One Health in Somalia: Present status, opportunities, and challenges

One Health (OH) is an integrated approach aiming at improving the health of people, animals, and ecosystems. It recognizes the interconnectedness of human health with the health of animals, plants, and the environment. Since Somali people's livelihoods are mainly based on livestock, agriculture, marine resources, and their shared environment, OH-oriented initiatives could significantly impact the country toward reducing complex problems affecting the health of humans, animals, and the environment. The term "One Health" was first introduced into the global scientific community in September 2004 and in 2013 in Somalia. After ten years, there is still a long road ahead for implementing the OH approach in the country. Herein, we present the status, opportunities, and challenges of OH in Somalia and recommend ways to promote and institutionalize it. The country has been involved in various OH initiatives solely driven by external funding, focusing on research, capacity development, and community interventions, apart from university-led initiatives such as Somali One Health Centre. In Somalia, OH initiatives face numerous challenges, ranging from limited infrastructure and resources to weak governance and institutional capacity. We urge the Somali government to address these challenges and prioritize OH as the main approach to tackling critical health issues. We suggest the Somali government institutionalize and implement OH actions at all administrative levels, including Federal, State, District, and community, through a mechanism to improve multisectoral coordination and collaboration to predict, prevent, detect, control, and respond to communicable and non-communicable diseases at the human-animal-ecosystem interface for improving health outcomes for all.

Insights into the use of two novel supramolecular compounds as corrosion inhibitors for stainless steel in a chloride environment: experimental as well as theoretical investigation

Novel supramolecular (SCPs) compounds such as: {[Ni (EIN)4(NCS)2]}, SCP1 and {[Co (EIN)4 (NCS)2]}, SCP2 have been studied using weight loss (WL) and electrochemical tests on the corrosion performance of stainless steel 304 (SS304) in 1.0 M hydrochloric acid (HCl) solution. The experimental results revealed that inhibition efficacy (η%) rises with increasing concentrations of SCPs and reached 92.3% and 89.6% at 16 × 10-6 M, 25 °C, from the WL method for SCP1 and SCP2, respectively. However, by raising the temperature, η% was reduced. Polarization measurements (PDP) showed that the SCPs molecules represent a mixed-type. The SCPs were adsorbed on a SS304 surface physically, and the Langmuir adsorption isotherm was found to govern the adsorption process. The determination of thermodynamic parameters was carried out at various temperatures. Quantum chemical calculations were calculated to prove the adsorption process of SCP components, using the molecular dynamics (MD) simulations and electron density map. The inhibition performance of SCPs for SS304 dissolution in an acidic medium was proved to be excellent through FT-IR and AFM analysis. The results obtained from all measurements exhibit a high level of agreement with each other.

Structural, molecular and functional characterization of the aorta in HCM

Introduction

Changes in the Extracellular Matrix (ECM) in Hypertrophic Cardiomyopathy (HCM) is thought to involve the myocardium as well as extracardiac tissues. The extent and significance of extra-myocardial changes has not been adequately studied.

Purpose

To describe the structural, molecular, and functional changes in the aorta of HOCM patients.

Methods

The structural and molecular changes in the aortic wall were studied in a cohort of 102 consecutive patients with hypertrophic obstructive cardiomyopathy undergoing myectomy. The biopsies were examined histologically, immunohistochemically and by Electron microscopy. The findings were compared to 10 normal controls obtained from the homograft bank of the Harefield hospital, following IRB guidelines. Changes in expression were quantified using morphometry and western blotting. For aortic stiffness, pulse wave velocity [PWV] was measured using Cardiac Magnetic Resonance (CMR), in the 102 HCM patients as well as age-matched 166 normal controls.

Results

Specimens from HCM aortas showed a misalignment in collagen and elastin fibres. There was a significant reduction in smooth muscle cells [SMCs] markers; integrin beta1 and smooth muscle actin, and an increase in an apoptosis marker, Caspase3. In addition, there was a significant decrease in the number of lamellae and an increase in the interlamellar distance in HCM aortas. FBLNs 1, 2 and 5 showed a reduction in expression in tunica intima and tunica media of HCM biopsies. PWV was significantly higher in HCM patients compared to healthy controls with the highest levels in patients with LV fibrosis.

Conclusion

This study illustrates the link between functional abnormalities in the aorta of HCM patients with structural and molecular changes. These findings can have a potential value in risk stratification and identify new therapeutic targets in HCM.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): STDF-EgyptMagdi Yacoub Foundation

Rift Valley fever and Brucella spp. in ruminants, Somalia

Background

Fourteen-years after the last Rift Valley fever (RVF) virus (RVFV) outbreak, Somalia still suffers from preventable transboundary diseases. The tradition of unheated milk consumption and handling of aborted materials poses a public health risk for zoonotic diseases. Limited data are available on RVF and Brucella spp. in Somali people and their animals. Hence, this study has evaluated the occurrence of RVFV and Brucella spp. antibodies in cattle, goats and sheep sera from Afgoye and Jowhar districts of Somalia.

