HEV IgG antibodies were investigated in the paired maternal and newborn sera using an enzyme-linked immunoassay (ELISA). Two hundred and nine women were enrolled to the study. The mean (SD) of their age, parity and gestational age was 27.5 (5.5) years, 2.2(1.5) and 38.8 (1.8) weeks, respectively. Out of these 209, 25 (12.5%) women had a positive result for anti-HEV IgG and two (1.0%) newborns had a positive result for anti-HEV IgG.In logist...
We investigated zinc and copper levels in angiographically defined obstructive coronary artery di... more We investigated zinc and copper levels in angiographically defined obstructive coronary artery disease (CAD) in patients undergoing elective coronary angiography in El-Shaab Hospital, Sudan. We performed a cross-sectional study. One hundred forty-two patients were enrolled. Sociodemographic and medical characteristics were collected using a questionnaire. Glucose, lipid, zinc, and copper levels were measured. Out of 142 patients, 102 (71.8%) had CAD and 40 (28.2%) had patent coronary arteries. There were no significant differences in median (interquartile range) zinc [118.5 (97.2-151.0) vs. 130.0 (106.0-174.0) μg/ml, P = 0.120] and copper [150.6 (125.0-183.0) vs. 158 (132.0-180.0) μg/mL, P = 0.478] levels between patients with CAD and those with patent coronary arteries. In linear regression analysis, there were no associations between CAD and zinc and copper levels. The current study failed to show any significant association between CAD and zinc and copper levels.
Background: Schistosomiasis is a significant health problem in more than 70 countries distributed... more Background: Schistosomiasis is a significant health problem in more than 70 countries distributed between Africa, Asia and South America, with an infection rate of one in 30 individuals. Data on Schistosomiasis, Hepatitis B virus (HBV) and Hepatitis C virus (HCV) co-infection are scarce; however, there is a high prevalence in countries where schistosomiasis is endemic. Methods: A systematic search was performed on published data from 1980-2014. Published papers in the databases Google, Medline, PubMed, and MiPc library were searched using the keywords epidemiology, pathogenesis and outcomes of HBV, HCV and schistosomiasis and data were extracted from the relevant studies. Results: The prevalence of HBV/schistosomiasis co-infection in countries where schistosomiasis is endemic was high, ranging between 9.6 to approximately 64% in Egypt, and a maximum of 15.8% among hospitalized patients in Brazil. Concurrent infection between HBV and schistosomiasis is often associated with countries where schistosomiasis is endemic and may lead to chronic liver inflammation. Similarly, HCV infection rates in schistosomiasis populations range from 1% in Ethiopia reaching up to 50% in Egypt. Conclusion: There is controversy regarding the effects of HBV and HCV on schistosomiasis and vice versa. Vaccination might be a solution to the era of schistosomiasis and co-infection with HBV and HCV.
Background: Trichomoniasis is the most common sexually transmitted disease. However, limited data... more Background: Trichomoniasis is the most common sexually transmitted disease. However, limited data are available on an effective technique for the diagnosis of Trichomonas vaginalis. Methods: A cross-sectional study was conducted to evaluate the accuracy of wet mount microscopy, latex agglutination, Diamond's media, and polymerase chain reaction (PCR) for detection of T. vaginalis among symptomatic women who attended the gynecological clinic at Khartoum, Sudan. Results: Of the 297 women studied, 252 (84.8%) were positive for T. vaginalis by wet mount microscopy, 257 (86.5%) by latex agglutination, 253 (85.2%) by Diamond's media, and 253 (85.2%) by PCR. The sensitivity and specificity of wet mount microscopy were 99.2% and 97.7%, respectively, compared with PCR. The sensitivity and specificity of latex agglutination and Diamond's media were 99.6% and 88.6%, and 100.0% and 86.4%, respectively, compared with PCR. Conclusions: In this study, wet mount microscopy, latex agglutination, and Diamond's media were found to be highly sensitive and specific. However, the availability and cost effectiveness might limit the use of Diamond's media and PCR in routine practice. Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/ vs/7859723851211496.
