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Salman K, El Nagar SH, El Hussein ARM, El Hussein MA, Yassine HM, Al Khatib HA, Ali Al-Badr M, Farah I, Enan KA. First report of serological, molecular detection, and characterization of human parvovirus B19 infections among sickle cell anaemia patients in Khartoum State, Sudan. J Infect Public Health 2025; 18:102682. [PMID: 39922088 DOI: 10.1016/j.jiph.2025.102682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Revised: 01/20/2025] [Accepted: 01/21/2025] [Indexed: 02/10/2025] Open
Abstract
BACKGROUND Patients with haematological disorders, such as sickle cell anaemia, are at an elevated risk of transient aplastic crisis due to parvovirus B19 infection. The virus targets specific integration sites in the human genome, disrupting cellular division. However, the molecular mechanisms of infection remain poorly understood. AIM This study aimed to determine the prevalence of human parvovirus B19 among patients with sickle cell anaemia in Khartoum State, Sudan. METHODS Ninety patients (aged <5 to >15 years) with sickle cell disease attending Gaafer Ibnouaf Children's Hospital between November 2016 and February 2017 were recruited. Sera and plasma samples were analyzed. IgG and IgM antibodies were measured using ELISA, and viral DNA was detected in plasma using nested-PCR. Phylogenetic analysis of sequenced B19 strains focused on the overlapping region of the minor (VP1) and major (VP2) capsid protein genes. RESULTS Anti-parvovirus B19 IgG antibodies were detected in 57 of 90 patients (63.3 %), while IgM antibodies were present in 7 (7.8 %). Viral DNA was identified in 23 (25.5 %) patients. Among the 23 DNA-positive patients, 7 (30 %) were seronegative for both IgG and IgM antibodies, highlighting the importance of molecular diagnostics in identifying active infections, especially in early stages. Children under 5 years of age exhibited a higher nucleic acid detection rate compared to older age groups, suggesting the importance of molecular testing in younger patients particularly in the early detection of Parvovirus B19 during the acute phase of infection, before the body has developed detectable antibodies and also in immunocompromised children, who may not mount an antibody response detectable by serological methods. Phylogenetic analysis revealed two distinct Sudanese clusters: one (50 % of sequences) formed a unique clade with low similarity to existing genotypes, while the other (50 %) closely resembled genotype 1 A sequences from Iraq, Iran, and Tanzania. CONCLUSION Parvovirus B19 antibodies and DNA were detected at high prevalence among Sudanese children with sickle cell anaemia. Screening for parvovirus B19 is critical for patients requiring blood transfusions, particularly those with haematological disorders. This study provides the first report of parvovirus B19 detection, sequencing, and characterization among Sudanese patients with sickle cell anaemia.
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Affiliation(s)
- Khalid Salman
- Department of Virology, Central Laboratory, Ministry of Higher Education and Scientific Research, Khartoum, Sudan
| | | | - Abdel Rahim M El Hussein
- Department of Virology, Central Laboratory, Ministry of Higher Education and Scientific Research, Khartoum, Sudan
| | - Mohammed A El Hussein
- Department of Virology, Central Laboratory, Ministry of Higher Education and Scientific Research, Khartoum, Sudan
| | - Hadi M Yassine
- Biomedical Research Center, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Hebah A Al Khatib
- Biomedical Research Center, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Mashael Ali Al-Badr
- Preventive Reference Laboratory, Department of Health Protection & Communicable Diseases Control, Ministry of Public Health, Doha, Qatar
| | - Ibrahim Farah
- Preventive Reference Laboratory, Department of Health Protection & Communicable Diseases Control, Ministry of Public Health, Doha, Qatar
| | - Khalid A Enan
- Department of Virology, Central Laboratory, Ministry of Higher Education and Scientific Research, Khartoum, Sudan; Preventive Reference Laboratory, Department of Health Protection & Communicable Diseases Control, Ministry of Public Health, Doha, Qatar.