Methods

Serum samples from 609 ruminants (201 cattle, 203 goats and 205 sheep), were serologically screened for RVF by a commercial cELISA, and Brucella species by modified Rose Bengal Plate Test (mRBPT) and a commercial iELISA.

Results

Two out of 609 (0.3 %; 95 %CI: 0.04–1.2 %) ruminants were RVF seropositive, both were female cattle from both districts. Anti-Brucella spp. antibodies were detected in 64/609 (10.5 %; 95 %CI: 8.2–13.2 %) ruminants by mRBPT, which were 39/201 (19.4 %) cattle, 16/203 (7.9 %) goats and 9/205 (4.4 %) sheep. Cattle were 5.2 and 2.8 times more likely to be Brucella-seropositive than sheep (p = 0.000003) and goats (p = 0.001), respectively. When mRBPT-positive samples were tested by iELISA, 29/64 (45.3 %; 95 %CI: 32.8–58.3 %) ruminant sera were positive for Brucella spp. Only 23/39 (58.9 %) cattle sera and 6/16 (37.5 %) goat sera were positive to Brucella spp. by iELISA.

Conclusions

The present study showed the serological evidence of RVF and brucellosis in ruminants from Afgoye and Jowhar districts of Somalia. Considering the negligence of the zoonotic diseases at the human-animal interface in Somali communities, a One Health approach is needed to protect public health.

Prevalence of Anti-Toxoplasma gondii and Anti-Brucella Spp. Antibodies in Pregnant Women From Mogadishu, Somalia

Toxoplasmosis and brucellosis are zoonotic diseases of worldwide distribution. They both cause abortion and infertility in human and animals. Limited data are available about these pathogens in Somali people and their animals. Hence, this study has evaluated the prevalence of anti-Toxoplasma gondii and anti-Brucella spp. antibodies in pregnant women in Mogadishu, Somalia. Serum samples from 307 pregnant women from Mogadishu, Somalia were tested for anti-T. gondii antibodies by Latex Agglutination Test (LAT) and anti-Brucella spp. antibodies by Rose Bengal Plate Test (RBPT) and a commercial competitive-ELISA (cELISA). A total of 119/307 (38.76%) pregnant women had a prior history of abortion. A total of 159/307 (51.79%; 95% CI: 46.2–57.35%) pregnant women were seroreactive for T. gondii by LAT at different stages of pregnancy. For Brucella spp., when RBPT and cELISA were combined 4/307 (1.30%; 95% CI: 0.36–3.30%) pregnant women were seroreactive to anti-Brucella spp. antibodies, being 2/307 (0.65%; 95% CI: 0.18–2.34%) by RBPT and 3/307 (0.98%; 95% CI: 0.33–2.83%) by cELISA. Two women were seroreactive for both agents. A high seropositivity to T. gondii and low seropositivity to Brucella spp. have been found in pregnant women from Mogadishu, Somalia. Considering the high number of abortions in the country associated to the fact that awareness on other zoonotic abortifacient pathogens in Somalis is very low, further studies should be conducted to evaluate the potential causes of abortions.

Parasitological, serological and molecular survey of camel trypanosomiasis in Somalia

Background

Camel trypanosomiasis or surra is of great concern in Somalia, since the country possesses the largest one-humped camel (Camelus dromedarius) population in the world. Civil war in Somalia has resulted in the destruction of educational, research, economic and social structures, making the country scores very low for most humanitarian indicators. Previous studies on detection of Trypanosoma species in Somali camels have only been performed during the 1990s using standard trypanosome detection methods (STDM). Considering the lack of state-of-the-art knowledge on camel trypanosomiasis in Somalia, the present study aimed to assess the prevalence of Trypanosoma spp. in three districts of Somalia.

Methods

A total of 182 blood samples from C. dromedarius from nomadic and dairy farms were evaluated using STDM, serological (CATT/T. evansi) and molecular (ITS1-PCR) methods.

Results

All samples were negative for Trypanosoma spp. by STDM. A total of 125/182 (68.7%, 95% CI: 61.4–75.3%) camels were seropositive for T. evansi by CATT/T. evansi. Camels reared in nomadic system were more likely to be seropositive for T. evansi than those under dairy production system (OR: 5.6, 95% CI: 2.1–15.2, P = 0.0001). Five out of 182 (2.7%, 95% CI: 0.9–6.3%) camels tested positive for Trypanosoma sp. by ITS1-PCR. Sequencing of the ITS1 region of the Trypanosoma species detected herein revealed that camels were infected with T. evansi and T. simiae.

Conclusions

Trypanosoma evansi is highly prevalent in camels from the Banadir region of Somalia, particularly in nomadic herds. To our knowledge, this is the first study to confirm infections with T. evansi and T. simiae in Somali camels through DNA sequencing. Our data highlight the need for implementation of adequate control measures aiming to reduce the impact on camel production in the country.

