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Volume No. Date Topics
Volume No. 1 2011-10-08 18
Volume No. 2 0000-00-00 3
Volume No. 3 0000-00-00 16
Volume No. 4 2012-03-23 11
Volume No. 5 2012-06-01 9
Volume No. 6 2012-09-01 7
Volume No. 7 10
Volume No. 8 2013-01-01 12
Volume No. 9 2013-03-01 8
Volume No. 10 2013-06-01 10
Volume No. 11 2013-08-01 9
Volume No. 12 2013-11-01 10
Volume No. 13 2014-03-01 9
Volume No. 14 2014-06-01 6
Volume No. 15 2014-09-01 7
Volume No. 16 2016-04-01 8
Volume No. 17 2016-05-01 5
Volume No. 18 2016-06-01 5
Volume No. 19 2017-02-01 7
Volume No. 20 2017-03-01 8

Cryptosporidiosis among under-five-year-old Sudanese Children with Diarrhoea: A commonly underdiagnosed Disease

*Gihan El Taieb
**Adam, AA

Background: -                                                                                                               Cryptosporidiosis is a well recognized diarrhoeal disease that leads to dehydration and electrolytes disturbance. Under-five-year-old children, both immunosuppressed and immunocompetent are affected by this disease. They may succumb from fluid deficit and electrolytes derangement if not promptly treated. The disease is commonly underdiagnosed in the paediatric clinical practice in Sudan.
Materials and Methods: -                                                                                                         One hundred immunocompetent, under-five-year-old Sudanese children attending Omdurman Paediatric Hospital with diarrhoea were enrolled in the study. Stool specimen from each child was investigated for Cryptosporidium species oocysts by safranine/ methylene blue stain technique. Relevant data were recorded from children caregivers by structured questionnaire and from hospital records.                                                                                Thirty six medical practioners and 33 laboratory technologists in the hospital were also included in the study. Their knowledge and attitude regarding diagnosis of cryptosporidiosis were collected by structured questionnaire.
Results: -                                                                                                                    Cryptosporidium species oocysts were detected in stool specimens of seven (7%) children whose ages ranged between six and 18 months. Active entero-parasites, pus cells or red blood cells were not detected in any stool specimen from the positive cases. All patients with cryptosporidiosis presented to the hospital with copious non-bloody diarrhoea.  Five of these patients received their water for home domestic use from traditional wells, contained in barrels and brought on donkey-dragged wheel carts.                                                                                                                                             Thirty one (86.1%) medical practioners did not include cryptosporidiosis in the differential diagnosis of children presenting with non-bloody diarrhoea. Moreover, 31 (93.9%) laboratory technologists were not familiar with any laboratory test used for diagnosis of cryptosporidiosis. Eleven (30.6%) medical practioners used to prescribe different antibiotic drugs for children with diarrhoea if no specific aetiological cause was identified.
Conclusion: -                                                                                                                             The prevalence of cryptosporidiosis in this study is 7 % among the immunocompetent under-five-year-old Sudanese children. The absence of active entero-parasites, pus cells or red blood cells in stool specimens was consistent with the secretory diarrhoea which is characteristic of cryptosporidiosis. The risk factor for the infection of these children might be the unsafe water for home domestic use. Copious non-bloody diarrhoea was the presenting complaint of all positive patients and such diarrhoea in these children may be fatal due to dehydration and electrolytes disturbance.                                                               The disease was commonly underdiagnosed by the vast majority of the treating medical practioners who did not include it in the differential diagnosis in children with diarrhoea. The unfamiliarity of laboratory technologists with the laboratory tests used in diagnosis of cryptosporidiosis further contributed to underdiagnosis of many cases.                                                                                                   Safranine-methylene stain used in this study is simple in procedure, specific and its sensitivity can be improved if stool is concentrated by a simple technique such as formol-ether technique. Moreover, this tests is not time consuming and its fee is affordable for almost all patients’ caregivers.                                                                                                                                    In conclusion, we recommend that medical practioners have to include cryptosporidiosis in the differential diagnosis of diarrhoea in children. Moreover, routine investigation of diarrhoeal stool for Cryptosporidium species oocysts especially in under-five-year-old children is to be implemented regardless of their immunological status.