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Obeagu EI, Obeagu GU. Implications of climatic change on sickle cell anemia: A review. Medicine (Baltimore) 2024; 103:e37127. [PMID: 38335412 PMCID: PMC10860944 DOI: 10.1097/md.0000000000037127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/02/2024] [Accepted: 01/10/2024] [Indexed: 02/12/2024] Open
Abstract
Sickle cell anemia (SCA) is a hereditary blood disorder characterized by abnormal hemoglobin, causing red blood cells to assume a sickle shape, leading to various complications. Climate change has emerged as a significant global challenge, influencing environmental conditions worldwide. This paper explores the implications of climatic variations on the prevalence, management, and outcomes of SCA. Climate change affects weather patterns, leading to altered temperatures, increased frequency of extreme weather events, and variations in humidity levels. These changes can have a profound impact on individuals living with SCA. High temperatures exacerbate the symptoms of SCA, potentially triggering painful vaso-occlusive crises due to dehydration and increased blood viscosity. Conversely, cold temperatures may induce vaso-occlusion by causing blood vessels to constrict. Changes in rainfall patterns might also affect water accessibility, which is crucial for maintaining adequate hydration, particularly in regions prone to droughts. The management of SCA is multifaceted, involving regular medical care, hydration, and avoiding triggers that could precipitate a crisis. Adverse weather events and natural disasters can disrupt healthcare infrastructure and access to essential medications and resources for SCA patients, especially in vulnerable communities. To mitigate the implications of climatic change on SCA, interdisciplinary strategies are essential. These strategies may include enhancing healthcare systems' resilience to climate-related disruptions, implementing adaptive measures to address changing environmental conditions, and promoting public awareness and education on managing SCA amidst climate variability. In conclusion, climatic variations pose significant challenges for individuals with SCA, affecting the prevalence, management, and outcomes of the disease.
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Mamoun Abdelmageid S, Mousa Alamir F, Yousif Abdelrahman H, Mohamed Abushama H. Association of COMT Val158Met Polymorphism with Fibromyalgia in Khartoum State, Sudan. Pain Res Manag 2023; 2023:7313578. [PMID: 37305098 PMCID: PMC10257546 DOI: 10.1155/2023/7313578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 02/19/2023] [Accepted: 03/24/2023] [Indexed: 06/13/2023]
Abstract
Fibromyalgia (FM) is a disorder characterized by chronic musculoskeletal pain, fatigue, and cognitive problems. Neurotransmitters, mainly catecholamines, appear to be involved in regulating the etiology of FM. Catechol-O-methyltransferase (COMT) is involved in catabolizing catecholamines such as norepinephrine. The most common variant studied in the COMT gene is the valine (Val) to methionine (Met) substitution at codon 158. This is the first study in Sudan addressing FM cases and genetic susceptibility to the disease. We aimed in this study to investigate the frequency of COMT Val 158 Met polymorphism among patients with FM, rheumatoid arthritis, and in healthy individuals. Genomic DNA from forty female volunteers was analyzed: twenty were from primary and secondary FM patients, ten were from rheumatoid arthritis patients, and ten were from healthy control. FM patients' age was ranging from 25 years to 55 with a mean of 41.14 ± 8.90. The mean age of the rheumatoid arthritis patients and healthy individuals was 31.3 ± 7.5 and 38.6 ± 11.2, respectively. Samples were genotyped for COMT single nucleotide polymorphism rs4680 (Val158Met), using the amplification-refractory mutation system (ARMS-PCR). Genotyping data have been analyzed using the Chi-square and Fisher exact test. The most common genotype among the study participants was the heterozygous Val/Met found in all participants. It was the only genotype found in the healthy participants. The genotype Met/Met was found only in FM patients. The genotype Val/Val was found only in rheumatoid patients. Analyses have shown no association between the Met/Met genotype and FM, and this could be due to a small sample size. In a larger sample size, a significant association could be found as this genotype was shown only by FM patients. Moreover, the Val/Val genotype, which is shown only among rheumatoid patients, might protect them from developing FM symptoms.