Differential Responding to Positive and Negative Items: The Case of a Negative Item in a Questionnaire for Course and Faculty Evaluation

Previous factor-analytic studies of self-rating scales have yielded a factor on which negatively worded items loaded separately. The present study investigated the existence for such a factor in a questionnaire for course and teacher evaluation which included one negative item. The questionnaire was administered in 1,095 university classes Two factors emerged, an exclusively positive-item factor and another factor on which the single negative item and one positive item loaded It was suggested that both items of Factor 2 were ambiguous and may identify tendencies such as acquiescence, random responding, and response sets.

Studies on the molluscicidal activity of Agave angustifolia and Pittosporum tobira on schistosomiasis transmitting snails

In the search for new molluscicidal plants for controlling the snail vectors of schistosomiasis, laboratory evaluation was made to assess the molluscicidal activity of Agave angustifolia and Pittosporum tobira plants against Biomphalaria alexandrina snails. Results indicated that both plants have promising molluscicidal activity as the LC90 of the dry powder of both plants was 120 ppm. Both plants showed marked cercaricidal and miracidicidal potencies against S. mansoni larvae. The LC90 of both plants (120 ppm) killed most B. alexandrina eggs within 24 h of exposure. The sub-lethal concentrations of both plants markedly suppressed the survival rate of B. alexandrina snails and the mortality increased with increasing the concentrations and the exposure period up to 10 successive weeks. The accumulative toxic effect of these concentrations was continuous during the recovery period. Also, the reproductive rates of exposed snails were greatly affected even through the recovery period. This depression in reproductive ability of snails was accompanied by histological damage in the hermaphrodite glands of exposed snails. Meanwhile, the growth of snails was estimated weekly and it showed great inhibition in exposed snails comparing with the control ones.

Fibulin-2 is involved in early extracellular matrix development of the outgrowing mouse mammary epithelium

Cell-matrix interactions control outgrowth of mammary epithelium during puberty and pregnancy. We demonstrate here that the glycoprotein fibulin-2 (FBLN2) is strongly associated with pubertal and early pregnant mouse mammary epithelial outgrowth. FBLN2 was specifically localized to the cap cells of the terminal end buds during puberty and to myoepithelial cells during very early pregnancy (days 2-3) even before morphological changes to the epithelium become microscopically visible, but was down-regulated thereafter. Exposure to exogenous oestrogen (E2) or E2 plus progesterone (P) increased Fbln2 mRNA expression in the pubertal gland, indicating hormonal control. FBLN2 was co-expressed and co-localised with the proteoglycan versican (VCAN) and co-localised with laminin (LN), while over-expression of FBLN2 in HC-11 cells increased cell adhesion to several extracellular matrix proteins including LN and fibronectin, but not collagens. Mammary glands from Fbln2 knockout mice showed no obvious phenotype but increased fibulin-1 (FBLN1) staining was detected, suggesting a compensatory mechanism by other fibulin family members. We hypothesise that similar to embryonic aortic smooth muscle development, FBLN2 and VCAN expression alters the cell-matrix interaction to allow mammary ductal outgrowth and development during puberty and to enable epithelial budding during pregnancy.

Progress towards implementation of ACT malaria case-management in public health facilities in the Republic of Sudan: a cluster-sample survey

BACKGROUND

Effective malaria case-management based on artemisinin-based combination therapy (ACT) and parasitological diagnosis is a major pillar within the 2007-2012 National Malaria Strategic Plan in the Sudan. Three years after the launch of the strategy a health facility survey was undertaken to evaluate case-management practices and readiness of the health facilities and health workers to implement a new malaria case-management strategy.

METHODS

A cross-sectional, cluster sample survey was undertaken at public health facilities in 15 states of Sudan. Data were collected using quality-of-care assessment methods. The main outcomes were the proportions of facilities with ACTs and malaria diagnostics; proportions of health workers exposed to malaria related health systems support activities; and composite and individual indicators of case-management practices for febrile outpatients stratified by age, availability of ACTs and diagnostics, use of malaria diagnostics, and test result.

RESULTS

We evaluated 244 facilities, 294 health workers and 1,643 consultations for febrile outpatients (425 < 5 years and 1,218 ≥ 5 years). Health facility and health worker readiness was variable: chloroquine was available at only 5% of facilities, 73% stocked recommended artesunate and sulfadoxine/pyrimethamine (AS+SP), 51% had the capacity to perform parasitological diagnosis, 53% of health workers had received in-service training on ACTs, 24% were trained in the use of malaria Rapid Diagnostic Tests, and 19% had received a supervisory visit including malaria case-management. At all health facilities 46% of febrile patients were parasitologically tested and 35% of patients were both, tested and treated according to test result. At facilities where AS+SP and malaria diagnostics were available 66% of febrile patients were tested and 51% were both, tested and treated according to test result. Among test positive patients 64% were treated with AS+SP but 24% were treated with artemether monotherapy. Among test negative patients only 17% of patients were treated for malaria. The majority of ACT dispensing and counseling practices were suboptimal.