Clinical Profile of Sickle Cell Anaemia in Sudanese Children

Fataherahman Elawad Ahmed1, Hadia Osman Gaboli2, karimeldin M A Salih3

Background: Although everyone with sickle cell anaemia shares a specific, invariant genotypic mutation, the clinical variability in the pattern and severity of disease manifestations is astounding.
Objective:- To determine the clinical profile of sickle cell anaemia among Sudanese children.
Patient and methods:- This was a cross-sectional hospital-based study of 100Sudanese children with sickle cell anaemia (SCA) age 5-15 years .It was conducted at the main tertiary children hospital in Sudan, between April-Augst2010 .The data was collected using a questionnaire that included medical history and clinical examination. Haemoglobin electrophoresis result was obtained from patients records.
Results: There were 37(37%) males and 63 (63%) females. Eighty two percent of the patients were of low socioeconomic background  .Painful crisis  was the most frequent presentation(  83%),while  dactylitis represented  the early manifestation of the disease  in70% of the cases .Haepatomegaly was present in 7% of patients , splenomegaly in  2% and haepatosplenomegaly in another 2% . More than half of the cases presented in the first year of life.
Conclusion: Most of the patients with SCA were from low socioeconomic class. They presented in the first year of life with dactylitis. Painful crises were the most frequent manifestation.
Key word: - sickle cell anaemia, Sudan
Sickle cell anaemia (SCA), prevalent worldwide, is a gene disorder with
 autosomal recessive pattern of inheritance. 1, 2 The first reported case of sickle cell anaemia in Sudan was in 1926 by Archibald3 and it was the first reported case in Africa. A prevalence rate of 2% to 30.4% was reported in Sudan depending on the geographical location and ethnic background.4-8
Most of the children present  to hospital with crises with  necessity   for hospital admission. Vaso- occlusive crisis is  the  frequent crises with pain that can involve any part of the  body.9With chronic haemolytic anaemia, infections  can lead to the  development of  aplastic crisis.10 Sepsis presents a great challenges to those patient with sickle cell anaemia .In fact many organism such as Streptococcus pneumoniae, Salmonella species, and Haemophilus influenza can cause severe sepsis and death.11, 12Other crises such as hyposthenuria, splenic sequestration,
acute chest syndrome, neurological manifestation, pripism, renal problem and avascular necrosis can develop. 13-22
The clinical profile of sickle cell anaemia among Sudanese children was
reported for the first time 25 years ago. The aim of this study was to determine the clinical profile of sickle cell anaemia among Sudanese children.

Patients and Methods:-

Study Design:
This was a prospective cross-sectional, hospital-based study.
The sickle cell outpatient clinic, general pediatrics outpatient clinic and the emergency department at Gafar Ibn Aof Specialized children hospital,
Khartoum, Sudan.This is the main tertiary hospital for children in Sudan.

Study Duration:
August 2012 to February 2013.
Study Populations׃
Sudanese children, age 5-15 years with sickle cell anaemia were eligible to be enrolled in this study if they agreed. Only those with the genotype (SS) were included. The genotype was confirmed using the result of haemoglobin electrophoresis present in the patient medical records or newly ordered.
A designed questionnaire was used. It included personal data, past medical history, family history, socioeconomic status (using the standard of the Sudanese ministry of social affairs) complaint, vital signs, anthropometric measurements and detailed clinical examination.
The study was approved by the hospital ethical committee. A verbal and written consent were obtained from the child's parents or caregivers.
The data was collected in a data sheet and then analyzed using SPSS
version (16).The data was presented in percentage and mean.


Out of 100 patients with SCA there were 63 females (63%) and37 (37%) males, with a male-female ratio of 0.37-1.There were 82 patients (82%) of low socioeconomic status, 10(10%) and 8(8%) of moderate and high socioeconomic status respectively. The most frequent presentation was painful crises (83%) followed by heart failure. (table1). Dactylitis was the first presenting symptom in 70 % of patients followed by jaundice (9%) and anaemia (7%) (table 2).Haepatomegaly, splenomegaly or haepatosplenomegaly were detected in 7%, 2% and 2% respectively.70% of the patients presented to the hospital in the first 12 months of life (table 3).

Patients’ Satisfaction with Nursing care of Wound Dressing and Other related Hospital Services in Three Teaching Hospitals in Khartoum State

Amani Mukhtar Mustafa, Abdullah El-hag Musa

Quality of wound dressing is very important in order to prevent infection, amputation and even death. Moreover, it strongly enhances patient’s satisfaction.
This cross sectional descriptive study was carried out to determine patients’ satisfaction with nursing care of wound and hospitals services, in relation to wound dressing in three teaching hospitals in Khartoum State, Sudan
Materials and Methods:
One hundred and seven patients with wounds were admitted to surgical wards in three teaching hospitals (Khartoum, Omdurman and Khartoum North teaching hospitals). Data were collected by interviewing questionnaires and analyzed by SPSS software.
Results: Seventy six (71%) of patients were males and 29% were females.  The residence of 33% patients was Khartoum while the remaining patients (67%) came from outside Khartoum.  The researcher drew from the response of the patients that the nursing care in terms of approach, from wound assessment and wound dressing the following: 37% of respondents were not satisfied and 13% were not strongly satisfied from nurse, that were not doing assessment for wounds, and 90% of patients’ were not given time to discuss suffering pain during wound cleaning, 88% did  not get an  explanation for the reason of unhealed wound and they were not given advices that facilitate wound healing. Concerning hospital facilities and services in related to wound, the rate of services was 32% bad and 49% was very bad.
Conclusion: Most of patients’ not satisfied from the services given for them in related to wound dressing.

