Bilharziasis is a tropical parasitic disease caused by different species of the genus Schistosoma. One species, S. haematobium, is widely spread in Sudan. There is a scarcity of information about S. haematobium infection among the fishermen in the country. Therefore, this study was designed to determine the prevalence of S. haematobium infection among fishermen, and the immune status among non-infected fishermen in two villages, El Hadib and Hawer-Ajowel at the White Nile state in Sudan. A cross-sectional survey was conducted among 119 fishermen in addition to 20 samples from non-endemic area which were included as a control group. Urine samples were examined by sedimentation method and faecal samples were examined by the Kato Katz method and formalin-ether concentration technique. Blood samples were examined for enumeration of IgE antibody and cytokines, interferon Gamma (IFN-γ), Tumor Necrosis Factor (TNF) and Interleukin10 (IL–10) levels using ELISA. The result of the study indicated that the overall prevalence of S. haematobium among the fishermen was 35 (29.41 %). Of the 35 positive participants, 23 (65.71 %) were infected for the first time, and 12 (34.29 %) for the second time (re-infection). Twenty-four candidates of the non-infected fishermen were included in the immunological study. The total IgE mean titer was 282.90 ±70.93 iu/ml, IFN-γ mean level was 9.62±4.60 pg/ml. TNF, 114.64±46.63 pg/ml and the IL–10 was 1.51±0.58 pg/ml. High prevalence of S. haematobium exists among fishermen and the non-infected fishermen from the endemic area showed high immune response similar to those exposed to the infection.
Cytokines ; Allergy and Immunology ; Sudan

Membranous lipodystrophy is a peculiar type of fat necrosis, present in patients with various types of skin diseases. It is charaeterized by the presence of microcysts and macrocysts lined by amorphous eosinophilic material with a crenelated arabesque appearance and microgranules in the subcutis with massive fat necrosis. The eosinophilic lining and microgranules stain positively with periodic acid-Schiff, are resistant to diastase, and also stain with Sudan black B. We report three cases of subcutanous membranous lipodystrophy in patients with erythema induratum, posttraumatic panniculitis and morphea with typical clinical and histopathologic findings.
Amylases ; Eosinophils ; Erythema Induratum ; Fat Necrosis ; Humans ; Lipodystrophy* ; Panniculitis ; Scleroderma, Localized ; Skin Diseases ; Sudan

BACKGROUND: Sickle cell disease is an autosomal recessive condition that results from the presence of a mutated form of hemoglobin. Some genetic variants of BCL11A are amenable to therapeutic manipulation. The present study investigated the relationship of a BCL11A variant (rs1427407) and its plasma levels with vaso-occlusive crises and stroke complications among patients in Sudan with sickle cell disease. METHODS: This cross-sectional study was performed between June 2014 and October 2016. The subjects included 166 patients who were diagnosed with sickle cell disease and 35 healthy control subjects, who were grouped according to sex and age ( < 15 years, 15–25 years, and >25 years). All patients and/or their guardians provided informed consent. Blood samples were collected from the patients and controls under aseptic conditions. RESULTS: Plasma BCL11A levels were elevated in cases with vaso-occlusive crises that lasted for >3 years. In addition, plasma BCL11A levels were high in cases with the GG genotype (vs. GT and TT) at rs1427407. Furthermore, the BCL11A rs1427407 GG/GT genotypes increased the risk of vaso-occlusive crisis and stroke in the patients with sickle cell disease. CONCLUSION: The BCL11A variant (rs1427407) and its plasma levels were associated with vaso-occlusive crisis and stroke in patients with sickle cell disease.
Anemia, Sickle Cell* ; Cross-Sectional Studies ; Genotype* ; Humans ; Informed Consent ; Plasma ; Stroke* ; Sudan*

