A recent symposium and workshop in Khartoum, the capital of the Republic of Sudan, brought together broad expertise from three universities to address the current burden of communicable and non-communicable diseases facing the Sudanese healthcare system. These meetings identified common challenges that impact the burden of diseases in the country, most notably gaps in data and infrastructure which are essential to inform and deliver effective interventions. Non-communicable diseases, including obesity, type 2 diabetes, renal disease and cancer are increasing dramatically, contributing to multimorbidity. At the same time, progress against communicable diseases has been slow, and the burden of chronic and endemic infections remains considerable, with parasitic diseases (such as malaria, leishmaniasis and schistosomiasis) causing substantial morbidity and mortality. Antimicrobial resistance has become a major threat throughout the healthcare system, with an emerging impact on maternal, neonatal and paediatric populations. Meanwhile, malnutrition, micronutrient deficiency and poor perinatal outcomes remain common and contribute to a lifelong burden of disease. These challenges echo the United Nations (UN) sustainable development goals and concentrating on them in a unified strategy will be necessary to address the national burden of disease. At a time when the country is going through societal and political transition, we draw focus on the country and the need for resolution of its healthcare needs.

The effect of relative humidity (RH) and temperature on the survival of airborne bovine rotavirus UK isolate (BRV-UK) and a murine rotavirus (MRV) was studied. In any one experiment, the virus under test was suspended in tryptose phosphate broth (TPB) supplemented with uranine (physical tracer) and an antifoam, was aerosolized using a Collison nebulizer into the rotating drum with the RH at either low (30 +/- 5%), medium (50 + 5%) or high (80 +/- 5%) level at 20 +/- 1 degrees C. Following a 15-min period of viral aerosol stabilization, sequential samples of drum air were collected using an All-Glass Impinger (AGI) for 24 h post-aerosolization. Both of the rotavirus isolates were found to survive best at medium RH level and high RH was found least favorable for the survival of these aerosolized rotaviruses. The survival pattern of aerosolized MRV was found to be the best when compared with survival pattern of all animal and human rotavirus isolates studies performed under aerosolized conditions in our laboratory. The findings of these experiments confirm and extend our previous reports on the survival of other animal and human aerosolized rotaviruses and emphasize the fact that air may be one of the vehicles for their dissemination and could explain why it is difficult to control nosocomial outbreaks of rotavirus gastroenteritis and to keep animal colonies rotavirus-free.

Carbapenem resistant Acinetobacter baumannii (CRAb) is an important global pathogen contributing to increased morbidity and mortality in hospitalized patients, due to limited alternative treatment options. Nine international clonal (IC) lineages have been identified in many countries worldwide, however, data still lacks from some parts of the world, particularly in Africa. We hereby present the molecular epidemiology of MDR A. baumannii from four hospitals in Khartoum, Sudan, collected from 2017 to 2018. Forty-two isolates were whole-genome sequenced, and subsequent molecular epidemiology was determined by core genome MLST (cgMLST), and their resistomes identified. All isolates had an array of diverse antibiotic resistance mechanisms conferring resistance to multiple classes of antibiotics. We found a predominance (88%) of IC2 (with the intrinsic OXA-66 and acquired OXA-23), and some with NDM-1. IC2 isolates were sub-divided into 4 STs separated by 5 to 431 allelic differences, and with evidence of seven transmission clusters. Isolates belonging to IC1, IC5, and IC9 were also identified. These data illustrate that MDR IC2 A. baumannii are widely distributed in Khartoum hospitals and are in possession of multiple antibiotic resistance determinants.

SUMMARYUsing direct agglutination methods, a simple serological scheme for the classification of Bacteroides fragilis is described. Twenty strains of B. fragilis were selected by a process of successive screening from 151 strains obtained from various sources. 0-antigens were prepared from the 20 strains, and used to raise antisera in rabbits.Each of the 20 antisera reacted with its homologous antigen and eight antisera cross-reacted with other subspecies. These cross-reactions were successfully removed after absorption of the antisera with the cross-reacting antigens, resulting in 19 type-specific antisera, titres ranging from 40 to 320, and 19 distinct serotypes of B. fragilis. There was no correlation between the antigenic and the biochemical characteristics of these strains and no cross-reactions occurred with other gramnegative anaerobes, B. melaninogenicu8, Sphaerophorus necrophoruw and Fu8o-bacterium necrogenes.

SUMMARYAntisera against live cultures of 20 strains of Bacteroides fragilis produced in rabbits agglutinated homologous whole-cell as well as 0-antigen suspensions with several cross-reactions. Pure specific antisera were produced by absorbing crossreacting antigens. 0-antisera reacted against O-antigens but failed to do so against most whole-cell suspensions, suggesting the presence of surface structures which might have blocked the reactions. The titres of the whole-cell antisera were not significantly higher than those of 0-antisera, but the reactions were more definite and easier to read.This system may prove useful in serological studies of B. fragilis.