Physicians' Knowledge, Attitude and Practice toward Child Maltreatment-Khartoum Teaching Hospital and Jafae Ebn Oaf Pediatric Hospital-Sudan- October-November 2011

Dr. Amira Adam Ahmed Elaalem-Bachelor Degree in physical therapy -Elneelain University – Faculty of Medicine and Health Sciences-Teaching assistant- Faculty of Physical Therapy-Elneelain University,
Dr. Mustafa Khidir Mustafa Elnimeiri-MB.Bch.MD-Professor of Preventive Medicine & Epidemiology-Faculty of Medicine-Elneelain University

Child abuse is the physical, sexual, emotional mistreatment, or neglect of a child, Child abuse can occur in a child's home, or in the organizations, schools or communities the child interacts with. Worldwide, approximately 40 million children are subjected to child abuse each year. The overall objective of the study was to assess the physicians' knowledge, attitude and practice toward cases of child abuse.
The study was descriptive cross sectional hospital based study, it was conducted in Jafar Ebn Oaf Pediatric Hospital and Physical Therapy Department- Khartoum teaching hospital during October-November (2011). The sample size was 70 of physicians who were chosen by convenience sampling technique and the collected data were analyzed using SPSS software program, version 16.
47% of the interviewed physicians identified correctly all signs of child maltreatment  while 35% of them recognized shaken baby syndrome. 34% of the interviewed physicians knew all types of child maltreatment while 53% of them did not consider neglect as part of child maltreatment. 99% of the interviewed physicians considered reporting a case of child maltreatment as mandatory but 54% of them did not know where to report the suspected case. 63% of the interviewed physicians did not suspect a case of child maltreatment before while 62% of those suspected a case of child maltreatment did not report it.
It was recognized that knowledge of physician was insufficient toward child maltreatment, their attitude was positive toward importance of reporting, and had poor practice toward reporting these cases. I highly recommend programs to increase their knowledge and thereafter their practice because they play an role in revealing and dealing with such cases.


Cigarette Smoking & Oral Hygiene Measure among Chronic Periodontitis Patients in Khartoum Dental Hospital

Wafaa Mohammed Abdelwahab Eltazi
Faculty of Dentistry, Department of Periodontology, AlNeelain University.

Background information: Periodontal diseases comprise a group of inflammatory conditions of the supporting structures of teeth, including the gingiva, periodontal ligament and alveolar bone. Cigarette smoking is a major systemic risk factor for periodontal diseases. Microbial dental plaque biofilms are the principal etiological factor of periodontitis. Aim of study: Evaluate the effect of cigarette smoking on the level of oral hygiene. Materials and methods: Smoking status was assessed by Self reported questionnaire. The level of oral hygiene was assessed by plaque index (PI)Silness and Loe (1964)&Sextants were used according to FDI (WHO 1983).Result:70.3% of patients with poor plaque indices (N =239) were smokers. Alternatively, all patients with good and fair plaque indices (N =111) were non-smokers. Smokers risk of developing poor plaque index is more than twice that of non-smokers (RR =2.56).Conclusion: Smokers showed more plaque accumulation than non-smokers. Recommendation: There is an urgent need to start an intensive education program to the public on the negative health consequences of cigarette smoking.

Apprehension of Reproductive Health Information, Education and Communication printed materials- Khartoum and East Nile localities- Khartoum State-Sudan (2013)

Soad Mohammed Abdulla Alnassri; Dr. Mustafa Elnimeiri ; Dr. Daffalla A’lam Elhuda

Regular using IEC printed materials during antenatal and postnatal  period through individual or group approach, brings desirable changes in health practices of mothers resulting in a healthy mother and baby.The overall aim was to assess the apprehension of reproductive health IEC printed materials.  
Materials and methods:
A descriptive -cross sectional study was conducted in health facilities at Khartoum and East Nile localities at Khartoum State. The total number of mothers enrolled in this study mounted to 385 mothers. Data were collected using a standardized administered questionnaire and two focus group discussions to assess the apprehension of information, education and communication printed materials in reproductive health.   SPSS   version 16 was used to analyze the collected data while manual method was used to analyze the generated qualitative data of the focus group discussion.  
The mean age of the mothers in both samples was 27.66 =SD: 6.563. Half and more than half (50%, 58.4%) of women respectively were aged between (20 - 29 years).
IEC messages regarding appropriate nutrition, clothing for pregnant mother and serious signs and symptoms during pregnancy were comprehend by 94.4 % of the respondents in Khartoum locality and 70.3%, 80.8% by the respondents in East Nile locality respectively. However, these differences were statistically insignificant.
IEC message regarding birth spacing, were apprehend by 100% of respondents in Khartoum locality and 69.2% by the respondents in East Nile locality. This difference was statistically significant (P value =0.025).
Respondents in both localities had difficulty in apprehending IEC message regarding delivery plan represented by 44.4% and 64.1% respectively. There was no significant differences between respondents interviewed at Khartoum and East Nile localities (P value =0.302). Apprehension of IEC materials showed highly significant association with educational level of the respondents (P value = 0.000).
Conclusions:  IEC materials addressing appropriate nutrition and clothing for pregnant mother, serious signs and symptoms during pregnancy and birth spacing were apprehended by majority of respondents in both localities (including apprehension of the image, text and possibility to explain IEC materials to someone else). These results showed highly statistically association with educational level (P value = 0.000). Some modifications will be required to enhance apprehension of IEC material delivery plan.