Renal function in Sudanese school children withSchistosoma mansoni infection

Renal function was investigated in 218 school children withSchistosoma mansoni infection in the Province of Gezira in central Sudan and in 65 Sudanese and 65 German age-matched controls. Serum creatinine was normal in all children. A pathological urinary protein-creatinine ratio was found in 3% ofS. mansoni-infected children and in 5% of Sudanese controls but in none of the European children. Characterization of pathological proteinuria using albumin nephelometry, alpha-1 microglobulin immunodiffusion and SDS-polyacrylamide gel electrophoresis in these children showed glomerular, tubular or mixed glomerulotubular patterns. One, 4 and 6 months following treatment of schistosomiasis with praziquantel, stools were re-examined; 57% of patients were cured, 16% were found to be reinfected and 27% had persistent egg excretion. Six months after therapy, pathological urinary protein-creatinine ratios were encountered in 3% ofS. mansoni patients and in none of the 34 reinvestigated controls. Proteinuria was similar in patients with persistentS. mansoni egg excretion and in children cured of schistosomiasis infection. It is concluded that there was no evidence forS. mansoni associated glomerulonephritis in this group of Sudanese children. The high rate of pathological proteinuria inS. mansoni-infected and non-infected Sudanese children may be due to other causes.     

Economic burden on families of childhood type 1 diabetes in urban Sudan

The aims of this study were to estimate the direct costs of childhood diabetes in a low income country, Sudan, and to assess the effectiveness of care paid for by the families. For this purpose, socio-economic and demographic data on families were obtained from the parents of 147 children with type 1 diabetes, attending public or private clinics in Khartoum State, Sudan. The median annual income of the families of diabetic children was US dollars (US$) 1222 (range 0-14,338) of which 16% was received as financial help from relatives and friends. The median annual expenditure of diabetes care was US$ 283 per diabetic child of which 36% was spent on insulin. Of the family expenditure on health, 65% was used for the diabetic child. Families of diabetic children who were attending private clinics had a significantly higher total expenditure on health and home blood glucose monitoring than those who were attending the public clinics. However, there was no difference in total income between the two groups and glycaemic control was poor in 86% of the patients, regardless of whether care was being given by private or public clinics. The occurrence of the disease and its poor control appeared to exert a negative impact on the school performance of the diabetic child. In conclusion, the low direct costs reflect the minimal care given to the diabetic patients. Under the present economic conditions, families pay a considerable part of their income to sponsor the health of their diabetic children and receive little support other than that from relatives and friends. The present organization of diabetes care does not provide the patient with empowerment, knowledge and self-care ability. Well-trained diabetic teams and education programs may improve this situation.     

Inhibition of bladder tumor growth by 1,1-bis(3'-indolyl)-1-(p-substitutedphenyl)methanes: a new class of peroxisome proliferator-activated receptor gamma agonists

1,1-Bis(3'-indolyl)-1-(p-substitutedphenyl)methanes containing p-trifluoromethyl (DIM-C-pPhCF3), p-t-butyl (DIM-C-pPhtBu), and phenyl (DIM-C-pPhC6H5) substituents have been identified as a new class of peroxisome proliferator-activated receptor gamma (PPARgamma) agonists that exhibit antitumorigenic activity. The PPARgamma-active C-DIMs have not previously been studied against bladder cancer. We investigated the effects of the PPARgamma-active C-DIMs on bladder cancer cells in vitro and bladder tumors in vivo. In this study, the PPARgamma-active compounds inhibited the proliferation of KU7 and 253J-BV bladder cancer cells, and the corresponding IC50 values were 5 to 10 and 1 to 5 micromol/L, respectively. In the less responsive KU7 cells, the PPARgamma agonists induced caveolin-1 and p21 expression but no changes in cyclin D1 or p27; in 253J-BV cells, the PPARgamma agonists did not affect caveolin-1, cyclin D1, or p27 expression but induced p21 protein. In KU7 cells, induction of caveolin-1 by each of the PPARgamma agonists was significantly down-regulated after cotreatment with the PPARgamma antagonist GW9662. DIM-C-pPhCF3 (60 mg/kg thrice a week for 4 weeks) inhibited the growth of implanted KU7 orthotopic and s.c. tumors by 32% and 60%, respectively, and produced a corresponding decrease in proliferation index. Treatment of KU7 cells with DIM-C-pPhCF3 also elevated caveolin-1 expression by 25% to 30%, suggesting a role for this protein in mediating the antitumorigenic activity of DIM-C-pPhCF3 in bladder cancer.     