Background: Anaemia during pregnancy can lead to adverse maternal and perinatal outcomes. The WHO... more Background: Anaemia during pregnancy can lead to adverse maternal and perinatal outcomes. The WHO recommends that all pregnant women in areas where anaemia is prevalent receive supplements of iron and folic acid. However, due to many factors, the use of iron and folic acid supplementation is still low in many countries. This study was conducted to assess the rates of iron-folic supplementation and the associated factors during pregnancy and the effects of taking iron-folic acid supplementation on rates of maternal anaemia and low birth weight (LBW) infants. Methods: A cross-sectional study was conducted at Khartoum Hospital, Sudan. Enrolled women answered a questionnaire on socio-demographics characteristics, their pregnancy and delivery. Results: Of 856 women, 788 (92.1%) used iron-folic acid supplementation during pregnancy and 65.4% used folic acid. While place of residence, occupation and level of education were not associated with iron-folic acid usage, older age (OR = 3, CI = 1.4-6.3) and use of antenatal care (OR = 14.3, CI = 7.4-27.5) were associated with iron-folic acid use. Primiparity (OR = 3.8, CI = 1.9-7.6), maternal employment (OR = 3.9, CI = 2.25-6.77) and use of antenatal care (OR = 7.9, CI = 4.1-15) were the factors associated with folic acid. Using iron-folic acid was protective against anaemia (OR = 0.39, CI = 0.2-0.7) and LBW infants (OR = 0.3, CI = 0.17-0.68). Conclusion: There was a high rate of iron-folic acid supplementation use among pregnant women in Khartoum, Sudan, which was beneficial in preventing anaemia in expectant mothers and infants of LBW.
The Journal of Infection in Developing Countries, 2013
Introduction: The epidemiology of viral hepatitis during pregnancy is of paramount importance for... more Introduction: The epidemiology of viral hepatitis during pregnancy is of paramount importance for health planners and program managers. Data on viral hepatitis during pregnancy are not readily available in many African and Arab countries. Both regions have their own unique geography, and comprise over 59 states with crossover and interaction of different cultures. Methodology: A systematic electronic search of the published literature was conducted and data on epidemiology and risk factors of maternal hepatitis B virus (HBV) infection and hepatitis C (HCV) infection in Arab and African countries were extracted from relevant studies. Results: The serology of hepatitis viruses varies greatly among these countries, with different viral genotype patterns. Such a variation in prevalence could be explained by the different risk factors involved. Sexual contact, perinatal infection, blood and its derivatives, hemodialysis, intravenous and percutaneous drug use, and occupational, habitual, ...
Background: In spite of the World Health Organization recommendations for the treatment of malari... more Background: In spite of the World Health Organization recommendations for the treatment of malaria, febrile patients are still infrequently tested and erroneously treated for malaria. This study aimed to investigate the adherence to malaria national protocol for the management of malaria among under five years old children. Methods: A cross sectional hospital-based study was conducted during the period from September through December 2013 among febrile children below the age of five years attending the outpatient department of Omdurman Children Hospital, Sudan. Demographic, clinical and laboratory data [blood film, rapid diagnostic test (RDTs), haemoglobin, WBCs and chest X ray] and anti-malarials and/or antibiotics prescription were recorded. Results: A total of 749 febrile children were enrolled. The mean (SD) age was 37.51 (41.6) months. Less than a half, (327, 43.7%) of children were investigated for malaria using microscopy (271, 82.9%), RDT (4, 1.2%) or both (52, 15.9%). Malaria was not investigated for more than a half, (422, 56.3%) however investigations targeting other causes of fever were requested for them. Malaria was positive in 72 (22%) of the 327 investigated children. Five (1.6%) out of 255 with negative malaria tests were treated by an anti-malarials. Quinine was the most frequently prescribed anti-malarials (65, 72.2%) then artemisinin-based combination therapy (ACT) (2, 27.8%). The majority of the 749 children (655, 87.4%) were prescribed an antibiotic. Conclusion: There is a poor adherence to malaria management protocol in Sudan among physicians treating children below five years of age. There was a high rate of antibiotic prescription needs.