CONCLUSIONS

Five years following change of the policy from chloroquine to ACTs and 3 years before the end of the new malaria strategic plan chloroquine was successfully phased out from public facilities in Sudan, however, an important gap remained in the availability of ACTs, diagnostic capacities and coverage with malaria case-management activities. The national scale-up of diagnostics, using the findings of this survey as well as future qualitative research, should present an opportunity not only to expand existing testing capacities but also to implement effective support interventions to bridge the health systems gaps and support corrective case-management measures, including the discontinuation of artemether monotherapy treatment.

Adnexal mass vascularity assessed by 3-dimensional power Doppler: does it add to the risk of malignancy index in prediction of ovarian malignancy?: four hundred-case study

The Risk of Malignancy Index (RMI) is used for the prediction of ovarian malignancy. It includes menopausal status, carbohydrate antigen 125 serum levels, and ultrasound criteria. Three-dimensional power Doppler (3-DPD) is a reproducible investigation for assessment of tumor vascularity, classifying vascularity to avascular, parallel, and chaotic patterns. In this study; 3-DPD was added to RMI for prediction of malignancy in 400 cases of ovarian masses. Sensitivity of RMI for prediction of malignancy was 88%, with a cutoff value of 202.5 at 95% confidence interval. Sensitivity of 3-DPD for prediction of malignancy was 75%, adding 3-DPD to RMI increased its sensitivity to 99%. Considering the pilot nature of the study, further studies are needed to corroborate such findings.

Preoperative breast ultrasound and Doppler velocimetric findings in patients with breast cancer

PURPOSE

To evaluate the role of ultrasound and Doppler velocimetry in the diagnosis of breast cancer.

METHODS

Thirty breast cancer patients, diagnosed by clinical examination, mammography and fine needle aspiration, or trucut biopsy were assessed by breast ultrasound including Doppler velocimetry to evaluate blood flow in the axillary and lateral thoracic arteries. Postoperative histopathological examination proved malignancy in all cases. This cohort was compared to another group of 30 patients with proven benign breast disease and a cross-matched control group of 30 asymptomatic women with no breast disease.

RESULTS

In the 30 cancer patients, the size of masses ranged from 1-4 cm (2.51 +/- 1.13), the mean axillary artery resistance index (RI) ranged from 0.8-0.88 (0.84 +/- 0.03), and the lateral thoracic artery RI ranged from 0.45-0.59 (0.55 +/- 0.106). However, power Doppler did not detect any increased perfusion. In the benign group, the lateral thoracic artery RI ranged from 0.78-0.86 (0.85 +/- 0.8) and the axillary artery RI ranged from 0.81-0.89 (0.81 +/- 0.05), while in the control group, the mean lateral thoracic artery RI ranged from 0.85 to 0.89 (0.87 +/- 0.082), and the axillary artery RI ranged from 0.84-0.9 (0.88 +/- 0.16). Statistical analysis revealed only a high statistical significance (p < 0.01) for the lateral thoracic artery indices between the malignant group as compared to the benign and normal groups. There was no statistical significant difference in the axillary artery RI between the three groups.

CONCLUSION

It is suggested that a marked decrease in the lateral thoracic artery RI with a cut-off value less than 0.6 is highly suggestive of malignancy. Taking the pilot nature of the results, further studies with much larger numbers are needed to corroborate such findings.

Cystic echinococcosis of livestock and humans in central Sudan

New information was collected on cystic echinococcosis in livestock (camels, cattle and sheep) and humans in the central region of Sudan. The livestock data were collected in abattoir-based surveys in the towns of Omdurman, Tamboul and Wad Madani, between 1998 and 2001, and covered a total of 8205 animals. The highest prevalence of infection was found in the camels (44.6% of 242 infected), followed by the sheep (6.9% of 5595) and cattle (3.0% of 2368). Records were made of the sizes of the 1320 hydatid cysts detected in the livestock (907 in sheep, 71 in cattle, and 342 in camels), whether or not each cyst was fertile, and where it occurred in the body of the host. Cysts collected from cattle and camels where much more likely to be fertile (22% and 24%, respectively) than those from sheep (1%). Camels and cattle therefore appear to be the principal intermediate hosts for Echinococcus granulosus in central Sudan, whereas sheep apparently play a marginal role in transmission. In 2002, as a preliminary assessment of the public-health impact of the disease, 300 residents of a rural village 60 km west of Wad Madani were surveyed using a portable ultrasound scanner. Only one (0.33%) of the villagers investigated was found infected. The implications of these finding are discussed in terms of the various strains of E. granulosus and the role of each in human disease.