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Affiliation(s)
| | - Faisal Mousa Alamir
- Department of Zoology, Faculty of Science, University of Khartoum, Khartoum, Sudan
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Ali EH, Alkindi S, Mohamed AO, Awadalla KE, Abdlgadir O, Adam G, Magdi M, Ibrahim AK, Ghebremeskel K. Adverse Pregnancy Outcomes in Sickle Cell Trait: a Prospective Cohort Study Evaluating Clinical and Haematological Parameters in Postpartum Mothers and Newborns. Mediterr J Hematol Infect Dis 2023; 15:e2023002. [PMID: 36660349 PMCID: PMC9833303 DOI: 10.4084/mjhid.2023.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 12/10/2022] [Indexed: 01/03/2023] Open
Abstract
Background Sickle cell trait (SCT) is a congenital condition caused by the inheritance of a single allele of the abnormal haemoglobin beta gene, HbS. Carriers of SCT are generally asymptomatic, and they do not manifest the clinical and haematological abnormalities of sickle cell anaemia (SCA). However, there is evidence that they display some symptoms in stressful situations. Pregnancy is a stressful physiological event, and it is not clear if SCT adversely affects pregnancy outcomes, particularly in those from developing countries where people regularly suffer from nutritional insufficiency. Objective This study aims to investigate pregnancy outcomes in Sudanese women with SCT. Subjects and methods: Pregnant women with (HbAS, n=34) and without (HbAA, n=60) SCT were recruited during their first trimester at El Obeid Hospital, Kordofan, Western Sudan. Following appropriate ethical approval and informed consent from the participants, detailed anthropometric, clinical, haematological, obstetric, and birth outcome data were registered. In addition, blood samples were collected at enrolment and at delivery. Results At enrolment in the first trimester, the SCT group did not manifest SCA symptoms, and there was no difference in the haematological parameters between the SCT and control groups. However, at delivery, the women with SCT, compared with the control group, had lower levels of hemoglobin (Hb, p=0.000), packed cell volume (PCV, p=0.000), mean corpuscular haemoglobin (MCH, p=0.002) and neutrophil counts (p=0.045) and higher mean corpuscular volume (MCV, p=0.000) and platelet counts (p=0.000). Similarly, at delivery, the babies of SCT women had lower birth weight (p=0.000), lower Hb (p=0.045), PCV (p=0.000), MCH (p=0.000), and higher neutrophil (p=0.004) and platelet counts (p=0.000) than the babies of the healthy control group. Additionally, there were more miscarriages, stillbirths, and admissions to the Special Care Baby Unit (SCBU) in the SCT group. Conclusions The study revealed that SCT is associated with adverse pregnancy outcomes, including maternal and neonatal anaemia, low birth weight, and increased risk of stillbirth, miscarriage, and admission to SCBU. Therefore, pregnant women with SCT should be given appropriate pre-conceptual advice and multidisciplinary antenatal and postnatal care.
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Affiliation(s)
- E H Ali
- Lipidomics and Nutrition Research Centre, School of Human Sciences, London Metropolitan University, UK
| | - S Alkindi
- Department of Haematology, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - A O Mohamed
- Department of Biochemistry, Faculty of Medicine, University of Khartoum, Sudan
| | | | - O Abdlgadir
- Sudan Sickle Cell Anaemia Centre, El Obeid - SUDAN
| | - G Adam
- Faculty of Education, Al Azhri University, Sudan
| | - M Magdi
- Directorate of Planning, Ministry of Health Oman, Muscat, Sultanate of Oman
| | - A K Ibrahim
- Sudan Sickle Cell Anaemia Centre, El Obeid - SUDAN
| | - K Ghebremeskel
- Lipidomics and Nutrition Research Centre, School of Human Sciences, London Metropolitan University, UK
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Mustafa AEM, Tahir NM, Ahmed Mohamed NAE, Mohammed AA, Mohammed SI. Deep Vein Thrombosis of the Left Lower Limb in a Sudanese Child with Sickle Cell Disease. MEDICINES (BASEL, SWITZERLAND) 2022; 9:52. [PMID: 36355057 PMCID: PMC9697196 DOI: 10.3390/medicines9110052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/13/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
This is a case of an eleven-year-old female Sudanese child, a known Sickle Cell Anemia (SCA) patient, who presented with fever, as well as left thigh and leg swelling that was associated with pain and warmness, which was diagnosed as Deep Vein Thrombosis (DVT) of her left lower limb. She had a previous history of admissions to the emergency room, during which she once received blood. The patient was managed by carrying out a basic routine initial laboratory investigation. A Doppler ultrasound scan showed features consistent with DVT. Based on the clinical findings and investigation results, management began by providing the patient with intravenous fluid, analgesia, packed Red Blood Cells (RBCs), intravenous antibiotics, and low-molecular-weight heparin. Further consultations showed that there was no need for vascular surgery or surgical intervention. This case highlights the need for more studies on DVT and Venous Thromboembolism (VTE) complications in children with SCA, so as to develop strategies for diagnosis and management in order to reduce the risk of life-threatening complications of VTE in patients with Sickle Cell Disease SCD.
