BackgroundDengue fever, caused by dengue virus (DENV), has become one of the most important mosquito-borne viral diseases with a steady rise in global incidence, including the Sudan. Sporadic cases and frequent acute febrile illness outbreaks, compatible with Dengue fever, have been reported in El-Gadarif State, Sudan. However, diagnosis was based almost exclusively on clinical signs without confirmatory laboratory investigations. Despite the magnitude of the problem in El-Gadarif State, no information is currently available with regard to the epidemiology of the disease in this State. El-Gadarif State is one of the largest commercial centers in the Sudan. The objective of the present investigation is to estimate the prevalence of DENV antibodies, and determine the potential risk factors associated with seropositivity among residents of El-Gadarif State.MethodsA cross sectional study was conducted in a total of 701residents randomly selected from all 10 localities in El-Gadarif State. The sera from the 701 residents were tested for the presence of DENV-specific immunoglobulin G (IgG) antibodies using a commercially available Anti-dengue IgG enzyme-linked immunosorbent assay (ELISA).ResultsAmong the 701 residents, 334 residents (47.6%) were seropositive for DENV. Mosquito control (OR = 2.73, CI = 1.37–5.87, p-value = 0.001); low income (OR = 2.31, CI: 1.71–6.36, p value = 0.032); sleeping out-doors (OR = 3.73, CI = 2.63–6.23, p-value = 0.013), and localities were determined as potential risk factors for contracting DENV infection.ConclusionsThe prevalence rate of DENV antibodies among residents of El-Gadarif State is significantly high (47.6%). Further epidemiologic studies including, distribution of mosquito vectors and implementation of improved surveillance are urgently warranted for better prediction and prevention of a possible DENV outbreak in El-Gadarif State, Sudan.

Abstract.Early diagnosis and treatment is the principal strategy to control visceral leishmaniasis (VL), or kala-azar in East Africa. As VL strikes remote rural, sparsely populated areas, kala-azar care might not be accessed optimally or timely. We conducted a qualitative study to explore access barriers in a longstanding kala-azar endemic area in southern Gadarif, Sudan. Former kala-azar patients or caretakers, community leaders, and health-care providers were purposively sampled and thematic data analysis was used. Our study participants revealed the multitude of difficulties faced when seeking care. The disease is well known in the area, yet misconceptions about causes and transmission persist. The care-seeking itineraries were not always straightforward: “shopping around” for treatments are common, partly linked to difficulties in diagnosing kala-azar. Kala-azar is perceived to be “hiding,” requiring multiple tests and other diseases must be treated first. Negative perceptions on quality of care in the public hospitals prevail, with the unavailability of drugs or staff as the main concern. Delay to seek care remains predominantly linked to economic constraint: albeit treatment is for free, patients have to pay out of pocket for everything else, pushing families further into poverty. Despite increased efforts to tackle the disease over the years, access to quality kala-azar care in this rural Sudanese context remains problematic. The barriers explored in this study are a compelling reminder of the need to boost efforts to address these barriers.

Background:Increasingly, women in rural areas in Sudan reported to hospital with puerperal infections.Aims:This study was design to identify the common pathogens causing puerperal infections and their susceptibility to current antibiotics.Subjects and methods:We prospectively studied 170 women from January, 2011 through January 2012 attended Hussein Mustafa Hospital for Obstetrics and Gynecology at Gadarif State, Sudan. We included patients if they met the criteria proposed by the WHO for definition of maternal sepsis. Blood was collected on existing infection guidelines for clean practice and equipments.Results:Out of the 170 samples, 124 (72.9%) were pathogen-positive samples. Out the 124 positive cases, aerobes were the predominant isolates 77 (62.1 %%) which included Staph.aureus 49 (39.5%), Staph. epidemics 7 (5.6%) and Listeria monocytogenes 21 (16.9%). The anaerobes isolates were Clostridium perfringens 34 (27.4 %) and Entrobactor cloacae 13 (10.5%). Standard biochemical test were for bacterial isolation. Higher rate of infections followed vaginal delivery compared to Cesarean section 121 (97.6%), 3 (2.5%) respectively. All strains of Staph were sensitive to Vancomycin, Gentamicin and Ceftriaxone. C. perfringens were sensitive to Ceftriaxone, Penicillins, Vancomycin and Metronidazole, while E. cloacae were sensitive to Gentamicin and Ceftriaxone.Conclusion:Despite the limited resources in the developing countries, treatment based on cultures remains the only solution to reduce maternal morbidity and mortality rates following puerperal infections.

Background: Acute arboviral infections are distributed worldwide including Sudan, and dengue fever (DENV) is not an exception. The virus activity has recently been frequently reported in Kassala State, eastern Sudan. However, an appropriate epidemiological study would be necessary to provide accurate and precise estimates of the magnitude of recent DENV transmission in this area of endemicity. Methods: In the present investigation, a cross sectional study was conducted to advance beyond the current knowledge of the epidemiology of the disease in Kassala State. The prevalence of the disease was estimated and associated risk factors were determined. Sampled sera were collected and screened for recent dengue transmissionas as determined by DENV-IgM enzyme-linked immunosorbent assay (ELISA). The collection of data for risk assessment was supported by a well designed structured questionnaire. Results: The prevalence of recent DENV infection was estimated to be (11.42%). Potential risk factors to DENV seropsitivity include, age (OR = 3.24, CI = 1.81-5.77,p-value = 0.001); low income (OR = 3.75, CI = 1.57-8.93, p-value = 0.027); mosquito control (OR = 4.18, CI = 2.33-7.51, p-value = 0.004); and localities. Conclusion: The present study showed a high rate of circulating DENV IgM antibodies among the participants of the study (11.42%), suggesting recent transmission of DENV in Kassala State, eastern Sudan. The frequent occurrence of DENV infections necessitates the need for improved surveillance programs and prevention measures to combat this important arboviral disease in Sudan.

Background: Increasingly, women in rural areas in Sudan reported to hospital with puerperal sepsis. Aims: This study was design to identify the common pathogens causing puerperal sepsis and their susceptibility to current antibiotics. Materials and Methods: We prospectively studied 170 women from January 2011 through December 2012 who attended Hussein Mustafa Hospital for Obstetrics and Gynecology at Gadarif State, Sudan. We included patients if they met the criteria proposed by the World Health Organization (WHO) for de inition of puerperal sepsis. Results: Out of the 170 patients, 124 (72.9%) were pathogen-positive samples. Out of 124 positive isolates, aerobes were the predominant isolates 77 (62.1%) which included Staphylococcus aureus 49 (39.5%), Staphylococcus epidermidis 7(5.6%), and Listeria monocytogenes 21 (16.9%). The anaerobe isolates were Clostridium perfringens 34 (27.4%) and Enterobactor cloacae 13 (10.5%). Standard biochemical test were for bacterial isolation. Higher rate of infections followed vaginal delivery compared to Cesarean section, 121 (97.6%) and 3 (2.5%), respectively. All strains of Staph were sensitive to vancomycin, gentamicin, and ceftriaxone. C. perfringens were sensitive to ceftriaxone, penicillin, vancomycin, and metronidazole, while E. cloacae was sensitive to gentamicin and ceftriaxone. Conclusion: In this study, the main bacteriological isolates were S. aureus, S. epidermidis, L. monocytogenes, C. perfringens, and E. cloacae. Despite the limited resources in the developing countries, treatment based on cultures remains the only solution to reduce maternal morbidity and mortality rates following puerperal sepsis.