Efficacy of Sulphadoxine and Pyrimethamine, Doxycycline and their combination in the treatment of chloroquine resistant Falciparum Malaria

OBJECTIVE

The present in vivo study evaluates the efficacy of sulphadoxine/pyrimethamine, doxycycline and their combination in the treatment of Sudanese patients infected by chloroquine resistant falciparum malaria.

METHODS

Febrile patients with positive blood smears of Plasmodium falciparum were given chloroquine 25mg-base/kg body weight and followed up for 3 days. Patients with recrudescence due to chloroquine resistance were readmitted for test treatment. Using simple number randomization patients were divided into groups, A, B and C. These were treated with doxycycline, sulphadoxine/ pyrimethamine and a combination therapy of sulphadoxine/pyrimethamine plus doxycycline. Doxycycline was initially administered as a single dose of 200mg followed by 100mg daily for 6 days whereas sulphadoxine/pyrimethamine was given as a single dose of sulphadoxine 1500mg and pyrimethamine 75mg. Patients of group C received the combination therapy of sulphadoxine/pyrimethamine and doxycycline. Clinical observations and examination of blood films were carried out for each patient daily for 6 days and thereafter weekly for 4 weeks.

RESULTS

A high level of chloroquine resistance (75%) was documented amongst 280 patients (age 15-53 years) visiting Omdurman Hospital of Endemic Diseases during 1996-1998. The study demonstrated that only 46% and 78% of the patients were cured after 4 days of treatment by doxycycline and sulphadoxine/pyrimethamine. Patients treated with sulphadoxine/pyrimethamine in combination with doxycycline had a cure rate of 90% and 100% after 3-4 days of treatment, a single recrudescent case was detected on day 6. No relapses occurred during the follow up period. All patients were successfully treated by all regimens with the exception of one case treated by doxycycline. All treatments were well tolerated but a few cases had complaints of nausea.

CONCLUSION

The combination therapy of doxycycline/sulphadoxine/pyrimethamine appeared to be significantly effective in the treatment of patients with chloroquine resistant falciparum malaria without causing any serious side effects. Such a combination regimen has the advantages of being available at a reasonable cost and less prone to development of resistance.

Effect of combined praziquantel and recombinant glutathione S-transferase on resistance to reinfection in murine Schistosomiasis mansoni

This study was undertaken to evaluate the effect of recombinant Schistosoma mansoni-26 Glutathione S-transferase (rSm 26 GST) or soluble egg antigen (SEA) alone and in addition to praziquantel (PZQ) on the state of resistance to S. mansoni reinfection. The associated changes in the immune responses were evaluated. The experimental group of mice were injected intravenously before S. mansoni infection (80 cercariae/mouse) either with rSm26 GST (1 microgx4) or SEA (10 microgx4) in addition to PZQ (2x500 mg/kg) administered 6 weeks post-infection. Seven control groups were used, three of them were the infected (80 cercariae/mouse), the challenged (240 cercariae/mouse) and the infected challenged controls (80+240 cercariae/mouse). The rest of the four groups were the treated controls receiving: the GST-Lyzate, rSmGST, SEA and PZQ in the same doses and at the same timings. Challenge infection was conducted for all the groups 8 weeks post-infection. Animals were sacrificed 3 weeks post-challenge. After sacrifice animals were perfused and percentage resistance to reinfection was calculated. Immune responses were assessed by the measurement of hepatic granuloma diameter, intralesional T-cell phenotypes and serum immunoglobulin isotypes. The highest percentage of resistance to reinfection was observed in rGST-treated group while the lowest percentage of resistance was detected in PZQ-treated group. Whereas in mice receiving combined rGST or SEA and PZQ, percentage resistance to reinfection was significantly higher than that in PZQ treated mice. The remarkable reduction in granuloma diameter in rGST-treated group with or without PZQ was associated with decrease in the intralesional L(3)T(4)(+) and increase in Lyt(2)(+) T-cell phenotypes. However, no special relationship was observed between the percentage of resistance and the changes in granuloma diameter or intralesional T-cell phenotypes. The increase in percentage resistance to reinfection was found accompanied by increased anti SWAP IgE. Combined rGST and PZQ provided the complementary goals of improved state of resistance to reinfection 'which was compromized after cure with PZQ' and the maximal reduction in granuloma diameter.

Involvement of the cavernous sinus by malignant (extracranial) tumour: palliation in six cases without surgery

Involvement of the cavernous sinus region due to haematogenous spread or by local extension of a malignant head and neck tumour does not occur frequently. Six patients were treated by external beam radiation with (n=3) or without neoadjuvant chemotherapy between December 1989 and February 1996. Manifestations of the condition mainly consisted of fifth and sixth cranial nerve deficits (n=4). Complete resolution of cranial nerve deficits after therapy occurred in two of the four patients with only three individuals having been evaluable. Three of the six patients survived for more than 3 years. Thus, palliation can be achieved by chemoradiation or radiotherapy alone, and long term survival is not precluded.

