Background: Sudan is a highly endemic country for hepatitis B virus (HBV). Screening for HBV during pregnancy may help to decide on appropriate antiviral therapy and the institution of steps to minimize vertical transmission to the newborns. Of the epidemiological studies carried in different regions of Sudan, few are available regarding pregnant women. In Darfur region such data is absent, so our aim was to evaluate seroprevalence of HBV among antenatal care attendants in Al Fashir town. Method: A cross sectional study was conducted between 2013 and 2015. Blood samples were collected from 900 pregnant women attending antenatal clinics in Al Fashir town. Plasma was separated and tested for markers of HBV (HBcAb, HBsAg, HBeAg, HBeAb) using ELISA. Sociodemographic, obstetrics and medical data were collected using structured questionnaires. Results: AntiHBc was detected in 46% and HBsAg was detected in 18% of study population. HBeAg and HBeAb frequencies were found to be 2.6% and 37.7% among positive HBsAg pregnant women. There was significant association between residence, income, occupation, bloodletting and ear piercing with HBV infection (P < 0.05). Conclusion: The results of the study suggest that HBsAg has a high prevalence among the pregnant women in Al Fashir town, North Darfur State. So, to minimize vertical transmission, antenatal women must be routinely screened for HBV.

The treatment options for mycosis fungoides (MF) have been expanding but unfortunately many of the currently used treatment modalities are unavailable in Egypt and other African/Arab countries. In addition, there is a lack of consensus on the treatment of hypopigmented MF (HMF), which is a frequently encountered variant in our population. We aimed to develop regional treatment guidelines based on the international guidelines but modified to encompass the restricted treatment availability and our institutional experience. Special attention was also given to studies conducted on patients with skin phototype (III-IV). Treatment algorithm was formulated at Ain-Shams cutaneous lymphoma clinic through the collaboration of dermatologists, haematologists, and oncologists. Level of evidence is specified for each treatment option. For HMF, phototherapy is recommended as a first line treatment, while low-dose methotrexate is considered a second line. For early classical MF, we recommend Psoralen-ultraviolet A (PUVA), which is a well-tolerated treatment option in dark phenotype. Addition of either retinoic acid receptor (RAR) agonist and/or methotrexate is recommended as a second line. Total skin electron beam (TSEB) is considered a third-line option. For advanced stage, PUVA plus RAR agonist and/or methotrexate is recommended as first line, TSEB or monochemotherapy is considered a second line option. Polychemotherapy is regarded as a final option. All patients with complete response (CR) enter a maintenance and follow-up schedule. We suggest a practical algorithm for the treatment of MF for patients with dark phenotype living in countries with limited resources.

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