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Siddig EE, Mohamed NS, Ahmed A. Severe coinfection of dengue and malaria: A case report. Clin Case Rep 2024; 12:e9079. [PMID: 38868112 PMCID: PMC11166561 DOI: 10.1002/ccr3.9079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 05/29/2024] [Accepted: 05/31/2024] [Indexed: 06/14/2024] Open
Abstract
Key Clinical Message In countries like Sudan, where several infectious diseases are prevalent, health care providers should not be satisfied with initial detection of a single pathogen and whenever it is feasible, they should investigate coinfections. Infections with high mortality or severe morbidity should be prioritized during the differential diagnosis particularly for diseases with similar clinical manifestations to reduce the death and disability rates. However, this requires substantial improvement in the diagnostic capacity. Abstract Here we report a case of dengue and malaria coinfection from the southeast region of Sudan, bordering Ethiopia and Eritrea. A 25-year-old male from Sudan presented with symptoms of fever, chills, vomiting, and muscle and joint pain. Laboratory investigations confirmed a coinfection of dengue and malaria, which is assumingly not uncommon in areas heavily syndemic with several diseases but it is severely under-detected, underreported, and underestimated. The case has fully recovered after the supportive care for dengue and chemotherapy treatment for malaria. In such a case, it was important to monitor the patient's recovery and the treatment outcome through clinical indicators and laboratory parameters to update the treatment course whenever needed, according to response. The increasing burden and outbreaks of vector-borne diseases including dengue and malaria in Sudan, indicates the need for improving the implementation of the global vector control response that established by the World Health Organization. Additionally, the increasing prevalent of coinfections is urging substantial improvement in the diagnostic capacity in endemic countries.
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Affiliation(s)
- Emmanuel Edwar Siddig
- Faculty of Medical Laboratory SciencesUniversity of KhartoumKhartoumSudan
- Department of Medical Microbiology and Infectious DiseasesErasmusMC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Nouh Saad Mohamed
- Molecular Biology UnitSirius Training and Research CentreKhartoumSudan
| | - Ayman Ahmed
- Swiss Tropical and Public Health Institute (Swiss TPH)AllschwilSwitzerland
- Faculty of ScienceUniversity of BaselBaselSwitzerland
- Institute of Endemic DiseasesUniversity of KhartoumKhartoumSudan
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Msellemu D, Tanner M, Yadav R, Moore SJ. Occupational exposure to malaria, leishmaniasis and arbovirus vectors in endemic regions: A systematic review. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2024; 6:100185. [PMID: 39027087 PMCID: PMC11252614 DOI: 10.1016/j.crpvbd.2024.100185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/26/2024] [Accepted: 06/01/2024] [Indexed: 07/20/2024]
Abstract
Vector-borne diseases, including dengue, leishmaniasis and malaria, may be more common among individuals whose occupations or behaviours bring them into frequent contact with these disease vectors outside of their homes. A systematic review was conducted to ascertain at-risk occupations and situations that put individuals at increased risk of exposure to these disease vectors in endemic regions and identify the most suitable interventions for each exposure. The review was conducted in accordance with PRISMA guidelines on articles published between 1945 and October 2021, searched in 16 online databases. The primary outcome was incidence or prevalence of dengue, leishmaniasis or malaria. The review excluded ecological and qualitative studies, abstracts only, letters, commentaries, reviews, and studies of laboratory-acquired infections. Studies were appraised, data extracted, and a descriptive analysis conducted. Bite interventions for each risk group were assessed. A total of 1170 articles were screened and 99 included. Malaria, leishmaniasis and dengue were presented in 47, 41 and 24 articles, respectively; some articles presented multiple conditions. The most represented populations were soldiers, 38% (43 of 112 studies); refugees and travellers, 15% (17) each; migrant workers, 12.5% (14); miners, 9% (10); farmers, 5% (6); rubber tappers and missionaries, 1.8% (2) each; and forest workers, 0.9% (1). Risk of exposure was categorised into round-the-clock or specific times of day/night dependent on occupation. Exposure to these vectors presents a critical and understudied concern for outdoor workers and mobile populations. When devising interventions to provide round-the-clock vector bite protection, two populations are considered. First, mobile populations, characterized by their high mobility, may find potential benefits in insecticide-treated clothing, though more research and optimization are essential. Treated clothing offers personal vector protection and holds promise for economically disadvantaged individuals, especially when enabling them to self-treat their clothing to repel vectors. Secondly, semi-permanent and permanent settlement populations can receive a combination of interventions that offer both personal and community protection, including spatial repellents, suitable for extended stays. Existing research is heavily biased towards tourism and the military, diverting attention and resources from vulnerable populations where these interventions are most required like refugee populations as well as those residing in sub-Saharan Africa.