Ketotifen in treatment of uncomplicated falciparum malaria

OBJECTIVE

The present in vivo study evaluates the potential use of ketotifen, a tricyclic antihistaminic drug, in treatment of Sudanese patients with uncomplicated Plasmodium falciparum malaria (19-38 years).

METHODS

Four groups of patients (each has 15) were randomly selected and treated by chloroquine (25mg/kg wt) in comparison with regimen combinations of ketotifen (0.13 mg/kg body wt) with chloroquine, ketotifen with Fansidar (33.3mg/kg body wt) and ketotifen with both chloroquine and Fansidar.

RESULTS

Prior to treatment all patients had a parasite density that varied from 1 x 10(3)-3.46 x 10(4)/mL blood. On day 2, the highest level of parasitaemia was recorded in patients treated with chloroquine only. Other patients had a significantly lower parasitaemia (P<0.05) with an average range of 111-243 parasites/300 leucocytes. On day 3 no parasites were detected in groups treated by ketotifen and Fansidar or by ketotifen in combination with Fansidar and chloroquine. The mean time of parasite clearance was minimum (<32 h) amongst patients that had chloroquine administered with ketotifen alone or with both Fansidar and ketotifen. The cumulative percentage of cases with recrudescence was >39% in groups that had the chloroquine regimen alone or the combination of chloroquine with ketotifen. A single case of recrudescence was also diagnosed on day 28 in the group treated with ketotifen plus fansidar but no recrudescence occurred in the group treated with the combination of the three drugs.

CONCLUSION

This study indicates the possible role of ketotifen in treatment for falciparum malaria particularly when administered in combination with chloroquine and fansidar.

Effect of Schistosoma mansoni infection on offsprings born from infected mothers

Offsprings C57BL/6 mice (4 weeks old) coming from either moderately infected (40 S. mansoni cercariae) or heavily infected (100 S. mansoni cerariae) mothers, were exposed to 40 S. mansoni cercariae each. Seven weeks post infection (P.I.), Offsprings were sacrificed. In both groups there was significant reduction in the worm load, both hepatic and intestinal tissue egg count. The oogram profile was not altered. Humoral immune response as regards the level of anti S. mansoni SEA Ab was elevated in both groups in comparison to their parallel controls at 2 weeks post delivery and 7 weeks P.I. The level of antibodies was significantly higher in heavily infected Offsprings than that present in offsprings coming from moderately infected mothers. Delayed footpad swelling and hepatic granuloma size were significantly reduced in both groups comparing with their corresponding controls.

Mutual effect of Schistosoma mansoni infection and pregnancy in experimental C57 BL/6 black mice

Sixty female C57BL/6 mice were infected with 40 Schistosoma mansoni cercariae each. Seven weeks later, they were mated with normal syngeneic males. Uninfected mice (30) were bred in parallel, and both groups were bred several more times with daily records of pregnancy, delivery and number of offsprings. The number of pregnancy was 146, with 50 survived infants (34.2%) in contrast to 121 pregnancy with 93 survived infants (76.8%) in controls. The outcome of pregnancy was 13% abortion, 10.9% maternal death and 41.7% infanticide. The weight of offspring at 2 and 4 weeks of age was significantly less than in controls (P < 0.01). Again, C57BL/6 (40) female mice were mated, then infected with 100 S. mansoni cercariae each. The results showed that, pregnancy had no effect on bilharzial infection as the total worm burden and distribution, hepatic and intestinal tissue egg count and the oogram profile, were not significantly differ from that in the control group (20). Besides, the immediate footpad swelling was significantly higher but the delayed footpad swelling and the level of antibodies against S. mansoni soluble egg antigen were insignificantly differ from that present in the parallel control (infected but not pregnant). As regards histopathological parameters, although there was insignificant difference in the size of hepatic granuloma, yet there was more collagenous fibrous tissue deposition distributed in-between inflammatory cells specially at the periphery of the granuloma.

Phosphatidylinositol transfer protein in lung: cellular and subcellular localization

Determination of the cellular distribution of phosphatidylinositol transfer protein in rat lung by immunocytochemistry revealed that the protein is more readily observed in the nonciliated bronchial epithelial cells (Clara cells) than in other lung cells. By light microscopy, the phosphatidylinositol transfer protein (PtdIns-TP) was localized to the dome-shaped apical region of Clara cells that were identified by staining with an antibody to Clara cell protein. Further investigation by electron microscopy revealed that the PtdIns-TP accumulated at the limiting membrane surrounding secretory granules and at the apical plasma membrane. This localization is compatible with the proposed roles for PtdIns-TP in formation of vesicles and exocytosis of secretory granules and, when considered in the context of the proposed role of PtdIns-TP in phosphatidylinositide metabolism, suggests that phosphatidylinositides may be involved in the mechanisms regulating Clara cell secretion.