Background There are few published reports on severe Plasmodium vivax malaria in Africa. Methods ... more Background There are few published reports on severe Plasmodium vivax malaria in Africa. Methods Clinical pattern/manifestations of severe P. vivax were described in children admitted at New Halfa Hospital in Sudan between September 2009-December 2011. Results Eighteen children were admitted at the hospital during the study period with different manifestations of severe P. vivax malaria namely: severe anaemia (6, 33.3%), jaundice (5, 27.8%), thrombocytopenia (4, 22.2%), hypotension (3, 16.7%), cerebral malaria (2, 11.1%), epistaxis (2, 11.1%), renal impairment (1, 5.5%), hypogylcaemia and more than one manifestation (5, 27.8%). By day 2, all patients were asymptomatic, a parasitaemic and had started oral quinine and primaquine. There was no death among these patients Conclusion Severe P. vivax malaria is an existing entity in eastern Sudan. Further studies are required to understand emergence of severe P. vivax malaria.
Hemoglobin A1c (HbA1c) is affected by the red blood cell (RBC) lifespan. The association of HbA1c... more Hemoglobin A1c (HbA1c) is affected by the red blood cell (RBC) lifespan. The association of HbA1c with RBC indices in pregnant women is not widely investigated. In this study, we investigated the association between HbA1c and Hb/RBCs count and RBCs indices; specifically, Hb/RBCs count and indices in non- diabetic pregnant women. Across-sectional study was carried- out at the antenatal care of Saad Abu Elela Hospital, Khartoum, Sudan. Obstetrics history was gathered using questionnaire and body mass index was calculated. Fasting blood sugar, at one hour, at two hours post prandial and HbA1c were investigated. Complete blood count parameters of RBCs count was performed, including, hematocrit, Hb, RBCs indices of MCV, MCH, and MCHC. One hundred twenty three women were enrolled. The mean age of the participants was 28±5.6 years and a mean body mass index was 27.65±6.8 k/m2. There was significant positive correlation between HbA1c and Hb (r=0.174, P=0.037), Hct (r=0.174, P=0.037), and MC...
Sub-Saharan Africa suffers from a dual impact of communicable (CDs) and non-communicable diseases... more Sub-Saharan Africa suffers from a dual impact of communicable (CDs) and non-communicable diseases (NCDs). There is scarce data on causes, trends of admission, and deaths among patients in Sudan. We aimed to determine the causes, trends of admission, and mortality among adult patients admitted to Gadarif Hospital in Eastern Sudan. Patients and Methods: The medical records of adult patients admitted to Gadarif medical wards from January 2017 to December 2020 were reviewed for age, gender, causes of admission, and outcomes. Multivariate Cox regression analysis was used to analysis factors (age, sex, years, and disease) associated with the mortality. Results: Of the 7230 patients who were admitted, 2221 (34.7%) were females and 5009 (69.3%) were males. The median age (interquartile range, IQR) was 47.0 (35.0) years. Of these 7230 patients, 3167 (43.8%) and 4063 (56.2%) patients were admitted with CDs and NCDs, respectively. Cardiovascular diseases (18.4%), snakebites (12.9%), and visceral leishmaniasis (12.0%) were the most common causes of admission. The overall in-patient adult deaths were 674 (9.3%). Cardiovascular diseases (22.3%), neurological diseases (16.9%), sepsis (15.9%), renal diseases (13.9%), and snakebites (8.3%) were the most common causes of inpatient mortality. Malignancy (20.7%), sepsis (20.9%), neurological diseases (17.4%), and cardiovascular diseases (13.8%) comprised the highest case fatality rates among the admitted patients. Using a Cox regression model (adjusted), age (adjusted hazard ratio = 1.02, 95% confidence interval = 1.01-1.03) was associated with increased mortality hazard. However, the gender and years of admission were not associated with increased mortality hazard. Conclusion: Admissions and mortality rates for CDs and NCDs are high compared with other African countries. Preventive measures are required to avert the high burden of these diseases. Health care systems in Sudan need to be prepared to deal with the dual burden of the diseases.