Validation of the indirect TaSP enzyme-linked immunosorbent assay for diagnosis of Theileria annulata infection in cattle

An ELISA based on a recombinant Theileria annulata surface protein (TaSP) was evaluated for detection of antibodies in sera from cattle exposed to tropical theileriosis in Sudan. The reference positive samples, used in this study, were from Theileria-infected populations and consisted of 80 cattle from an endemic area in Khartoum State, with high antibody titers in the indirect fluorescent antibody test (IFAT). The reference negative samples were taken from non-exposed populations and consisted of 120 cattle maintained under strict tick control at a commercial farm in Sudan. The cut-off value determined by Two-Graph Receiver-Operating Characteristic (TG-ROC) curves was set at 31.6%, based on the positive reference samples. Further diagnostic validation was performed, which consisted of the measurement of the area under the ROC (AUC) and by valid range proportion (VRP), which was 0.97 and 0.98 for the cut-off, respectively. There were no cross-reactions with antibodies raised against Babesia spp. It is concluded that the TaSP ELISA is a useful test for the diagnosis of T. annulata infection in cattle under field conditions.Omer E. Shariff Deceased.     

Peace impact on health: population access to iodized salt in south Sudan in post-conflict period

Aim

To determine the population access to salt/iodized salt during and after the armed conflict in south Sudan and to illustrate geographical variations in population consumption of iodized salt in south Sudan after the armed conflict.

Methods

The sources of data for the conflict period were the 2004 Toward a Baseline: Best Estimates of Social Indicators for Southern Sudan study report and the 2000 Multiple Indicators Cluster Survey, and for the post-conflict period the 2005 Sudan Household Health Survey (SHHS) data set.

Results

After peace agreement, population access to salt increased by 6.8% (Z = 5.488, P < 0.001) and the consumption of iodized salt increased by 32.9% (Z = 24.668, P < 0.001). More than 73% of families were using iodized salt but geographical differences existed between states.

Conclusion

Peace had positive impact on population access to iodized salt in south Sudan. Public health authorities in south Sudan need to establish quality monitoring and surveillance systems to track progress toward Universal Salt Iodization goal defined by the World Health Organization, United Nations Children’s Fund, and the International Council for the Control of Iodine Deficiency Disorders.War and peace have profound direct and indirect impacts on health (1). In many African countries, civil wars have become endemic; almost 20% of sub-Saharan Africa’s population now lives in countries that are at war (2). Different studies have documented the effect of war on health (3,4).Sudan is the largest country in Africa with an area of about 2.5 million kilometers. The population of Sudan was 39.2 million in 2008 and the majority (72%) lived in rural areas (5). Before it gained independence in 1956, Sudan had been embroiled in a civil war and after 1956 it was involved in three major civil wars: 1955-72 in Southern Sudan; 1982-2005 in Southern Sudan, Abyei, Nuba Mountains, Blue Nile, and Eastern Sudan; and 2003 in Darfur (6). On 9 January 2005, the Government of Sudan and the Sudan People’s Liberation Movement signed the Comprehensive Peace Agreement, which ended the last civil conflict in the south (7).It is conceivable that the peace agreement between the Government of Sudan and the Sudan People’s Liberation Movement affected public health in south Sudan. One way to explore this is to look at the changes in population access to iodized salt during armed conflict and in the peace period. Iodine is a natural essential element for human and animal development; it is a constituent of the thyroid hormones, which play a crucial role in growth and development (8). Iodine deficiency is the single greatest cause of preventable mental retardation in the world. Elimination of iodine deficiency contributes to 6 of the 8 Millennium Development Goals defined by the United Nations member states in 2000 (9,10). The national Iodine Deficiency Disorders (IDD) Control Program in Sudan started in October 1989 using Lipiodol in some of the highly endemic regions of the country and adopted salt iodization as the long-term national strategy in 1994 (11). In Sudan, about 1 million newborns yearly (91% of all newborns) are not protected against brain damage. In addition, the goiter prevalence is 22%, which leads to a reduction of up to 25% in the productivity of the affected people (12).In this study, we used the officially published data by national and international agencies concerning the Universal Salt Iodization program to explore the impact of peace agreement on south Sudan population health using population consumption of iodized salt as a proxy indicator. The specific aims of this study were to determine the changes in the population access/consumption of salt/iodized salt during and after the armed conflict in south Sudan and to illustrate geographical variations in population consumption of iodized salt in south Sudan after the armed conflict.     

First confirmed report of outbreak of malignant ovine theileriosis among goats in Sudan

An outbreak of malignant ovine theileriosis among goats was confirmed and documented. In this outbreak, 16 out of 22 (72.7%) goats died within 4 days showing clinical signs of malignant ovine theileriosis as well as in the postmortem findings. The goats were reared in a mixed flock with sheep in Atbara Town, Northern Sudan. The infection was detected microscopically and confirmed serologically by IFA test and molecularly by PCR technique using specific primer for Theileria lestoquardi. Hyalomma anatolicum was the most prevalent (dominant) tick species found in the farm. It is recommended to undertake future research on the role of goats on the epidemiology of malignant ovine theileriosis.