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Affiliation(s)
- Daniel Msellemu
- Vector Control Product Testing Unit, Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Tanzania
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
| | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
| | - Rajpal Yadav
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
- Academy of Public Health Entomology, Udaipur, 313 002, India
| | - Sarah J. Moore
- Vector Control Product Testing Unit, Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Tanzania
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Petersplatz 1, 4003, Basel, Switzerland
- The Nelson Mandela African Institution of Science and Technology (NM-AIST), P.O. Box 447, Tengeru, Arusha, Tanzania
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Ahmed A, EL‐Sadig SM, Eltigani HF, Bongomin F, Siddig EE. The first Helicobacter pylori-induced Guillain-Barré syndrome in Sudan. Clin Case Rep 2023; 11:e8204. [PMID: 38028082 PMCID: PMC10645600 DOI: 10.1002/ccr3.8204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/15/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Key Clinical Message This case report highlights the role of Helicobacter pylori infection in the development of GBS. Healthcare providers should consider H. pylori in their differential diagnosis for patients with neurological syndromes. Astract We report the first known case of Guillain-Barré syndrome (GBS) associated with Helicobacter pylori infection in Sudan. This case highlights the role of H. pylori infection in the development of GBS. It also emphasizes the importance of wide screening of different endemic infections for patients with neurological syndromes for early detection and improves the case management in resource-limited settings like Sudan. Further research is needed to better understand the underlying mechanisms of H. pylori-inducing neurological disorders.
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Affiliation(s)
- Ayman Ahmed
- Swiss Tropical and Public Health Institute (Swiss TPH)AllschwilSwitzerland
- University of BaselBaselSwitzerland
- Institute of Endemic DiseaseUniversity of KhartoumKhartoumSudan
| | | | | | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of MedicineGulu UniversityGuluUganda
| | - Emmanuel Edwar Siddig
- Faculty of Medical Laboratory SciencesUniversity of KhartoumKhartoumSudan
- Department of Medical Microbiology and Infectious Diseases, ErasmusMCUniversity Medical Center RotterdamRotterdamThe Netherlands
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Abdallah ATH, Abdelkhalig RE, Hamid E, Ahmed A, Siddig EE. Unusual manifestation of cystic mycetoma lesions: A case report. Clin Case Rep 2023; 11:e8054. [PMID: 37854263 PMCID: PMC10580693 DOI: 10.1002/ccr3.8054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/02/2023] [Accepted: 10/04/2023] [Indexed: 10/20/2023] Open
Abstract
Key Clinical Message This case presents an atypical cystic presentation of mycetoma without sinuses or discharge. Awareness of these variations is crucial for accurate diagnosis and timely intervention, highlighting the need for healthcare professionals to consider diverse manifestations of mycetoma. Abstract Mycetoma is a chronic and debilitating infectious disease characterized by localized swellings and granulomatous lesions. It primarily affects individuals in tropical and subtropical regions and is caused by certain fungi or bacteria. While mycetoma typically presents with sinuses and discharge, this case report presents a unique cystic presentation without these features. The patient, a 12-year-old female from Sudan, presented with a painless swelling on the dorsum of her right foot. Physical examination revealed a round, non-tender, and fluctuant mass. Histopathological examination confirmed actinomycetoma caused by Streptomyces somaliensis. The patient was successfully treated with a combination of antibiotherapy. This atypical presentation underscores the need for healthcare professionals to consider uncommon variations of mycetoma for accurate diagnosis and management.