Clofazimine (Lamprene or B668) is a phenazine congener that is used in leprosy, and the patients treated with the drug may develop red discoloration, dark brown pigmentation and ichthyotic skin. The authors observed 181 leprosy patients who had developecl discoloration, pigmentation and ichthyotic skin during clofazimine therapy, as well as disappearance of the pigmentation after stop of it. The results are summarized as follows: 1) Reddish discoloration was most frequently observed 2 weeks after beginning treatment in 66 patients (50. 4%), which showed earlier in the higher dosage grow up, 2) Dark brown pigmentation was iviost frequently observed 4 weeks after beginning treatment in 64 patients (48. 9%), which showed earlier in the higher dosage group. R) For histopathological evaluation of pigmentation, various ataining rnethods were used. On unstained frozen sections, yellow brown crystals were scattered in the dermis of both discolored and pigmented skin, and in H R E stain pigments, melanin were niarkedly increased in the epidermal basal layer and a, faint yellow brown. ghost was seen in dermis of pigmented skin. With fat stains using oil-red-0 and Sudan III, reddish amorphous materials were scattered in and around the cytoplasm of the macrophages c>f the pigmented skin. 4) Ichthyotic skin was observed in 97 patients, and most frequently 2 and R months after beginning treatment in 26 patients (26. 8%), but it was never observec1 in 34 of all patients in spite of a continuous intake of the drug for more than a. year. -countinue-
Clofazimine* ; Coloring Agents ; Cytoplasm ; Dermis ; Frozen Sections ; Humans ; Leprosy* ; Macrophages ; Melanins ; Pigmentation ; Skin ; Sudan

OBJECTIVES: The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan. METHODS: This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test. RESULTS: A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection. CONCLUSIONS: Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients’ adherence to treatment, and to reduce contact with MDR-TB patients.
Body Weight ; Case-Control Studies ; Humans ; Logistic Models ; Odds Ratio ; Risk Factors ; Smoking ; Sudan ; Tuberculosis ; Tuberculosis, Multidrug-Resistant ; Water

BACKGROUND: Although immunophenotyping of leukemias has improved diagnostic accuracy and reproducibility, it has also caused diagnostic confusion regarding the lineage of leukemic cells. So far, lots of papers about acute leukemias with coexpression of another lineage markers with different technical methodologies and different criteria have been published in Korea and other countries. The authors investigated the frequency and immunophenotypic characteristics of the leukemias with aberrant lineage markers from data obtained at Korea University Hospital by a retrospective study. METHODS: From Jan. 1993 to Feb. 1996, 179 leukemias had been requested for immunophenotypig and 28 cases among them with unusual immunophenotypes were retrieved according to their immunophenotyping results. For the final diagnosis all the slides stained with Wright-Giemsa, peroxidase, Periodic-Acid Schiff, Sudan black B, and nonspecific esterase were re-examined, and all the flow cytometric results were reanalyzed. RESULTS: Among 28 cases, 3 cases(10%) were acute biphenotypic leukemias(BP) one with B lymphoid and myeloid markers and the other two with T lymphoid and myeloid markers. One case of intralineage bilinear acute leukemia(ILBL) with two separate populations of megakaryocytic cells and monocytic cells was noted. 6 cases(21%) were acute myeloblastic leukemias expressing lymphoid associated markers(Ly+AMLs; CD19) and 8 cases(28%) were myeloid antigen-positive acute lymphoblastic leukemias(My+ALLs, four with CD13+ and three with CD33+ and one with blastic transformation of chronic myelogeneous leukemia). Because of the change in diagnostic criteria, lymphocyte contamination, or low setting of negative control, 10 cases (36%) were not included to be of unusual immunophenotypes. CONCLUSIONS: Frequency of acute hybrid leukemia was 2.2 % of all leukemias. Ly+AMLs was 3.4%, and My+ALL was 4.4%. In conclusion, first, quality control of the flow cytometry and careful interpretation especially in terms of positive cut-off value and gating, are needed. Secondly, national guidelines for the criteria of the hybrid leukemia and My+ALLs and Ly+AMLs are necessary for the elucidation of the prognostic implication of those leukemias.
Carboxylesterase ; Diagnosis ; Flow Cytometry ; Immunophenotyping ; Korea ; Leukemia* ; Leukemia, Myeloid, Acute ; Lymphocytes ; Peroxidase ; Quality Control ; Retrospective Studies ; Sudan

OBJECTIVES: The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan.METHODS: This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test.RESULTS: A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection.CONCLUSIONS: Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients' adherence to treatment, and to reduce contact with MDR-TB patients.
Body Weight ; Case-Control Studies ; Humans ; Logistic Models ; Odds Ratio ; Risk Factors ; Smoking ; Sudan ; Tuberculosis ; Tuberculosis, Multidrug-Resistant ; Water

