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    Assessment of leishmania donovani infection among children in Rashid village in eastern Sudan
    (University of Khartoum, 2008-06) Dafalla, Ahmed ; M. Mukhtar, Moawia ; M. Elamin, Elwaleed
    Sudan is one of five countries where more than 90 % of visceral leishmaniasis occurs Little data is available on the immune epidemiology of VL in Sudan. A descriptive longitudinal study was conducted in Rashid village in Gadraref state — eastern Sudan, during the period between January and November 2006. Informed consents were obtained from parent and guardian of children before been enrolled in the study. 741 of School age ( 17-5 years) children were selected to participate in the study. The study aimed to determine the immune responses of children living in VL endemic area . Three surveys were conducted in January, May and November 2006, and three tests ( LST, DAT, and PCR) were done. 6.9 % of the children were reactive in LST during the three surveys , and non of these children had a significant antibody titer ( DAT> 3200) , despite that some of them had past history of VL. The highest LST reaction was detected mostly in older children. Conversion from — ye LST to + ye LST was observed in about 0.7 % participant in the second survey (May) and also in 1.3 % of them in the third one (November). About 6.1 % of the participants were DAT + ye during the three surveys ,although no one of them had VL clinical symptoms . Conversion from — ye DAT to + ye DAT was observed in 1.1 % of the participant in the second survey (May ) and also in 0.3 % of them in the third one (November) with out development of VL clinical symptoms. The phenomena of negative conversion in both LST and DAT need to be further investigated. No circulating parasite DNA was detected by PCR technique in peripheral blood of all participants, and no infected sand fly was captured in the study area during the study indicating low transmission rate.
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    Leishmania donovani In Southwest of Sudan: Rapid assessment and Application of Geographic Information System
    (University of Khartoum, 2006) M. El Magzoub, Ranyab ; Hassan, Abdalla
    Visceral leishmaniasis (VL) comprises a major health problem in several parts of the Sudan and it leads to severe morbidity and high mortality if uncontrolled. Western Upper Nile State and Southern Kordofan State were a scene of a huge outbreak that claimed hundreds of thousands of lives in the late eighties, which demonstrated the inability, and inadequacy of the health authorities, at that time, in dealing with such disasters that are more likely to occur from time to time. Control of VL is obstructing by the elusive nature of the vector and failure to identify a reservoir host. Case detection and treatment with antimonial drugs contribute to disease control. In this study we introduced the concept of rapid epidemiological assessment of patterns of L. donovani infection and visualized the data in a geographic information system (GIS) hoping to open new avenues into the question of VL control. Coupling this map with the map of vector distribution and climatic changes will provide valuable information that will help in disease control, despite our meagre health resources. This survey was based on simple in vivo and in vitro immunological techniques (leishmanin skin reactivity and the Direct Agglutination Tests), combined with clinical history to obtain data about the spectrum of L donovani infection in communities at risk of developing VL. The data was represented in map format to give an enhanced visual impact. Treatment and future control strategies can easily be formulated from such data. XI In this study clinical history and immunological tests were conducted on 1781 volunteers randomly selected from the mesairiya tribe who areliving in western Kordofan State. The mean age of the selected volunteers was 20.7 years with an equal male:female ratio. The overall leishmanin skin reactivity of ≥5 was 24.5%, where children below 15 years had higher (13.2%) leishmanin reactivity compared to 11.3% among adults above that age. The DAT results showed that 88% (1567/1781) of the study volunteers had DAT titres below the cut-off point of 3200, whereas 6% (112/1781) had a DAT titers = 3200, while the rest 5.7% (238/1781) had titres > 6400. DAT results were shown in Table (3.5) and Figure (3.7). Six L donvani and one L. major strains were in vitro tested in their amastigote forms against Pentostam and Amphotericin B using J774 murine macrophage-like cell line. The number of parasite in the infected cells decreased steadily at drug concentration 7.8μg/ml to 250μg/ml for Pentostam and 0.22μg/ml to 0.75μg/ml for Amphotericin B and the capacity of parasites to replicate inside the cells was also affected. In this system the parasite survival index (PSI) was similar for both tested drugs. L major showed the same response as other tested strains. Geographic information system (GIS) was applied in this study and the ArcGIS software was used to draw a map of the Sudan with different layers and themes. The maps included all the obtained information with coordinates of the studied area. In conclusion: the use of clinical interview combined with simple immunological tests can give valuable information about the pattern of L. donovani infection and predict future prevalence of VL in a short time. Leishmanin non-reactive individuals are a useful piece of data to plan for future vaccine efficacy studies. It is also clear that in vivo drug XII unresponsiveness does not correlate well with in vitro sensitivity for the same drugs. The interactive dynamic map that was produced in the ArcGIS can act as a nucleus for development of a Leishmania network in Sudan and the nearby countries that have the same belt of visceral leishmaniasis.