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Affiliation(s)
| | | | - Elwasila Hamid
- Consultant Surgeon, Rufa'a Teaching HospitalAlbutana UniversityRufaSudan
| | - Ayman Ahmed
- Institute of Endemic diseasesUniversity of KhartoumKhartoumSudan
- Swiss Tropical and Public Health Institute (Swiss TPH)AllschwilSwitzerland
- University of BaselBaselSwitzerland
| | - Emmanuel Edwar Siddig
- ErasmusMC, University Medical Center RotterdamDepartment of Medical Microbiology and Infectious DiseasesRotterdamthe Netherlands
- Faculty of Medical Laboratory sciencesUniversity of KhartoumKhartoumSudan
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Alsedig K, Eldigail MH, Elduma AH, Elaagip A, Altahir O, Siam HA, Ali Y, Abdallah T. Prevalence of malaria and dengue co-infections among febrile patients during dengue transmission season in Kassala, eastern Sudan. PLoS Negl Trop Dis 2023; 17:e0011660. [PMID: 37792705 PMCID: PMC10550125 DOI: 10.1371/journal.pntd.0011660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/12/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Malaria and dengue are common mosquito-borne diseases around the world that cause high mortality and morbidity. The number of cases of both diseases is currently rising in Sudan and is associated with climate and environmental changes. Limited information is available on malaria and dengue co-infections and the severity of the two diseases among febrile patients in eastern Sudan. Thus, this study aimed to estimate the prevalence of malaria and dengue co-infections among febrile patients in Kassala, eastern Sudan. METHODOLOGY/PRINCIPAL FINDINGS A cross-sectional hospital-based study was conducted among febrile patients from September to December 2019. A total of 395 patients were enrolled after consenting to participate in the study. Demographic and clinical data were collected by structured questionnaires. Blood samples were provided to diagnose malaria infections using microscopy and polymerase chain reaction (PCR) and for serology diagnosis of dengue using enzyme-linked immune sorbent assay (ELISA) IgM. Multiple logistic regression analysis was used to assess the association between demographic information, clinical symptoms and malaria and dengue co-infections. Out of 395 febrile patients examined 158 (40%) were malaria positive and 67 (17%) were dengue positive. The prevalence of malaria and dengue co-infections was 6.6% (26/395). Results of multiple logistic regression indicated that elder patients (41-60 years) had less rate of co-infections (OR = 0.3, 95% CI 0.11 to 0.81, p-value = 0.018), while patients of co-infections were eight times more likely to have fatigue, and two times more likely to suffer from joint and muscle pain and this difference was statistically significant with (OR = 8.3, 95% CI: 1.89 to 37.22, p-value = 0.005) and (OR = 2.4, 95% CI 1.10 to 5.39, p-value = 0.027), respectively. CONCLUSIONS/SIGNIFICANCE This study confirmed the existence of malaria and dengue co-infections among febrile patients in Kassala, eastern Sudan for the first time. The severity of clinical symptoms of patients with malaria and dengue co-infections was observed, and the co-infections were found prevalent among young people.
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Affiliation(s)
- Khider Alsedig
- Department of Medical Entomology, National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Mawahib H. Eldigail
- Epidemiology Department, National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Adel Hussein Elduma
- Epidemiology Department, National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Arwa Elaagip
- Department of Parasitology and Medical Entomology, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
| | - Omnia Altahir
- Department of Epidemiology, Tropical Medicine Research Institute, National Center for Research, Khartoum, Sudan
| | - Hanaa Adli Siam
- Department of Medical Entomology, National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Yousif Ali
- Health Emergencies and Epidemics Control General Directorate, Federal Ministry of Health, Khartoum, Sudan
| | - Tajeldin Abdallah
- Department of Internal Medicine and Microbiology, Faculty of Medicine, University of Kassala, Kassala, Sudan
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Ali Y, Siddig EE, Mohamed N, Ahmed A. Rift Valley fever and malaria co-infection: A case report. Clin Case Rep 2023; 11:e7926. [PMID: 37731970 PMCID: PMC10507219 DOI: 10.1002/ccr3.7926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/22/2023] Open
Abstract
Key Clinical Message We report a case of febrile illness that was presented with mild symptoms. However, laboratory investigation confirmed a malaria and Rift Valley fever co-infection. Healthcare providers in settings endemic with several infectious diseases should seek rolling out possibilities of other infections prior to starting treatment for achieving effective case management with less resources and better safety of patients. Abstract Here we report a case of febrile illness that confirmed to be a co-infection of malaria and Rift Valley fever. The patient was initially diagnosed with malaria and started on treatment immediately. However, due to the lack of response to the treatment further laboratory investigations were pursued.
