Genotyping of foot-and-mouth disease viruses collected in Sudan between 2009 and 2018

Foot-and-mouth disease (FMD) is widely distributed in Sudan where outbreaks occur on an annual basis especially during the winter months (December-February). This study aimed to increase our understanding of the epidemiological patterns of FMD in Sudan and connections to neighbouring countries by characterizing the genetic sequences of FMD viruses (FMDV) collected from samples collected in 10 Sudanese states over a 10-year period (between 2009 and 2018). FMDV was detected in 91 of the 265 samples using an antigen-detection ELISA. Three serotypes were detected: O (46.2%), A (34.0%), and SAT 2 (19.8%). Fifty-two of these samples were submitted for sequence analyses, generating sequences that were characterized as belonging to O/EA-3 (n = 17), A/AFRICA/G-IV (n = 23) and SAT 2/VII/Alx-12 (n = 12) viral lineages. Phylogenetic analyses provided evidence that FMDV lineages were maintained within Sudan, and also highlighted epidemiological connections to FMD outbreaks reported in neighbouring countries in East and North Africa (such as Ethiopia and Egypt). This study motivates continued FMD surveillance in Sudan to monitor the circulating viral lineages and broader initiatives to improve our understanding of the epidemiological risks in the region.

Serological detection and genetic characterization of foot-and-mouth disease virus from cattle in northern sudan, 2016‑2018

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Clinical FMD was confirmed as serotype O of an unnamed lineage within the topotype East Africa 3 (EA3).

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Unlike Western, Eastern, Central and Southern Sudan, no predominance of serotype O antibodies was detected in Northern Sudan.

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Sero-prevalence estimates of serotype-specific antibodies ranged between 15.4% (serotype A) in the River Nile State to 3.4% (serotype SAT2) in the Northern State.

Northern Sudan is an important corridor cluster between pools of foot-and-mouth disease virus (FMDV) in East and North Africa. It involves almost the whole border area with Egypt and represents a considerable part of a projected disease-free zone in Sudan. The study monitored FMD infection between 2016 and 2018 in Northern Sudan. Clinical and serological surveillance were carried out. Results largely confirmed previous reports that have described the relatively lower circulation of FMDV in the area than in other parts of the country. Clinical FMD was confirmed, once in the three years period, as serotype O of an unnamed lineage within the topotype East Africa 3 (EA3). Using serial testing (the ID ELISA and virus neutralization test), sero-prevalence estimates of serotype-specific antibodies in the two States of Northern Sudan ranged between 15.4% (serotype A) in the River Nile State to 3.4% (serotype SAT2) in the Northern State. Striking disparities between patterns of FMD in Northern Sudan and the rest of Sudan were observed. Unlike Western, Eastern, Central and Southern Sudan, no predominance of serotype O antibodies was detected in Northern Sudan. Concurrently, a serotype O isolate from Northern Sudan in 2016 was found to be of transboundary nature circulating in East and North Africa and in the Middle East (nt. id. > 99%); like serotype O that caused the last episode of disease in Northern Sudan in 2012. Molecular findings were compatible with the inferred low circulation of FMDV in Northern Sudan. Elsewhere in Sudan, endogenous serotype O viruses seemed to be circulating more unabated. It was concluded that low animal density and limited animal movement in Northern Sudan together with the high antibody levels against serotype O in immediately neighbouring States (Khartoum and Kassala) effectively decreased infiltration of endogenous O viruses.

Comparison of different methods of detection of enteric pathogenic protozoa

PURPOSE

The study was conducted to compare different methods of detection of pathogenic protozoan parasites in stool specimens of People Living with HIV/AIDS (PLHA).

MATERIALS AND METHODS

Stool specimens of 242 HIV sero-positive patients were examined using the wet mount technique, modified Ziehl-Neelsen's (ZN) staining, auto-fluorescence and auramine fluorescence staining. Patient specimens, 94 and 40 out of 242, were also subjected to Giardia antigen detection using an enzyme immunoassay and Cryptosporidium antigen detection by immuno-chromatography, respectively. For calculation of sensitivity, specificity, positive and negative predictive values, light microscopy of wet mounts and modified ZN stained smears for Giardia and Coccidia, respectively, were considered as gold standards.

RESULTS

Sensitivity of auto-fluorescence, auramine-O staining and antigen detection techniques was found to be 100% as compared to the routine standards. The specificity of auto-fluorescence was 90.6% and 100% for Cyclospora and Isospora, respectively; that of auramine-O staining was 98.9% for Cryptosporidium, 99.30% for Cyclospora and 100% for Isospora; and that of antigen detection was 90.6% and 97.7% for Cryptosporidium and Giardia, respectively.

CONCLUSION

In laboratories requiring screening of large number of stool specimens for detection of protozoan parasites, fluorescence microscopy and antigen detection can be useful techniques. Confirmation of positive results, however, needs to be done with the standard techniques.

A rare case of cutaneous larva migrans due to Gnathostoma sp

A 28-year-old lady presented with recurrent erythematous skin lesions in different parts of the body for 3 months. There were several episodes of worm coming out of the lesions. Examination of the worms in the parasitology laboratory revealed it to be a larva of Gnathostoma sp. She was advised treatment with Albendazole for 21 days, and there was no recurrence of lesions.