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    Immune Profile of Sudanese Women with Conception Disorders: Possible Role for T-helper Cytokines.
    (uofk, 2009-03) Musa, Habab ; Awad, Eltahir
    Unexplained female infertility, recurrent miscarriages, premature delivery and pregnancy-induced hypertension may all, in some cases be linked to immune and cytokines networks of early pregnancy. Understanding these cytokines and their a ctions could be the new era of conception disorders treatment.
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    Pregnancy-associated malaria in Greater Khartoum: prevalence and immunological aspects
    (University of Khartoum, 2006)
    Abalaria continues to threaten more than ٤١٪ of the world’s population. Pregnancyassociated malaria is a well-documented cause of morbidity and mortality to mothers and their developing fetuses in sub-Saharan Africa. The presence of certain molecules like chonroitin sulphate A (CSA) and the predominance of Th٢ cell immune responses contribute greatly to the increased incidence, pathogenecity and morbidity of pregnancyassociated malaria. A prospective, longitudinal hospital based study was conducted in a central maternity referral hospital in Greater Khartoum during the period of July ٢٠٠٣-December ٢٠٠٤ to determine the prevalence of pregnancy-associated Plasmodium falciparum infection and immune profiles of the mothers and their newborns. Pregnancy outcome of mothers with pregnancy associated malaria was also investigated. Volunteers pregnant women consented to participate were interviewed and examined clinically. Blood samples were collected for thin and thick blood films, peripheral and cord blood mononuclear cells were collected for culture and stimulated with MSP١١٩. Anti-MSP١١٩ IgG antibodies were measured using bulk Enzyme Linked Immunosrbent Assay (ELISA) with determination of cut-off points. cytokine profiles of mothers and their babies were determined using commercial ELISA kits. Samples were also collected for DNA extraction and amplification using specific P. falciparum primers. Following DNA amplification P. falciparum multiplicity of infection was calculated.
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    Hyperreactive Malarial Splenomegaly (HMS) in Malaria Endemic Area in Eastern Sudan
    ( 2015-03-04) Allam, Mushal ; M. Elhassan, Ibrahim
    Hyrerreactive Malarial Splenomegaly (HMS) is a condition affecting adults in certain malarious areas. The present work was carried out in Kassala city, Eastern Sudan where HMS is considered as highly prevalent. The objectives of the study were to describe the epidemiology and magnitude of the disease in the area, help local clinicians to diagnose, and differentiate HMS cases from other diseases causing splenomegaly and to apply modern investigative methods particularly Nested Polymerase Chain Reaction (PCR) for detection of malaria parasites in HMS cases. A cross-sectional study was carried out in four health centers in the city between January and March 2004. 114 (11.2%) out of 1010 medical cases were reported had enlarge spleens. Identification using the major diagnostic criteria supported by clinical and laboratories investigations was revealed that 87 (8.6%) cases were HMS. All the cases included in this study are permanent residents of Kassala city. Forty one percent patients are Beni Amer, 25% Shaikia, 19.5% Hadendoa and 14% are from other tribes. Sixty three percent of HMS cases were males and 37% were females. The mean age of 27.7 years (median= 25 years). Clinical investigations showed that all cases suffered from abdominal pain in upper left quadrant and all had palpable firm spleen (10-26 cm) from the costal margin. Most of cases gave a past history fever associated with headache. The mean value of body temperature of all studied patients is in normal range (37ºC).