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Affiliation(s)
- Alam Eldin Musa Mustafa
- Department of Child Health, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia
- Department of Pediatrics, Faculty of Medicine and Health Sciences, Kordofan University, P.O. Box 160, El Obeid 51111, Sudan
| | - Niemat Mohammed Tahir
- Department of Child Health, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia
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Khalafallah TO, Ajab Eldoor AA, Babker AM, Bin Shaya AS, Alfahed A, Alharithi NS, Aloraini GS, Waggiallah HA. Hematological and molecular analyses of the HbS allele among the Sudanese population. J Int Med Res 2022; 50:3000605221125050. [PMID: 36134571 PMCID: PMC9502246 DOI: 10.1177/03000605221125050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective The purpose of this study was to perform hematological and molecular analyses of the HbS allele of the hemoglobin subunit beta gene in the Sudanese population. Methods This was a descriptive cross-sectional study. Hematological parameters and fetal hemoglobin (HbF) levels were assessed in all participants. Data were gathered through the use of questionnaires and laboratory investigations. The βS-globin haplotypes, S allele distributions, and hematological parameters with HbF levels were investigated using PCR-restriction fragment length polymorphism, gel electrophoresis, and a Sysmex hematology analyzer, respectively. Results According to our findings, the Bantu (BA) haplotype was found in 10.8% of participants with homozygous uncontested haplotypes, followed by Benin (BA) and Sudan (SU), each in 9.8% of participants. This Sudanese group from Northern Kordofan lacked the Arab-Indian haplotype. Two heterozygous versions of undisputed haplotypes were found in 17.3% of participants: SU/BA in 10.8% and CA/BE in 6.5%. Conclusion As a result of sickle cell anemia, this investigation found changes in hematological parameters. In the Sudanese population, a new haplotype of the S gene was discovered.
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Affiliation(s)
- Tariq Osman Khalafallah
- Department of Hematology, Faculty of Medical Laboratory Sciences, Kordofan University, Kordofan, Sudan
| | | | - Asaad Ma Babker
- Department of Medical Laboratories Science, College of Health Science, Gulf Medical University, Ajman, UAE
| | - Abdulkarim S Bin Shaya
- Department of Medical Laboratory Science, College of Applied Medical Science in Alkharj, Prince Sattam Pin Abdulaziz University, Alkharj, 11942, Saudi Arabia
| | - Abdulaziz Alfahed
- Department of Medical Laboratory Science, College of Applied Medical Science in Alkharj, Prince Sattam Pin Abdulaziz University, Alkharj, 11942, Saudi Arabia
| | - Nahed S Alharithi
- Department of Medical Laboratory Science, College of Applied Medical Science in Alkharj, Prince Sattam Pin Abdulaziz University, Alkharj, 11942, Saudi Arabia
| | - Ghfren S Aloraini
- Department of Medical Laboratory Science, College of Applied Medical Science in Alkharj, Prince Sattam Pin Abdulaziz University, Alkharj, 11942, Saudi Arabia
| | - Hisham Ali Waggiallah
- Department of Medical Laboratory Science, College of Applied Medical Science in Alkharj, Prince Sattam Pin Abdulaziz University, Alkharj, 11942, Saudi Arabia
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Elmahdi M, Fadalla T, Suliman M, Elsayed M, Awad Elhaj AM, Hussein H. Moyamoya syndrome and stroke among pediatric sickle cell disease patients in Sudan: A cross-sectional study. Ann Med Surg (Lond) 2022; 78:103815. [PMID: 35734737 PMCID: PMC9206931 DOI: 10.1016/j.amsu.2022.103815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/12/2022] [Accepted: 05/14/2022] [Indexed: 11/26/2022] Open
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Yousif M, Abdelrahman A, Al Jamea LH, Al-Yami FS, Woodman A. Psychosocial Impact of Sickle Cell Disease and Diabetes Mellitus on Affected Children and Their Parents in Khartoum State, Sudan. J Trop Pediatr 2022; 68:6596143. [PMID: 35641127 DOI: 10.1093/tropej/fmac042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This study aimed to assess the psychosocial impact of sickle cell disease (SCD) and diabetes mellitus on children and their parents in Sudan, and the relationship between socioeconomic status and psychosocial issues. A descriptive, cross-sectional study was conducted among n = 320 children aged 6-12 years, of whom n = 170 were diagnosed with SCD, n = 150 children with diabetes mellitus and their parents. The strengths and difficulties questionnaire (SDQ scale) was used to assess the psychosocial aspect of children. Depression, Anxiety, Stress Scale -21 Items (DASS 21) was used to assess the psychological well-being of the caregivers. Data on psychological problems of children with SCD showed that 66.5% had emotional symptoms, 18.2% had conduct problems and 19.4% hyperactivity. Data of parents showed that 45.9% of parents did not experience depression; 27.9% were moderately depressed group. Data on psychological problems among children with diabetes showed that 57.3% experienced emotional symptoms, conduct problems were close to the average among 66%. Data on psychological problems among parents of children with diabetes showed that 45.3% of parents did not experience depression; 22.7% belonged to the moderately depressed group. Psychosocial problems were common both among children and parents. More research is needed in the context of caring for a child with chronic diseases and the role of health care providers in adapting and mitigating psychological problems among both parents and children.