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Affiliation(s)
- Yousif Ali
- Sudan Field Epidemiology Training, Health Emergencies and Epidemics Control General DirectorateSudan Federal Ministry of HealthKhartoumSudan
| | - Emmanuel Edwar Siddig
- Faculty of Medical Laboratory SciencesUniversity of KhartoumKhartoumSudan
- Department of Medical Microbiology and Infectious DiseasesErasmus University Medical Center RotterdamRotterdamThe Netherlands
| | - Nouh Mohamed
- Molecular Biology UnitSirius Training and Research CentreKhartoumSudan
| | - Ayman Ahmed
- Swiss Tropical and Public Health Institute (Swiss TPH)AllschwilSwitzerland
- Faculty of ScienceUniversity of BaselBaselSwitzerland
- Institute of Endemic DiseasesUniversity of KhartoumKhartoumSudan
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7
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Ahmed A, El‐Amin R, Musa AM, Elsayed MA, Fahal LA, Ahmed ES, Ali Y, Nebie IE, Mohamed NS, Zinsstag J, Siddig EE, EL‐Sadig SM. Guillain-Barre syndrome associated with COVID-19 infection: A case series. Clin Case Rep 2023; 11:e6988. [PMID: 36852114 PMCID: PMC9957700 DOI: 10.1002/ccr3.6988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 01/03/2023] [Accepted: 02/06/2023] [Indexed: 02/27/2023] Open
Abstract
In this communication, we reported a series of six patients presented with Guillain-Barré syndrome that associated with COVID-19 infection, which was confirmed with RT-PCR. Here we discuss the laboratory investigation and case management, as well as clinical presentation and outcome of each case. The current report demonstrated the first case series of COVID-19-associated GBS-cases in Sudan.
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Affiliation(s)
- Ayman Ahmed
- Institute of Endemic DiseaseUniversity of KhartoumKhartoumSudan,Swiss Tropical and Public Health Institute (Swiss TPH)AllschwilSwitzerland,University of BaselBaselSwitzerland
| | - Rahba El‐Amin
- Faculty of MedicineUniversity of KhartoumKhartoumSudan
| | | | | | | | | | - Yousif Ali
- Health Emergencies and Epidemics Control General DirectorateSudan Federal Ministry of HealthKhartoumSudan
| | - Ipyn Eric Nebie
- Swiss Tropical and Public Health Institute (Swiss TPH)AllschwilSwitzerland,University of BaselBaselSwitzerland
| | - Nouh Saad Mohamed
- Molecular Biology UnitSirius Training and Research CentreKhartoumSudan
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute (Swiss TPH)AllschwilSwitzerland,University of BaselBaselSwitzerland
| | - Emmanuel Edwar Siddig
- Mycetoma Research CentreUniversity of KhartoumKhartoumSudan,Faculty of Medical Laboratory SciencesUniversity of KhartoumKhartoumSudan
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Ahmed A, Hemaida MA, Hagelnur AA, Eltigani HF, Siddig EE. Sudden emergence and spread of cutaneous larva migrans in Sudan: A case series calls for urgent actions. IDCases 2023; 32:e01789. [PMID: 37207175 PMCID: PMC10189479 DOI: 10.1016/j.idcr.2023.e01789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 05/21/2023] Open
Abstract
Cutaneous larva migrans (CLM) is a self-limiting dermatosis parasitic disease that is caused by zoonotic hookworm mainly infects cats, dogs, and accidentally humans. The disease affects hosts through the invasion and the migration of the hookworm larva into top layers of the skin. The disease occurs in tropical and subtropical regions; where people commonly are infected when sitting or barefoot walking on places contaminated with feces of infected cats or dogs. Due to self-limiting nature of the disease, the exact burden and prevalence are commonly underestimated. In this communication, we investigated all cases presented to the skin-diseases outpatient clinic' at the reference hospital of Tropical Diseases Medicine in Khartoum state between January 2019 and January 2021. This is the first-ever a case series report of cutaneous larva migrans in Sudan. We identified 15 cases of CLM presented with rash (100 %), redness of skin (67 %), and only adults were presented with larva crawling under their skins (27 %). Infection sites were (53 %) leg, (40 %) foot, only 7 % showed abdominal infection. The majority of patients were children or young adults, 47 % of them are ≤5 year-old, male to female ratio is 2.75:1. Duration of infection was one to three weeks and all patients fully recovered after treatment with albendazole. This urges for One Health interventions including deworming cats and dogs, improving water, sanitation, and hygiene, community-engagement and raising awareness in area with risk of infection.