Objectives: Severe sepsis is a major public health concern and a frequent cause of intensive care... more Objectives: Severe sepsis is a major public health concern and a frequent cause of intensive care unit (ICU) admission with a high fatality rate. Higher (Sequential Organ Failure Assessment score) SOFA score and co-morbidity of acute renal failure (ARF) are risk factors contributing to fatal outcome. This work was meant to study the epidemiology of sepsis in Buraidah central hospital. Methods: This is a descriptive study conducted in the period from January 1, 2012, to June 29, 2012 to determine the epidemiology (incidence, clinical characteristics) and the outcome of sepsis in Buraidah hospital, Saudi Arabia. Results: Out of 387 patients admitted to ICU, 62 (16%) patients had sepsis, their mean (SD) age was 62.7 (21.3) years. Three quarters of them 47 (75.8%) presented with septic shock. The median APACHE II score was 26.5 (8 to 48) and SOFA score 11 (5 to 21). The mean of duration of hospital stay was 11.95 days. The most frequent infection site was the pulmonary (69.5%). There were 37 isolated organism, gram-negative organisms (13; 35.13%) were the predominant isolates. There were 25 (40.3%) deaths; the majority of the deaths were due to septic shock 20(80%). There was a significant difference between deaths and the survivors, in the APACHI II score, SOFA score), and whether ventilated or not. Conclusions: There was a high incidence of septic shock (and higher mortality) among the patients admitted to the ICU of Buraidah central hospital, especially among the elderly patients with respiratory infections.
Introduction: The association between Iron Deficiency Anaemia (IDA) and Haemoglobin A1c (HbA1c) l... more Introduction: The association between Iron Deficiency Anaemia (IDA) and Haemoglobin A1c (HbA1c) levels is not yet fully investigated. It is suggested that iron-deficiency anaemia may increase concentrations of HbA1c during pregnancy. Aim: To assess the association between serum ferritin (S-ferritin), IDA and HbA1c among non-diabetic pregnant women. Materials and Methods: A cross-sectional study was carried out at Saad Abuelela hospital (Khartoum) during the period from February 2017 to August 2017. Data were gathered using a questionnaire. A 75-gram oral glucose tolerance test was performed. HbA1c and S-ferritin were measured. t-test, Mann−Whitney U test and linear regression were performed. Results: One hundred and fifty-four non-diabetic pregnant women were enrolled. The mean (SD) of age, parity and gestational age were 27.8 (4.7) years, 0.9 (1.0) and 26.8 (1.0) weeks, respectively. The median (interquartile) of HbA1c and S-ferritin were 4.4 (3.8-5.0)% and 20.7 (10.1-35.7) µg/L respectively. Of the 154 women, 103 (66.9%) had anaemia, 56 (36.4%) had iron deficiency (ID) and 38 (24.7%) had IDA. There was no significant difference in the level of HbA1c {4.4 (3.6-5.2)% vs. 4.4 (3.9-4.9)%, p=0.726} between women with IDA and women with no IDA. Likewise, there was no significant difference in the median (interquartile) of HbA1c level in anaemic women {4.5 (4.0-5.0)% vs. 4.4 (3.8-5.1)%, p=0.496}, ID {4.4(3.9−5.0)% 4.4 (3.8-4.9)%, p=0.562} compared with non-anaemic women. There was no association between haemoglobin, S-ferritin, IDA and log of HbA1c in linear regression. Conclusion: This study found no association between IDA and HbA1c in non-diabetic Sudanese pregnant women. www.jcdr.net Omar E Fadlelseed et al., Serum Ferritin, Iron Deficiency Anemia and Hemoglobin A1c in Non-diabetic Pregnant Women
Objectives: To assess the association between Helicobacter pylori (H. pylori) infection and insul... more Objectives: To assess the association between Helicobacter pylori (H. pylori) infection and insulin resistance among pregnant Sudanese women attending Saad Abuelela hospital (Khartoum). A cross-sectional study was conducted from 1st July 2017 to 31st January 2018. One hundred and sixty-six women were enrolled and underwent testing for H. pylori IgG antibodies using specific ELISA kits. The Quantitative insulin sensitivity check index (QUICKI) was computed from the fasting insulin and glucose levels. Results: Median age, gravidity and gestational age were 27 years, 2 and 26 weeks, respectively. Twenty (12%) women were found to have gestational diabetes mellitus (GDM). H. pylori IgG seroprevalence was 66.0% among the study population. Univariate analysis showed that H. pylori-seropositivity was significantly higher among women who have GDM while Log (Homeostatic Model Assessment-β) HOMA-B% was lower (P value = 0.038, and 0.028) respectively. There was no difference between the GDM group and the other group in terms of demographics, body mass index, haemoglobin and QUICKI index results. In multivariate analysis, a higher prevalence of H. pylori was associated with GDM (OR = 2.8, 95% CI 1.1-7.5, P = 0.036). The current study concludes that an increased prevalence of H. pylori is a risk factor for the development of GDM.