Cryptosporidium, a protozoan parasite that causes watery diarrhea, is found worldwide and is common in areas with low water hygiene. In February 2014, 866 stool samples were collected from the inhabitants of 2 rural areas in White Nile State, Sudan. These stool samples were assessed by performing modified acid-fast staining, followed by examination under a light microscope. The overall positive rate of Cryptosporidium oocysts was 13.3%. Cryptosporidium oocysts were detected in 8.6% stool samples obtained from inhabitants living in the area having water purification systems and in 14.6% stool samples obtained from inhabitants living in the area not having water purification systems. No significant difference was observed in the prevalence of Cryptosporidium infection between men and women (14.7% and 14.1%, respectively). The positive rate of oocysts by age was the highest among inhabitants in their 60s (40.0%). These findings suggest that the use of water purification systems is important for preventing Cryptosporidium infection among inhabitants of these rural areas in Sudan.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Cryptosporidiosis/epidemiology/*parasitology ; Cryptosporidium/genetics/*isolation & purification ; Feces/parasitology ; Female ; Humans ; Infant ; Male ; Middle Aged ; Prevalence ; Rural Population ; Sudan/epidemiology ; Young Adult

Fat embolism is the presence of fat globules in the peripheral circulation and in the lung, brain, kidney, heart, and so on -not in the fine emulsion of a metabolic lipemia but in globules large enough to obstruct arterioles and capillaries. The fat droplets can derive from fractures of long bone due to disruption of the fatty marrow, from extensive bruising of the soft tissue, and from fat tissue in burns. Fat embolism has also been reported in patients suffering from various diseases including alcoholism, fatty liver, diabetes mellitus and pancreatitis. We investigated 19 autopsies with fatty liver of varying degrees to establish a correlation between fatty change of liver and pulmonary fat embolism. Among 19 cases, 3 cases with moderate to severe fatty change of liver, and 1 case with submassive hepatic necrosis and mild fatty change showed Grade II pulmonary fat embolism. In histologic section with Sudan III stain, the arteries and capillaries of lung were occupied and distended by round, oval, or staghorn fat globules. The alveoli may contain edema fluid and blood. Although the pulmonary fat embolism occuring in the presented cases didn't cause death on its own, one should be aware that a life-threatening mobilization of fat into the lungs and even into the systemic circulation is possible in fatty liver and submassive hepatic necrosis.
Alcoholism ; Arteries ; Arterioles ; Autopsy ; Bone Marrow ; Brain ; Burns ; Capillaries ; Diabetes Mellitus ; Edema ; Embolism, Fat* ; Fatty Liver* ; Heart ; Humans ; Hyperlipidemias ; Kidney ; Liver ; Lung ; Necrosis ; Pancreatitis ; Sudan

Fat embolism is the presence of fat globules in the peripheral circulation and in the lung, brain, kidney, heart, and so on -not in the fine emulsion of a metabolic lipemia but in globules large enough to obstruct arterioles and capillaries. The fat droplets can derive from fractures of long bone due to disruption of the fatty marrow, from extensive bruising of the soft tissue, and from fat tissue in burns. Fat embolism has also been reported in patients suffering from various diseases including alcoholism, fatty liver, diabetes mellitus and pancreatitis. We investigated 19 autopsies with fatty liver of varying degrees to establish a correlation between fatty change of liver and pulmonary fat embolism. Among 19 cases, 3 cases with moderate to severe fatty change of liver, and 1 case with submassive hepatic necrosis and mild fatty change showed Grade II pulmonary fat embolism. In histologic section with Sudan III stain, the arteries and capillaries of lung were occupied and distended by round, oval, or staghorn fat globules. The alveoli may contain edema fluid and blood. Although the pulmonary fat embolism occuring in the presented cases didn't cause death on its own, one should be aware that a life-threatening mobilization of fat into the lungs and even into the systemic circulation is possible in fatty liver and submassive hepatic necrosis.
Alcoholism ; Arteries ; Arterioles ; Autopsy ; Bone Marrow ; Brain ; Burns ; Capillaries ; Diabetes Mellitus ; Edema ; Embolism, Fat* ; Fatty Liver* ; Heart ; Humans ; Hyperlipidemias ; Kidney ; Liver ; Lung ; Necrosis ; Pancreatitis ; Sudan