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Affiliation(s)
- Ayman Ahmed
- Institute of endemic diseases, University of Khartoum, Khartoum, Sudan
- Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- University of Basel, Petersplatz 1, Basel, Switzerland
| | - Maisa Aldai Hemaida
- Unit of Applied Medical Sciences, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
| | - Amel Ahmed Hagelnur
- General Director, Tropical Medicine Hospital, Omdurman, Khartoum State, Sudan
| | | | - Emmanuel Edwar Siddig
- Unit of Applied Medical Sciences, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
- The Mycetoma Research Center, University of Khartoum, Khartoum, Sudan
- ErasmusMC, University Medical Center Rotterdam, Department of Medical Microbiology and Infectious Diseases, Rotterdam, the Netherlands
- Corresponding author at: Unit of Applied Medical Sciences, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan.
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Ahmed A, Abubakr M, Sami H, Mahdi I, Mohamed NS, Zinsstag J. The First Molecular Detection of Aedes albopictus in Sudan Associates with Increased Outbreaks of Chikungunya and Dengue. Int J Mol Sci 2022; 23:ijms231911802. [PMID: 36233103 PMCID: PMC9570206 DOI: 10.3390/ijms231911802] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 12/28/2022] Open
Abstract
As part of our surveys of the invasive malaria vector Anopheles stephensi in four Sudanese states, including North and South Kordofan, Sennar, and White Nile, we collected 166 larvae. Our morphological identification confirmed that 30% of the collected mosquito samples were Anopheles species, namely An. gambiae s.l. and An. stephensi, while the 117 Aedes specimens were Ae. luteocephalus (39%), Ae. aegypti (32%), Ae. vexans (9%), Ae. vittatus (9%), Ae. africanus (6%), Ae. metalicus (3%), and Ae. albopictus (3%). Considering the serious threat of Ae. albopictus emergence for the public health in the area and our limited resources, we prioritized Ae. albopictus samples for further genomic analysis. We extracted the DNA from the three specimens and subsequently sequenced the cytochrome oxidase 1 (CO1) gene and confirmed their identity as Aedes albopictus and their potential origin by phylogenetic and haplotype analyses. Aedes albopictus, originating from Southeast Asia, is an invasive key vector of chikungunya and dengue. This is the first report and molecular characterization of Ae. albopictus from Sudan. Our sequences cluster with populations from the Central African Republic and La Réunion. Worryingly, this finding associates with a major increase in chikungunya and dengue outbreaks in rural areas of the study region and might be linked to the mosquito’s spread across the region. The emergence of Ae. albopictus in Sudan is of serious public health concern and urges for the improvement of the vector surveillance and control system through the implementation of an integrated molecular xenosurveillance. The threat of major arboviral diseases in the region underlines the need for the institutionalization of the One Health strategy for the prevention and control of future pandemics.
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Affiliation(s)
- Ayman Ahmed
- Institute of Endemic Diseases, University of Khartoum, Khartoum 11111, Sudan
- Swiss Tropical and Public Health Institute (Swiss TPH), CH-4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland
- Molecular Biology Unit, Sirius Training and Research Centre, Khartoum 11111, Sudan
- Correspondence: ; Tel.: +249-123997091
| | - Mustafa Abubakr
- Directorate of Environmental Health, Federal Ministry of Health, Khartoum 11111, Sudan
| | - Hamza Sami
- Directorate of the Integrated Vector Management (IVM), Federal Ministry of Health, Khartoum 11111, Sudan
| | - Isam Mahdi
- Directorate of the Integrated Vector Management (IVM), Federal Ministry of Health, Khartoum 11111, Sudan
| | - Nouh S. Mohamed
- Molecular Biology Unit, Sirius Training and Research Centre, Khartoum 11111, Sudan
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute (Swiss TPH), CH-4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland
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Ahmed A, Ali Y, Siddig EE, Hamed J, Mohamed NS, Khairy A, Zinsstag J. Hepatitis E Virus Outbreak among Tigray War Refugees from Ethiopia, Sudan. Emerg Infect Dis 2022; 28:1722-1724. [PMID: 35876603 PMCID: PMC9328910 DOI: 10.3201/eid2808.220397] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We report hepatitis E virus (HEV) outbreaks among refugees from Ethiopia in Sudan during June 2021-February 2022. We identified 1,589 cases of acute jaundice syndrome and used PCR to confirm HEV infection in 64% of cases. Implementing vaccination, water, sanitation, and hygiene programs might reduce HEV outbreak risk.