History of disorders of thyroid dysfunction

The first description of thyroid diseases as they are known today was that of Graves disease by Caleb Parry in 1786, but the pathogenesis of thyroid disease was not discovered until 1882-86. Thyroidectomy for hyperthyroidism was first performed in 1880, and antithyroid drugs and radioiodine therapy were developed in the early 1940s. Thomas Curling first described hyopothyroidism (myxoedema) in 1850 and the cause and suitable treatment were established after 1883. This paper reviews the main landmarks in the history of thyroid disease, supplemented by a brief discussion of the historically relevant scientific aspects of the thyroid gland, and the evolution of endocrinology as a formal discipline.

Attitudes towards euthanasia and assisted suicide among Sudanese doctors

An anonymous questionnaire was used to survey the attitudes of 382 doctors towards euthanasia and assisted suicide at Khartoum's two main hospitals. Of the 382, 248 responded (65% response rate). The mean age was 38 +/- 13.5 years; male:female ratio was 130:118; 66% were house staff, 34% specialists; 92% Muslim, 8% Christian. The vast majority (85%) strongly opposed the practices, while 15% thought they should be performed only in certain situations, subject to strict safeguards. Reasons given for opposition included religious beliefs, inconsistency with the doctor's role, presence of subtle pressures on patients, and potential for misuse among the physically and intellectually handicapped.

Diabetic autonomic neuropathy

OBJECTIVE

The diabetic autonomic neuropathy is a poorly studied subject in our medical literature. This study is aimed at investigating the presence of diabetic autonomic neuropathy in a group of Sudanese diabetic patients and its relationship to factors like glycemic control, duration of diabetes and presence of peripheral neuropathy.

METHODS

During one year we examined 120 diabetic patients and an age-matched control group of 42 by applying a battery of 5 cardiovascular autonomic tests, beside a full history and clinical examination. The patients were also tested for glycemic control and presence of peripheral neuropathy.

RESULTS

Diabetic autonomic neuropathy was diagnosed in 48 patients (40%) of a mean age of 48.411 +/- 12.50 years, type 1/2 diabetes was 10/38, mean duration of diabetes 16.2 +/- 7.3 years, 41 with poor glycemic control (81%) and peripheral neuropathy was present in 32 patients (66%). We found a significant association between diabetic autonomic neuropathy and prolonged duration of diabetes (P<0.001), poor glycemic control (0.01>P>0.001) and presence of peripheral neuropathy (0.02>P>0.01).

CONCLUSION

Diabetic autonomic neuropathy (both asymptomatic and symptomatic) is a common problem among our diabetic patients. It is significantly associated with prolonged duration, poor control of diabetes and presence of peripheral neuropathy. We need to augment the awareness of diabetes care providers to the occurrence, and peculiar features and tests of this syndrome.

Diabetic autonomic neuropathy

OBJECTIVE

The diabetic autonomic neuropathy is a poorly studied subject in our medical literature. This study is aimed at investigating the presence of diabetic autonomic neuropathy in a group of Sudanese diabetic patients and its relationship to factors like glycemic control, duration of diabetes and presence of peripheral neuropathy.

METHODS

During one year we examined 120 diabetic patients and an age-matched control group of 42 by applying a battery of 5 cardiovascular autonomic tests, beside a full history and clinical examination. The patients were also tested for glycemic control and presence of peripheral neuropathy.

RESULTS

Diabetic autonomic neuropathy was diagnosed in 48 patients (40%) of a mean age of 48.411 + 12.50 years, type 1/2 diabetes was 10/38, mean duration of diabetes 16.2 + 7.3 years, 41 with poor glycemic control (81%) and peripheral neuropathy was present in 32 patients (66%). We found a significant association between diabetic autonomic neuropathy and prolonged duration of diabetes (P<0.001), poor glycemic control (0.01>P>0.001) and presence of peripheral neuropathy (0.02>P>0.01).

CONCLUSION

Diabetic autonomic neuropathy (both asymptomatic and symptomatic) is a common problem among our diabetic patients. It is significantly associated with prolonged duration, poor control of diabetes and presence of peripheral neuropathy. We need to augment the awareness of diabetes care providers to the occurrence, and peculiar features and tests of this syndrome.

Gastroparesis diabeticorum: A clinical study in Sudanese patients

Full text is available as a scanned copy of the original print version.

Hepatic hydatid cysts: sonographic follow-up after percutaneous sonographically guided aspiration

PURPOSE

We studied the sonographic appearances of hepatic hydatid cysts and used sonography to follow up these cysts after sonographically guided aspiration using the PAIR technique.

METHODS

Included in this study were 362 patients with 558 hepatic hydatid cysts. Initial sonographic examination revealed 510 noncomposite cysts and 48 composite cysts (18 rosette and 30 honeycomb pattern). Noncomposite hydatid cysts (510 cysts) were aspirated and treated with scolicidal agents using the PAIR technique. Sonographic follow-up was done for up to 5 years after aspiration.

RESULTS

There was immediate detachment of the germinal layer in all cysts during aspiration. There were no serious complications. Sonographic follow-up after 1 month and 1 year revealed complete cyst collapse in 326 cysts (64%) and 449 cysts (88%), respectively. Repeat ultrasound scanning showed a continued decrease in the sizes of all remaining cysts. Organized lesions (pseudosolid pattern) were detected in only 26 cases after up to 5 years of follow-up.

CONCLUSIONS

The most common sonographic appearance of hepatic hydatid cysts among Egyptians is noncomposite, anechoic cysts. The PAIR technique is a safe, effective, and inexpensive therapeutic modality.