Diarrheal diseases are a big public health problem worldwide, particularly among developing count... more Diarrheal diseases are a big public health problem worldwide, particularly among developing countries. The current study was conducted to detect and characterize group A rotavirus among admitted children with gastroenteritis to the pediatric hospitals, Sudan. A total of 755 stool samples were collected from Sudanese children with less than 5 years of age presenting with acute gastroenteritis during the period from April to September 2010. Enzyme-linked immunosorbent assay (ELISA) was used to Detection of Rotavirus antigens. Ribonucleic acid (RNAs) were extracted from rotavirus-positive stool samples using (QIAamp Viral RNA Mini Kit). (Omniscript Reverse Transcription kit) was used to convert RNA to complementary Deoxyribonucleic acid (cDNA). The cDNAs were used as template for detection of VP4-P (P for Protease-sensitive) and VP7-G (G for Glycoprotein) genotyping of Rotavirus using nested PCR and sequencing. Out of the 755 stool samples from children with acute gastroenteritis, 121 ...
The objective was to investigate the prevalence and the association between blood groups and Heli... more The objective was to investigate the prevalence and the association between blood groups and Helicobacter pylori IgG seropositivity among pregnant Sudanese women. A cross-sectional survey was carried-out at Saad Abul Ela Maternity Hospital, Khartoum, Sudan during the period of July 2014 through December 2015. Questionnaires covering socio-demographic and obstetrics information were administered. Specific H. pylori IgG antibody was analysed using ELISA. One hundred eighty six pregnant women were enrolled. The mean (SD) of the age, parity was 28.3 (2.6) years and 2.6 (3.5), respectively. Of the 186 women, 42 (22.6%), 24 (12.9%), 11(5.9%) and 109 (58.6%) had blood group A, B, AB and O, respectively. H. pylori IgG seropositivity rate was 132/186 (71.0%). There was no significant difference in age and parity between women with H. pylori IgG seropositive and seronegative. Compared with the women with H. pylori IgG seronegative, significantly higher numbers of women with H. pylori IgG sero...
Aim: To investigate the association between obesity and anemia/hemoglobin levels. Material & meth... more Aim: To investigate the association between obesity and anemia/hemoglobin levels. Material & methods: A cross-sectional study was conducted at Khartoum, Sudan. Obstetric data were collected from 388 pregnant women at mean (standard deviation) of 10.5 (3.1) weeks of gestation using questionnaires. Weight and height were determined, and BMI was calculated. Results: There were 15 (4.4%), 95 (28.1%), 127 (37.6) and 101 (29.9%) women who were underweight, normal weight, (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2) and obese (≥30 kg/m2), respectively. Hemoglobin levels and white blood cell counts were significantly higher in obese than nonobese groups. Compared with normal BMI, overweight and obesity were associated with higher hemoglobin level. Conclusion: Obese women had higher white blood cell count and hemoglobin level.