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Ahmed A, Ali Y, Salim B, Dietrich I, Zinsstag J. Epidemics of Crimean-Congo Hemorrhagic Fever (CCHF) in Sudan between 2010 and 2020. Microorganisms 2022; 10:928. [PMID: 35630372 PMCID: PMC9147186 DOI: 10.3390/microorganisms10050928] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/12/2022] [Accepted: 04/25/2022] [Indexed: 02/05/2023] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic arboviral disease that poses a great threat to global health in the Old World, and it is endemic in Europe, Asia, and Africa, including Sudan. In this retrospective study, we reviewed previous epidemiological reports about the major epidemics of CCHF throughout Sudan between 2010 and 2020. During these epidemics, the infection of humans with Crimean-Congo hemorrhagic fever virus (CCHFV), the causative agent of CCHF, was diagnosed using qRT-PCR. We have identified 88 cases of CCHF, including 13 fatalities reported during five epidemics that occurred in 2010, 2011, 2015, 2019, and 2020. The two epidemics in 2010 and 2011 were by far the largest, with 51 and 27 cases reported, respectively. The majority of cases (78%) were reported in the endemic region of Kordofan. Here, we document that the first emergence of CCHFV in the Darfur region, West Sudan, occurred in 2010. We were not able to investigate outbreak dynamics through phylogenetic analysis due to the limited diagnostic capacity and the lack of sequencing services in the country. These findings call for establishing a genomic-based integrated One Health surveillance and response system for the early preparedness, prevention, and control of CCHF in the country.
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Affiliation(s)
- Ayman Ahmed
- Institute of Endemic Diseases, University of Khartoum, Khartoum 11111, Sudan
- Swiss Tropical and Public Health Institute (Swiss TPH), CH-4123 Allschwil, Switzerland;
- Faculty of Science, University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland
- Sudanese National Academy of Sciences, Khartoum 11111, Sudan
| | - Yousif Ali
- Health Emergencies and Epidemics Control General Directorate, Sudan Federal Ministry of Health, Khartoum 11111, Sudan;
| | - Bashir Salim
- Faculty of Veterinary Medicine, University of Khartoum, Khartoum 11111, Sudan;
| | | | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute (Swiss TPH), CH-4123 Allschwil, Switzerland;
- Faculty of Science, University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland
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Ahmed KAHM, Hasabo EA, Haroun MS, Eljack MMF, Salih EH, Altayeb YFO, Nour AB, Abdallah AM, Osman WAM, Yousif MYE. Clinical Characteristics, Complications and Predictors of Outcome of Hospitalized Adult Sudanese Patients with COVID-19 and Malaria Co-Infection in Sudan: A Multi-Center Retrospective Cross-sectional Study. J Med Virol 2022; 94:3685-3697. [PMID: 35415939 PMCID: PMC9088527 DOI: 10.1002/jmv.27771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/10/2022] [Indexed: 01/08/2023]
Abstract
Malaria and coronavirus disease 2019 (COVID‐19) share several characteristics that could lead to cross‐infection, particularly in malaria‐endemic areas. Early COVID‐19 symptoms might be misdiagnosed for malaria in clinical settings. Also, both diseases can cause fatal complications. So, laboratory testing for both diseases was recommended by the World Health Organization. To study the clinical characteristics and outcomes of Adult Sudanese patients with COVID‐19 and malaria coinfection. This retrospective cross‐sectional study was conducted from January 2021 to October 2021 in Wad Medani. Total coverage of all Sudanese patients above 18 years old with a confirmed diagnosis of coinfection with COVID‐19 and malaria was included, and data were collected using a data collection sheet. Data were analyzed using R software version 4.0.2. Data were described and presented as mean, standard deviation, and number (percentage). To find associated factors with in‐hospital outcome, χ2 test, fisher exact test, and independent t test or Wilcoxon rank‐sum test were used. In this study, 156 participants were diagnosed with COVID‐19 and malaria coinfection. Most of them were between 60 and 70 years (30.8%), the majority were males (59%). Shortness of breath (76.3%) and acute respiratory distress syndrome (35.3%) were the most common symptom and complications among coinfected patients, respectively. Ground glass opacity (n = 47/49, 95.9%) is the most common result for computed tomography scan. Atrial fibrillation was the most common abnormal electrocardiogram finding (n = 6/62, 9.7%). Overall mortality among all participants was (63/156, 40.4%). High mortality rate was found among the coinfected patients. More attention is needed towards fighting COVID‐19 and malaria coinfection. There may be a link between malaria and COVID‐19.