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Affiliation(s)
- Magda Yousif
- Nursing Department, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
| | - Abdalla Abdelrahman
- Psychiatric Department, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Lamiaa H Al Jamea
- Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
| | - Fatimah S Al-Yami
- Department of Medical Laboratory, King Fahad Military Medical Complex, Dhahran, Saudi Arabia
| | - Alexander Woodman
- Vice Deanship of Postgraduate Studies and Research, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia
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Pediatric Sickle Cell Disease in Sudan: Complications and Management. Anemia 2022; 2022:3058012. [PMID: 35198244 PMCID: PMC8860554 DOI: 10.1155/2022/3058012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/18/2022] [Indexed: 11/18/2022] Open
Abstract
Background. Sickle cell disease (SCD) is a life-threatening genetic disorder due to the formation of sickle hemoglobin molecule (HbS) that polymerizes in hypoxic conditions leading to SCD-related complications. Different approaches have been used in the management of SCD including symptomatic management, supportive management, and preventive management. Objectives. To assess the management of SCD in pediatric patients in Gaafar Ibnauf Referral Hospital in Khartoum locality, Sudan. Method. A descriptive, retrospective, hospital-based study was conducted in Gaafar Ibnauf Hospital using a data collection sheet. The study included all medical files of pediatric patients with SCD attending the hospital during the period from the first of April 2018 to the first of July 2018. The data were analyzed using descriptive statistics and the chi-square test.
was considered statistically significant. Results. Out of 207 pediatric patients, 53.1% were females (mean age of 7.5 ± 3.1 years), with a 1.1 : 1 female:male ratio and low socioeconomic status. Only 4.3% of participants had health insurance. The Messeryia tribe in western Sudan had the highest prevalence of the disease among the Sudanese tribes (11.1%). Vaso-occlusive crisis (33.3%), infections (13.5%), and neurological complications (10.6%) were the most frequent complications reported during routine visits. After initiation of management, only 3.4% of pediatric patients had hemolytic crises, and 1.4% of the anemic patients had splenomegaly. 100% of patients received folic acid, 73.9% used hydroxyurea, and 69.6% underwent blood transfusion for the management of SCD. Prophylactic penicillin was prescribed for 15% of patients, and 41.1% were immunized with pneumococcal vaccine (PPSV23). Most patients had been scheduled for planned follow-up visits every 3–6 months (93.2%). Hydroxyurea and blood transfusion significantly reduced fever and vaso-occlusive crisis. Conclusion. The SCD treatment protocol in Gaafar Ibnauf Children’s Hospital, involving preventive and symptomatic therapy, is consistent with the internationally implemented protocols for SCD management. However, immunization and prophylactic penicillin approaches are deficient.
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Ali EH, Alkindi S, Osman MA, Hilali W, Mirgani HM, Adam G, Morsi MM, Hussein IS, Ghebremeskel K. Nutritional and Hematological Status of Sudanese Women of Childbearing Age with Steady-state Sickle Cell Anemia. Oman Med J 2021; 36:e270. [PMID: 34164159 PMCID: PMC8204634 DOI: 10.5001/omj.2021.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 10/11/2020] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES We sought to investigate the nutritional and hematological status of Sudanese women of childbearing age with sickle cell anemia (SCA). Anthropometry and hematology were used to assess nutritional status and health and disease conditions, respectively. METHODS Women with steady-state (HbSS, n = 39; age = 19.0±2.7) and without (HbAA, n = 36; age, 19.8±2.7) SCA were recruited during a routine visit to the Hematology Clinic, Ibn-Auf Teaching Hospital, Khartoum, Sudan. RESULTS The two groups of women lived in similar environmental conditions and ate similar diets three times a day. However, despite taking regular meals, the women with sickle anemia were thinner and lighter (p < 0.001) and shorter (p = 0.002) compared with those who do not have the disease. Also, they had higher levels of mean corpuscular hemoglobin (Hb) concentration and white cell count (p < 0.001), mean corpuscular volume (p = 0.003), and platelet (p = 0.002) and lower packed cell volume and Hb (p < 0.001). There was no difference in levels of anthropometric and hematological variables between the hydroxyurea treated and untreated SCA patients (p > 0.050). CONCLUSIONS The low anthropometric (height, weight, and body mass index) and abnormal hematological values in the women with SCA in steady-state reflect sustained nutritional insults inflected by the disease and poverty. Tailored nutritional counseling/advice must be an integral part of managing patients with SCA. Such advice is particularly vital for women of childbearing age because of the adverse effects of prepregnancy nutritional deficiency on outcomes.