Open Access Macedonian Journal of Medical Sciences, 2017
AIM: The aim was to investigate serum vitamin D (25-OH) level among females with hypothyroidism.M... more AIM: The aim was to investigate serum vitamin D (25-OH) level among females with hypothyroidism.MATERIALS AND METHODS: A case-control study (58 in each arm) was conducted in Arar Central Hospital, Kingdom Saudi Arabia. The cases were females with hypothyroidism, and healthy females were controls. TSH, thyroid hormones: Free T3 (FT3) and Free T4 (FT4) and haemoglobin levels were measured in all participants. Serum vitamin D (25-OH) level was measured using the spectrophotometry.RESULTS: While there was no significant difference in the age and haemoglobin level, body mass index (BMI) was significantly higher in the cases. Compared with the controls, cases had significantly higher TSH, had significantly lower T4, and there was no significant difference in FT3 and 25 (OH) vitamin D, [16.1 (8.8-26.7) vs. 14.0 (9.5-20.3 ng/ml; P = 0.577]. Linear regression showed no association between, age, BMI, haemoglobin, TSH, FT3, FT4 and the log of 25 (OH) vitamin D levels.CONCLUSION: There was no s...
Parasitic infections (e.g., malaria and helminthiases) have a huge impact on public health in end... more Parasitic infections (e.g., malaria and helminthiases) have a huge impact on public health in endemic areas. Moreover, parasitic infestations are prominent causes of anemia in the tropics and subtropics, further perpetuated by malnutrition, inflammatory, and genetic diseases. Anemia-associating parasitic infections vary depending on the requirements and pathophysiology of the parasites. There is an interplay between different factors that can be segregated as host and parasite factors, resulting in severe anemia accompanying these parasitic infestations. The pathophysiological mechanisms leading to anemia associated with the different parasites vary greatly, including hemolysis, anemia of inflammation, bone marrow suppression, and micronutrients deficiency. The major means to deal with this anemia include prevention and treatment of such infestations.
Estimating malaria parasite count is needed for estimating the severity of the disease and during... more Estimating malaria parasite count is needed for estimating the severity of the disease and during the follow-up. This study was conducted to determine the malaria parasite density among children using actual white blood cell (WBC) and the assumed WBC counts (8.0 × 10(9)/l). A cross-sectional study was conducted at New Halfa Hospital, Sudan. WBC count and count of asexual malaria parasite were performed on blood films. One hundred and three children were enrolled. The mean (SD) WBCs was 6.2 (2.9) cells × 10(9)/l. The geometric mean (SD) of the parasite count using the assumed WBCs (8.0 × 10(9)/l cells/μl) was significantly higher than that estimated using the actual WBC count [7345.76 (31 038.56) vs. 5965 (28 061.57) rings/μl, p = 0.042]. Malaria parasitemia based on assumed (8.0 × 10(9)/) WBCs is higher than parasitemia based on actual WBCs.
Hepatitis E virus (HEV) infection can lead to adverse maternal and perinatal outcomes and is a ri... more Hepatitis E virus (HEV) infection can lead to adverse maternal and perinatal outcomes and is a risk for mortality in pregnant women. There are few published data on the seroepidemiology of HEV infection in pregnant women and none are available from Sudan specifically. A cross-sectional study was conducted to investigate the seroepidemiology of anti-HEV Immunoglobulin G (IgG) antibodies in mothers and newborns in Medani Hospital, Sudan. Socio-demographic, clinical and obstetric characteristics of the women were gathered using questionnaires. Anti-HEV IgG antibodies were investigated in the paired maternal and newborn sera using an enzyme-linked immunoassay (ELISA). Two hundred and nine women were enrolled to the study. The mean (SD) of their age, parity and gestational age was 27.5 (5.5) years, 2.2(1.5) and 38.8 (1.8) weeks, respectively. Out of these 209, 25 (12.5%) women had a positive result for anti-HEV IgG and two (1.0%) newborns had a positive result for anti-HEV IgG.In logist...