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Affiliation(s)
| | | | | | | | | | | | - Alshareef B Nour
- Wad Medani College of Medical Science and Technology, Medani, Sudan
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Abubakr M, Sami H, Mahdi I, Altahir O, Abdelbagi H, Mohamed NS, Ahmed A. The Phylodynamic and Spread of the Invasive Asian Malaria Vectors, Anopheles stephensi, in Sudan. BIOLOGY 2022; 11:biology11030409. [PMID: 35336783 PMCID: PMC8945054 DOI: 10.3390/biology11030409] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/14/2022] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Abstract
Simple Summary Climate change increases the suitability of some environments for the establishment of newly introduced insects and is a major driver for the spread of mosquitoes that transmit diseases. Anopheles stephensi is a disease vector mosquito that transmits malaria and is naturally endemic in Asia. This vector newly emerged in Africa (first report from Djibouti in 2012), where annual malaria infections and deaths are the highest worldwide. This mosquito has different ecology and behavior from previously known malaria vectors in Africa, which makes control difficult for local under-resourced health systems. Considering the capacity of this vector to transmit at least two malaria-causing parasites (Plasmodium falciparum and Plasmodium vivax), we investigated its distribution and population structure in Sudan and assessed the potential risk of its further spread into neighboring countries. Using morphological and genomic sequencing techniques, we confirmed the presence of Anopheles stephensi along the borders of six countries previously assumed as free, including Chad, Egypt, Eritrea, Libya, Republic of Central Africa, and South Sudan. African countries need to enhance vector surveillance and control services and utilize genomics tools for tracking the dynamics of invasive disease vectors. Abstract Anopheles stephensi is an invasive Asian malaria vector that initially emerged in Africa in 2012 and was reported in Sudan in 2019. We investigated the distribution and population structure of An. stephensi throughout Sudan by using sequencing and molecular tools. We confirmed the presence of An. stephensi in eight border-states, identifying both natural and human-made breeding sites. Our analysis revealed the presence of 20 haplotypes with different distributions per state. This study revealed a countrywide spread of An. stephensi in Sudan, with confirmed presence in borders states with Chad, Egypt, Eritrea, Ethiopia, Libya, Republic of Central Africa, and South Sudan. Detection of An. stephensi at points of entry with these countries, particularly Chad, Libya, and South Sudan, indicates the rapid previously undetected spread of this invasive vector. Our phylogenetic and haplotype analysis suggested local establishment and evolutionary adaptation of the vector to different ecological and environmental conditions in Sudan. Urgent engagement of the global community is essential to control and prevent further spread into Africa.