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Affiliation(s)
- Eltigani Hassan Ali
- Lipidomics and Nutrition Research Centre, School of Human Sciences, London Metropolitan University, London, UK
| | - Salam Alkindi
- Department of Hematology, Sultan Qaboos University, Muscat, Oman
| | - Mohamed A. Osman
- Department of Biochemistry, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Wafa Hilali
- Department of Haematology, Ibn Auf Teaching Hospital, Khartoum, Sudan
| | - Hind M. Mirgani
- Department of Haematology, Ibn Auf Teaching Hospital, Khartoum, Sudan
| | - Gareeba Adam
- Department of Educational Technology, Faculty of Higher Studies, Al-Zaiem Al Azhari University, Khartoum, Sudan
| | - Magdi M. Morsi
- Directorate of Planning, Ministry of Health, Muscat, Oman
| | - Izzeldin S. Hussein
- Department of Micronutrient, Iodine Global Network, Middle East and North Africa
| | - Kebreab Ghebremeskel
- Lipidomics and Nutrition Research Centre, School of Human Sciences, London Metropolitan University, London, UK
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Sungura R, Onyambu C, Mpolya E, Sauli E, Vianney JM. The extended scope of neuroimaging and prospects in brain atrophy mitigation: A systematic review. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2020.100875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Severe childhood anemia and emergency blood transfusion in Gadarif Hospital, eastern Sudan. PLoS One 2019; 14:e0225731. [PMID: 31794569 PMCID: PMC6890167 DOI: 10.1371/journal.pone.0225731] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/11/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Anemia is a major cause of global morbidity and mortality, particularly among children. Management of anemia depends on causes and severity of anemia. However blood transfusion is a lifesaving intervention in severe and life-threatening anemia. There are no published data on blood transfusion for anemia in Sudan. METHODS A descriptive study was conducted in Gadarif Hospital in eastern Sudan during 1 August, 2017 to 31 March, 2018. Consecutive children who presented at the emergency room with an indication for blood transfusion were enrolled in the study. A detailed history was gathered from all patients. Physical examinations, including vital signs, were performed. The World Health Organization guidelines for blood transfusion were followed. RESULTS During the study period, a total of 1800 children were admitted to the emergency pediatric ward in Gadarif Hospital and were assessed for anemia, 513 (28.5%) were anemic and 141 (7.8%) had severe anemia. Three hundred anemic children received blood transfusion. The median (interquartile) of the age of the 300 children who received blood transfusion was 4.2 4.2(2.0-9.0) years. A total of 148 (49.3%) of the children were boys and 151 (50.3%) were younger than 5 years. The diagnoses associated with the order for blood transfusion were sickle cell disease (129, 43.0%), active bleeding (58, 19.3%), malaria (50, 16.7%), visceral leishmaniasis (25, 8.3%), severe acute malnutrition (16, 5.30%), snake bite (11, 3.7%), sepsis (5, 1.7%), and others. Two hundred eighty-five (95.0%) children improved, nine children were discharged against medical advice, and six (2.0%) children died. CONCLUSION There is a high burden of anemia in eastern Sudan. Sickle cell disease, malaria, and visceral leishmaniasis are the main causes of anemia in this region. Further research on blood transfusion is needed.
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Taha ZI, Mohammed SE, Essa MEA, Elsid WM, Hussein MMA, Osman SME, Ahmed HO, Yousif MD, Ahmed AA. Acute Soft Skull Syndrome in an Adult Male with Sickle Cell Anemia in Sudan: A Case Report. EXPLORATORY RESEARCH AND HYPOTHESIS IN MEDICINE 2019; 4:90-93. [DOI: 10.14218/erhm.2019.00024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Adam MA, Adam NK, Mohamed BA. Prevalence of sickle cell disease and sickle cell trait among children admitted to Al Fashir Teaching Hospital North Darfur State, Sudan. BMC Res Notes 2019; 12:659. [PMID: 31619285 PMCID: PMC6796395 DOI: 10.1186/s13104-019-4682-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 09/28/2019] [Indexed: 01/28/2023] Open
Abstract
Objective It is estimated that 50% to 90% of infants born with (SCA) in sub-Saharan Africa die before 5 years old. Northern Darfur State at western Sudan region has a multiethnic population with a high frequency of sickle cell anaemia, but little about it is published. This study aimed to determine the prevalence of sickle cell anaemia among children admitted to Al Fashir Teaching Hospital in Al Fashir, Northern Darfur State, Sudan. Results The prevalence of sickle cell disease by haemoglobin electrophoresis among these 400 children patients was 59 (14.8%). Sickle cell trait patients were 11.3% and Sickle cell disease positive patients were 3.5%. Individuals with SCA have consistently low blood Hb concentration, normal MCV and high mean WBC’s. Individuals with sickle cell trait had haematological parameters near to those of normal individuals.