We investigated zinc and copper levels in angiographically defined obstructive coronary artery di... more We investigated zinc and copper levels in angiographically defined obstructive coronary artery disease (CAD) in patients undergoing elective coronary angiography in El-Shaab Hospital, Sudan. We performed a cross-sectional study. One hundred forty-two patients were enrolled. Sociodemographic and medical characteristics were collected using a questionnaire. Glucose, lipid, zinc, and copper levels were measured. Out of 142 patients, 102 (71.8%) had CAD and 40 (28.2%) had patent coronary arteries. There were no significant differences in median (interquartile range) zinc [118.5 (97.2-151.0) vs. 130.0 (106.0-174.0) μg/ml, P = 0.120] and copper [150.6 (125.0-183.0) vs. 158 (132.0-180.0) μg/mL, P = 0.478] levels between patients with CAD and those with patent coronary arteries. In linear regression analysis, there were no associations between CAD and zinc and copper levels. The current study failed to show any significant association between CAD and zinc and copper levels.
Background: Schistosomiasis is a significant health problem in more than 70 countries distributed... more Background: Schistosomiasis is a significant health problem in more than 70 countries distributed between Africa, Asia and South America, with an infection rate of one in 30 individuals. Data on Schistosomiasis, Hepatitis B virus (HBV) and Hepatitis C virus (HCV) co-infection are scarce; however, there is a high prevalence in countries where schistosomiasis is endemic. Methods: A systematic search was performed on published data from 1980-2014. Published papers in the databases Google, Medline, PubMed, and MiPc library were searched using the keywords epidemiology, pathogenesis and outcomes of HBV, HCV and schistosomiasis and data were extracted from the relevant studies. Results: The prevalence of HBV/schistosomiasis co-infection in countries where schistosomiasis is endemic was high, ranging between 9.6 to approximately 64% in Egypt, and a maximum of 15.8% among hospitalized patients in Brazil. Concurrent infection between HBV and schistosomiasis is often associated with countries where schistosomiasis is endemic and may lead to chronic liver inflammation. Similarly, HCV infection rates in schistosomiasis populations range from 1% in Ethiopia reaching up to 50% in Egypt. Conclusion: There is controversy regarding the effects of HBV and HCV on schistosomiasis and vice versa. Vaccination might be a solution to the era of schistosomiasis and co-infection with HBV and HCV.
Background: Trichomoniasis is the most common sexually transmitted disease. However, limited data... more Background: Trichomoniasis is the most common sexually transmitted disease. However, limited data are available on an effective technique for the diagnosis of Trichomonas vaginalis. Methods: A cross-sectional study was conducted to evaluate the accuracy of wet mount microscopy, latex agglutination, Diamond's media, and polymerase chain reaction (PCR) for detection of T. vaginalis among symptomatic women who attended the gynecological clinic at Khartoum, Sudan. Results: Of the 297 women studied, 252 (84.8%) were positive for T. vaginalis by wet mount microscopy, 257 (86.5%) by latex agglutination, 253 (85.2%) by Diamond's media, and 253 (85.2%) by PCR. The sensitivity and specificity of wet mount microscopy were 99.2% and 97.7%, respectively, compared with PCR. The sensitivity and specificity of latex agglutination and Diamond's media were 99.6% and 88.6%, and 100.0% and 86.4%, respectively, compared with PCR. Conclusions: In this study, wet mount microscopy, latex agglutination, and Diamond's media were found to be highly sensitive and specific. However, the availability and cost effectiveness might limit the use of Diamond's media and PCR in routine practice. Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/ vs/7859723851211496.
Background: Anaemia during pregnancy can lead to adverse maternal and perinatal outcomes. The WHO... more Background: Anaemia during pregnancy can lead to adverse maternal and perinatal outcomes. The WHO recommends that all pregnant women in areas where anaemia is prevalent receive supplements of iron and folic acid. However, due to many factors, the use of iron and folic acid supplementation is still low in many countries. This study was conducted to assess the rates of iron-folic supplementation and the associated factors during pregnancy and the effects of taking iron-folic acid supplementation on rates of maternal anaemia and low birth weight (LBW) infants. Methods: A cross-sectional study was conducted at Khartoum Hospital, Sudan. Enrolled women answered a questionnaire on socio-demographics characteristics, their pregnancy and delivery. Results: Of 856 women, 788 (92.1%) used iron-folic acid supplementation during pregnancy and 65.4% used folic acid. While place of residence, occupation and level of education were not associated with iron-folic acid usage, older age (OR = 3, CI = 1.4-6.3) and use of antenatal care (OR = 14.3, CI = 7.4-27.5) were associated with iron-folic acid use. Primiparity (OR = 3.8, CI = 1.9-7.6), maternal employment (OR = 3.9, CI = 2.25-6.77) and use of antenatal care (OR = 7.9, CI = 4.1-15) were the factors associated with folic acid. Using iron-folic acid was protective against anaemia (OR = 0.39, CI = 0.2-0.7) and LBW infants (OR = 0.3, CI = 0.17-0.68). Conclusion: There was a high rate of iron-folic acid supplementation use among pregnant women in Khartoum, Sudan, which was beneficial in preventing anaemia in expectant mothers and infants of LBW.