Gender aspects and women's participation in the control and management of malaria in central Sudan

This work was designed to study the contribution of women in central Sudan in the control and management of malaria with particular emphasis on gender-related aspects that define women's role and participation. The Blue Nile Health Project (BNHP 1980-1990) was launched in 1980 mainly for control of water associated diseases in central Sudan. The BNHP model was chosen to conduct this work. The study showed that women were actively involved in the implementation of the BNHP strategies as health instructors (murshidat) who constituted 75% of the staff of BNHP unit of health education, as members of village health committees (VHC) where they constituted 40% of the VHC members and also as recipients of the project services. All murshidat were interviewed whereas multistage random sampling for VHC members and recipient women in 40 villages was used to select a sample which was interviewed. The results showed that the murshidat and VHC women members played a major role in the motivation, organization and health education of local communities prior to campaigns of environmental sanitation and vector control. Household commitments and difficulties in communication with the public were the main gender-related factors that contributed negatively to women's activities. Cases of malaria have more considerable socio-economic impact than other common diseases, especially with regard to women's household commitments and work. Recipient women were more concerned with aspects of self protection, management of family cases of malaria and health education programmes. They were less involved in drying mosquito breeding sites and spraying activities of insecticides which had been reluctantly accepted because of allergy and bad odour. Although the majority of women considered antimalarials to be less harmful than effects of malaria itself on pregnancy, they did not realize the role of malaria chemoprophylaxis during pregnancy. This needs more health education. The study showed that the BNHP programme was very successful in recruiting women in control and management programmes. Therefore, health planners are urged to persuade the subordinated communities of women in many African countries like Sudan to play a more active role in the health programmes and welfare of their communities.

The karyotypes of Calicophoron microbothrium and Carmyerius gregarius from Egyptian ruminants

The karotypes of the two amphistomes Calicophoron microbothrium Fischoeder, 1901 and Carmyerius gregarius (Looss, 1896), Stiles & Goldberger, 1910 from Egyptian ruminants were studied using the air drying technique. The two species have similar number of chromosomes (n = 9), but differ in chromosome morphology. All the chromosomes of C. microbothrium are subtelocentric, except the first and the fifth are metacentric, whereas the chromosomes of C. gregarius are submetacentric, subtelocentric and acrocentric. Some cells in the two species showed tetraploidy. The results are discussed in terms of the phylogenetic relationship of different amphistomes.

Marine algae that display anti-tumorigenic activity against Agrobacterium tumefaciens

Thirty-five extracts representing different seasonal growths of 17 marine algal species collected from the Alexandria coast were tested for anti-tumorigenic activity against Agrobacterium tumefaciens galls on potato discs. Eleven extracts (nine species) displayed > 20% inhibition of tumor initiation, with three of these (Codium tomentosum, winter; Jania rubens, summer; Padina pavonia, winter) displaying relatively high activity. Bacterial viability tests showed that the inhibitory effects were directly due to anti-tumorigenesis rather than an indirect result of anti-bacterial activity.

Oxazole, pyrazole and piperidine derivatives having an o-hydroxyaryl moiety with anticipated molluscicidal activity

The condensation reactions of hippuric acid and its furyl derivative with salicylaldehydes or that of salicylhippuric acid analogues with furaldehyde led to the corresponding oxazoles. These were subsequently treated with hydrazine hydrate, hydroxylamine or subjected to alkaline hydrolysis to yield new o-hydroxyaryl or salicyl containing derivatives. 5-Substituted salicylanilides were treated with piperidine and formaldehyde in a Mannich type reaction affording the corresponding 3-(N-piperidinomethyl) salicylanilides. It was noticed that the presence of an electron donating group in position 3 in the salicylanilide moiety decreases the molluscicidal activity.

Assessment of chloroquine resistance of Plasmodium falciparum in children of Wad Medani (Central Sudan)

The study reports on chloroquine resistance of Plasmodium falciparum among Sudanese children (6 month to 16 years) living at Wad Medani, Central Sudan. All RI-III levels of resistant response were confirmed, while in vitro sensitivity test indicated that 25 per cent of P. falciparum isolates examined had exhibited maturation of schizonts at CQ level greater than or equal to 1.6 pmol/microliters blood. CQ was sufficiently retained for 7 days after drug administration whereas an average peak level of CQ in blood (348 ng/ml) was recorded on day 1. Patients were successfully treated by an age-measured dose of parenteral quinine (10 mg/kg).