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Affiliation(s)
- Mudathir A Adam
- Faculty of Medical Laboratory Science, Al Fashir University, Al Fashir, Sudan.
| | - Nassreldeen K Adam
- Faculty of Medical Laboratory Science, Al Fashir University, Al Fashir, Sudan
| | - Babiker A Mohamed
- Pathology Department, Faculty of Medicine, Karari University, Khartoum, Sudan
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15
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Bower H, El Karsany M, Alzain M, Gannon B, Mohamed R, Mahmoud I, Eldegail M, Taha R, Osman A, Mohamednour S, Semper A, Atkinson B, Carter D, Dowall S, Furneaux J, Graham V, Mellors J, Osborne J, Pullan ST, Slack GS, Brooks T, Hewson R, Beeching NJ, Whitworth J, Bausch DG, Fletcher TE. Detection of Crimean-Congo Haemorrhagic Fever cases in a severe undifferentiated febrile illness outbreak in the Federal Republic of Sudan: A retrospective epidemiological and diagnostic cohort study. PLoS Negl Trop Dis 2019; 13:e0007571. [PMID: 31291242 PMCID: PMC6645580 DOI: 10.1371/journal.pntd.0007571] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 07/22/2019] [Accepted: 06/22/2019] [Indexed: 01/12/2023] Open
Abstract
Background Undifferentiated febrile illness (UFI) is one of the most common reasons for people seeking healthcare in low-income countries. While illness and death due to specific infections such as malaria are often well-quantified, others are frequently uncounted and their impact underappreciated. A number of high consequence infectious diseases, including Ebola virus, are endemic or epidemic in the Federal Republic of Sudan which has experienced at least 12 UFI outbreaks, frequently associated with haemorrhage and high case fatality rates (CFR), since 2012. One of these occurred in Darfur in 2015/2016 with 594 cases and 108 deaths (CFR 18.2%). The aetiology of these outbreaks remains unknown. Methodology/Principal findings We report a retrospective cohort study of the 2015/2016 Darfur outbreak, using a subset of 65 of 263 outbreak samples received by the National Public Health Laboratory which met selection criteria of sufficient sample volume and epidemiological data. Clinical features included fever (95.8%), bleeding (95.7%), headache (51.6%) and arthralgia (42.2%). No epidemiological patterns indicative of person-to-person transmission or health-worker cases were reported. Samples were tested at the Public Health England Rare and Imported Pathogens Laboratory using a bespoke panel of likely pathogens including haemorrhagic fever viruses, arboviruses and Rickettsia, Leptospira and Borrelia spp. Seven (11%) were positive for Crimean-Congo haemorrhagic fever virus (CCHFV) by real-time reverse transcription PCR. The remaining samples tested negative on all assays. Conclusions/Significance CCHFV is an important cause of fever and haemorrhage in Darfur, but not the sole major source of UFI outbreaks in Sudan. Prospective studies are needed to explore other aetiologies, including novel pathogens. The presence of CCHFV has critical infection, prevention and control as well as clinical implications for future response. Our study reinforces the need to boost surveillance, lab and investigative capacity to underpin effective response, and for local and international health security. The Federal Republic of Sudan has had at least 12 outbreaks of febrile illness of unknown cause associated with symptoms of haemorrhage and high case fatality rates since 2012. Outbreaks without clear diagnosis are concerning, particularly in countries such as Sudan where a range of high consequence diseases, including viral haemorrhagic fevers, are endemic or epidemic, and local laboratory capacity is limited. We transferred historical samples stored in the National Public Health Authority from one of these outbreaks that occurred in Darfur 2015–2016 to the Public Health England Laboratory at Porton, UK, and tested them against a wide range of infectious diseases to try to identify the cause, and to help the Sudanese Federal Ministry of Health to develop and target their limited laboratory capacity. We found that Crimean-Congo Haemorrhagic Fever was an important cause but not the only source of cases in this outbreak. This has implications for prevention and control as well as for treating cases. Our study also highlighted the need for future studies to explore other possible causes, including new pathogens, and reinforced the need to boost surveillance, lab and investigative capacity for more timely and complete outbreak response.