The Journal of Infection in Developing Countries, 2013
Introduction: The epidemiology of viral hepatitis during pregnancy is of paramount importance for... more Introduction: The epidemiology of viral hepatitis during pregnancy is of paramount importance for health planners and program managers. Data on viral hepatitis during pregnancy are not readily available in many African and Arab countries. Both regions have their own unique geography, and comprise over 59 states with crossover and interaction of different cultures. Methodology: A systematic electronic search of the published literature was conducted and data on epidemiology and risk factors of maternal hepatitis B virus (HBV) infection and hepatitis C (HCV) infection in Arab and African countries were extracted from relevant studies. Results: The serology of hepatitis viruses varies greatly among these countries, with different viral genotype patterns. Such a variation in prevalence could be explained by the different risk factors involved. Sexual contact, perinatal infection, blood and its derivatives, hemodialysis, intravenous and percutaneous drug use, and occupational, habitual, ...
Background: In spite of the World Health Organization recommendations for the treatment of malari... more Background: In spite of the World Health Organization recommendations for the treatment of malaria, febrile patients are still infrequently tested and erroneously treated for malaria. This study aimed to investigate the adherence to malaria national protocol for the management of malaria among under five years old children. Methods: A cross sectional hospital-based study was conducted during the period from September through December 2013 among febrile children below the age of five years attending the outpatient department of Omdurman Children Hospital, Sudan. Demographic, clinical and laboratory data [blood film, rapid diagnostic test (RDTs), haemoglobin, WBCs and chest X ray] and anti-malarials and/or antibiotics prescription were recorded. Results: A total of 749 febrile children were enrolled. The mean (SD) age was 37.51 (41.6) months. Less than a half, (327, 43.7%) of children were investigated for malaria using microscopy (271, 82.9%), RDT (4, 1.2%) or both (52, 15.9%). Malaria was not investigated for more than a half, (422, 56.3%) however investigations targeting other causes of fever were requested for them. Malaria was positive in 72 (22%) of the 327 investigated children. Five (1.6%) out of 255 with negative malaria tests were treated by an anti-malarials. Quinine was the most frequently prescribed anti-malarials (65, 72.2%) then artemisinin-based combination therapy (ACT) (2, 27.8%). The majority of the 749 children (655, 87.4%) were prescribed an antibiotic. Conclusion: There is a poor adherence to malaria management protocol in Sudan among physicians treating children below five years of age. There was a high rate of antibiotic prescription needs.
Background There are few published reports on severe Plasmodium vivax malaria in Africa. Methods ... more Background There are few published reports on severe Plasmodium vivax malaria in Africa. Methods Clinical pattern/manifestations of severe P. vivax were described in children admitted at New Halfa Hospital in Sudan between September 2009-December 2011. Results Eighteen children were admitted at the hospital during the study period with different manifestations of severe P. vivax malaria namely: severe anaemia (6, 33.3%), jaundice (5, 27.8%), thrombocytopenia (4, 22.2%), hypotension (3, 16.7%), cerebral malaria (2, 11.1%), epistaxis (2, 11.1%), renal impairment (1, 5.5%), hypogylcaemia and more than one manifestation (5, 27.8%). By day 2, all patients were asymptomatic, a parasitaemic and had started oral quinine and primaquine. There was no death among these patients Conclusion Severe P. vivax malaria is an existing entity in eastern Sudan. Further studies are required to understand emergence of severe P. vivax malaria.
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