Effect of the organophosphorous insecticide, chlorpyrifos (Dursban), on growth, fecundity and mortality of Biomphalaria alexandrina and on the production of Schistosoma mansoni cercariae in the snail

Exposure of Biomphalaria alexandrina to sublethal concentrations (0.125, 0.25 and 0.05 ppm) of the organophosphorous insecticide, chlorpyrifos (Dursban), induced a reduction in egg production and egg hatchability. Exposure of Schistosoma mansoni miracidia to the insecticide (60 min, 0.50 ppm) prior to infection of B. alexandrina did not affect the subsequent production of cercariae. However, exposure of S. mansoni-infected snails to the insecticide until day 55, from day 20 to day 62 and from day 35 to 62 following infection resulted in blockage of cercarial shedding. Cercarial shedding commenced in some snails when the treatment stopped. Exposure to the insecticide in concentrations of 0.125 and 0.25 ppm during the first 20 days following infection did not affect the subsequent production of cercariae, but exposure to 0.5 ppm during the first 20 days affected markedly the production of cercariae due to a high snail mortality. The findings indicate that the cercaria is the target stage for the activity of chlorpyrifos on the intramolluscan larval development. It is suggested that S. mansoni cercarial production in B. alexandrina may be a useful system for monitoring the effect of low concentrations of pesticides on the aquatic environment, and that the ability by chemical means to interrupt the cercarial production might be a useful tool in further analyses of important aspects of the snail/parasite relationship.

Tuberculosis in patients with malignant disease

Of 2,143 biopsy proven cancer patients seen at our hospital over a six year period, 4 (0.19%) patients developed active tuberculosis (TB) during anticancer therapy or shortly after its completion. The cancer diagnoses of those patients were non-Hodgkin's lymphoma, breast cancer, chronic myelogenous leukemia, and astrocytoma. Institution of antituberculous therapy was successful in three patients, however, the TB course was rapidly fatal in the fourth patient with non-Hodgkin's lymphoma despite therapy. The association between TB and neoplasia is emphasized. TB complicating malignant disorders represents complex problem regarding its early recognition and its managements.

A study of the relationship between the energy contents of Schistosoma mansoni cercariae and their death during penetration of mammalian host skin

Immersion of Biomphalaria pfeifferi in 1.5% glucose solution showed that the snails did not absorb any glucose during the first six hours but that almost 30% of the glucose was absorbed after 24 hours. The glycogen content of such "glucose-fed" snails was much higher than that of control normal snails. Cercariae of S. mansoni collected from the former snails exhibited a much lower level of death (20%), during penetration of mouse skin, than that of control normal cercariae (36%). It is suggested that death of S. mansoni cercariae during penetration of mammalian host skin is probably due to exhaustion of their energy reserves.

Protein-calorie malnutrition (PCM) in Egypt immunological changes of salivary protein in PCM

Whole saliva protein as well as the separated protein components were estimated in normal and malnourished Egyptian infants and young children. In normal, 8 protein components (Albumin, alpha1-antitrypsin, haptoglobin, beta2-lipoprotein, transferrin, IgA, IgM and IgG) were detected, while in PCM cases two more components (prealbumin and alpha2-macroglobulin) were found. The results also showed that the level of salivary protein components are markedly increased in edematous cases. In non-edeomatous ones, the level of these constituents are slightly increased in 3rd marasmus, but diminished in 2nd grade. It is concluded that the elevation of protein components in saliva of edematous cases could be a result of severe glandular tissue involvement as compared to controls and non-edematous cases. The value of IgA immunoglobulin as specific antibody originated from blood plasma and/or salivary glands may be used to reflect the extent of tissue affection in salivary glands of malnourished cases.

Diagnostic and prognostic significance of serum and urinary enzymes in nephropathies among Egyptian children

Study of serum and urinary enzyme pattern in nephropathies revealed that before treatment, cases of both acute nephritis and nephrotic syndrome were found to have an increased activity of the three enzymes studied in both serum and urine (Alkaline and acid phosphatases and Lactic dehydrogenase). However, there was no constant correlation between the level of serum and urinary enzyme activities. Distorted pattern of the enzymes has a more protracted course in nephrotics. After treatment, serum and urinary enzymes tended to normalise in cases of acute glomerulonephritis. However, urinary alkaline phosphatase remained high nephrotics after clinical remission. In some cases of acute nephritis, a persistently high level of serum enzyme may indicate an incipient nephrotic element. Nephrotics not responding to the four weeks course of corticosteroid therapy have persistently high serum and urinary enzyme activities. Thus, estimation of serum and urinary enzyme pattern in nephropathies may be of diagnostic and prognostic value.

On Allocreadium sudanensis sp. nov. (Trematoda: Digenea) from a freshwater fish in the Sudan

Allocreadium sudanensissp. nov. is described from a cyprinid fish (Barbus bynni) from the White Nile in the Sudan. The new species is compared with other related species ofAllocreadium.

A key for identification of five African species of the genusAllocreadiumis given.

The present material was collected by the senior author in January, 1969 from the intestine of a cyprinid fish,Barbus bynni(Forskal), caught from the White Nile at Rabag near Kosti (about 200 miles to the south of Khartoum) in the Sudan. Eighteen trematodes, collected from a single infected fish, were fixed in hot 70% alcohol. Examination of these specimens in whole mounts stained in aceto-alum carmine and in sectioned material revealed that they belong to a hitherto unknown species of trematodes belonging to the genusAllocreadium, Looss (1900) which is described here asAllocreadium sudanensissp.