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Affiliation(s)
- Hilary Bower
- UK Public Health Rapid Support Team, London, United Kingdom
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Mubarak El Karsany
- Department of Medical Microbiology, Karary University, Khartoum, Sudan
- National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Mazza Alzain
- Communicable Disease Surveillance and Event Unit, Federal Ministry of Health, Khartoum, Sudan
| | - Benedict Gannon
- UK Public Health Rapid Support Team, London, United Kingdom
- Global Public Health, Public Health England, London, United Kingdom
| | - Rehab Mohamed
- National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Iman Mahmoud
- National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Mawahib Eldegail
- National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Rihab Taha
- National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Abdalla Osman
- National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Salim Mohamednour
- Communicable Disease Surveillance and Event Unit, Federal Ministry of Health, Khartoum, Sudan
| | - Amanda Semper
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Barry Atkinson
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Daniel Carter
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Stuart Dowall
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Jenna Furneaux
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Victoria Graham
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Jack Mellors
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Jane Osborne
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Steven T. Pullan
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Gillian S. Slack
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Tim Brooks
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Roger Hewson
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Nicholas J. Beeching
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Jimmy Whitworth
- UK Public Health Rapid Support Team, London, United Kingdom
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Daniel G. Bausch
- UK Public Health Rapid Support Team, London, United Kingdom
- Global Public Health, Public Health England, London, United Kingdom
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Tom E. Fletcher
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Ismail WIM, Elnour M, Mustafa AEM. Evaluation of transcranial Doppler abnormalities in children with sickle cell disease in El-Obeid Specialized Children's Hospital. J Family Med Prim Care 2019; 8:1176-1181. [PMID: 31041270 PMCID: PMC6482797 DOI: 10.4103/jfmpc.jfmpc_112_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: This study aims to evaluate transcranial Doppler abnormalities in children with sickle cell disease (SCD) in a specialized children's hospital in El-Obeid. Materials and Methods: This is a cross-sectional study done on 119 patients (2–18 years of age were included) who attended the sickle cell clinic in a specialized children's hospital in El-Obeid from December 2016 to February 2017; when patients do not have recent stroke symptoms, blood flow velocities were measured in both proximal internal carotid and middle cerebral arteries (MCAs) using non-imaging Doppler method, and time average mean velocities were recorded along with hemoglobin concentration and of the patients. Results: None of the study population had MCA velocity higher than 200 cm/s; also no high conditional velocity (170–199 cm/s) was recorded, so no patient was at high risk to develop stroke. About 20.1% of patients showed low velocities in one or both MCAs; 4.2% had abnormal MCAs’ interhemispheric ratio; 4.2% of study population showed absent flow in one of their MCAs, reflecting previous occlusion. About 4.2% had poor temporal window. It was difficult to measure the velocity in one of the four vessels in 5.9% of the patient due to uncooperativeness. There was statistically significant relationship between hemoglobin concentration and blood velocity in the left MCA. Conclusion: Despite the international recommendations, using transcranial Doppler ultrasonography (TCD) as a stroke screening tool in children with SCD in Sudan is still not a well-known practice. Successful strategies to improve TCD screening rates must be encouraged in all healthcare institutions.
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Affiliation(s)
| | - Mustafa Elnour
- Department of Radiology, Faculty of Medicine, University of Khartoum, Sudan
| | - Alam Eldin Musa Mustafa
- Department of Pediatrics, King Khalid University, Abha, Saudi Arabia.,Department of Pediatrics, University of Kordofan, Sudan
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Abaker Gibreel MO, El Saeed Elkarsani M, Mohammed Munsour M, El Taher HB, Department of Hematology, Coordinator of MLS, Port Sudan Ahlia College, Khartoum, Sudan, Faculty of Medical Laboratory Sciences, University of Karary, Khartoum, Sudan, Hematology Department, Faculty of Medical laboratory Sciences, University of Sudan, Khartoum, Sudan, El-Emam El-Mahdi University, Khartoum, Sudan. Genotyping of Individuals with Hemoglobinopathies in Beja Tribes and Other Minor Groups in Port Sudan, Eastern Sudan. MEDICAL LABORATORY JOURNAL 2018. [DOI: 10.29252/mlj.12.6.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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