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Affiliation(s)
- Mustafa Abubakr
- Directorate of the Integrated Vector Management (IVM), Federal Ministry of Health, Khartoum 11111, Sudan; (M.A.); (H.S.); (I.M.)
| | - Hamza Sami
- Directorate of the Integrated Vector Management (IVM), Federal Ministry of Health, Khartoum 11111, Sudan; (M.A.); (H.S.); (I.M.)
| | - Isam Mahdi
- Directorate of the Integrated Vector Management (IVM), Federal Ministry of Health, Khartoum 11111, Sudan; (M.A.); (H.S.); (I.M.)
| | - Omnia Altahir
- Molecular Biology Unit, Sirius Training and Research Centre, Khartoum 11111, Sudan; (O.A.); (H.A.); (N.S.M.)
| | - Hanadi Abdelbagi
- Molecular Biology Unit, Sirius Training and Research Centre, Khartoum 11111, Sudan; (O.A.); (H.A.); (N.S.M.)
| | - Nouh Saad Mohamed
- Molecular Biology Unit, Sirius Training and Research Centre, Khartoum 11111, Sudan; (O.A.); (H.A.); (N.S.M.)
| | - Ayman Ahmed
- Directorate of the Integrated Vector Management (IVM), Federal Ministry of Health, Khartoum 11111, Sudan; (M.A.); (H.S.); (I.M.)
- Molecular Biology Unit, Sirius Training and Research Centre, Khartoum 11111, Sudan; (O.A.); (H.A.); (N.S.M.)
- Institute of Endemic Diseases, University of Khartoum, Khartoum 11111, Sudan
- Swiss Tropical and Public Health Institute (Swiss TPH), 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, Petersplatz 1, 4001 Basel, Switzerland
- Correspondence: or ; Tel.: +249-123997091
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Ilboudo DP, Zohoncon TM, Hien YE, Ouattara AK, Traore L, Ouermi D, Djigma WF, Nadembega CM, Belemgnegre M, Ouedraogo P, Karou DS, Traore Y, Simpore J. Dengue Immunological Markers Evolution at Saint Camille Hospital in Ouagadougou (HOSCO) Burkina Faso. Pak J Biol Sci 2022; 25:254-262. [PMID: 35234016 DOI: 10.3923/pjbs.2022.254.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
<b>Background and Objective:</b> Dengue is a remerging vector-borne viral disease in Burkina Faso since the outbreak of 2013 and requires special attention from health authorities. This study reports the prevalence of dengue fever serological markers (NS1Ag, IgM and IgG) and infection dynamic from January, 2018 to December, 2020 among patients tested for dengue infection at Saint Camille Hospital of Ouagadougou (HOSCO). <b>Materials and Methods:</b> The study population consisted of 6414 patients aged 0-97 years. Dengue virus infection was detected in serum or plasma using the SD bioline dengue duo rapid detection kit. <b>Results:</b> The prevalence of dengue NS1Ag was 2.25% (45/2003), 18.43% (501/2719) and 2.42% (38/1569) in the study population in 2018, 2019 and 2020, respectively. The age groups over 50 years and 15-20 years were significantly more infected compared to the group 21-30 years respectively in 2019 (p = 0.030) and 2020 (p = 0.035). Patients tested positive for at least one of these markers (NSlAg, IgG and IgM) represented 26.01% (521/2003) and 38.98% (1060/2719). The peak of infection during 2018 and 2019 was observed between October and November. The present study reports a high seroprevalence of acute dengue virus infection. The presence of NS1Ag, IgM and IgG in patients suggests an active circulation of the dengue virus in Ouagadougou. <b>Conclusion:</b> Data shows recurrent outbreaks of dengue infection in our country need strong surveillance and a suitable and affordable diagnostic system to clarify the burden, pinpoint the risk factors and for better case management.
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Ahmed A, Mohamed NS, Siddig EE, Algaily T, Sulaiman S, Ali Y. The impacts of climate change on displaced populations: A call for action. THE JOURNAL OF CLIMATE CHANGE AND HEALTH 2021; 3:100057. [DOI: 10.1016/j.joclim.2021.100057] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Ahmed A, Mahmoud I, Eldigail M, Elhassan RM, Weaver SC. The Emergence of Rift Valley Fever in Gedaref State Urges the Need for a Cross-Border One Health Strategy and Enforcement of the International Health Regulations. Pathogens 2021; 10:pathogens10070885. [PMID: 34358035 PMCID: PMC8308630 DOI: 10.3390/pathogens10070885] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/06/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022] Open
Abstract
This study investigated the causative agent of a haemorrhagic fever epidemic in Gedaref state, south-east Sudan. Six cases of febrile illness with haemorrhagic manifestations presented at outpatient health-clinics. Blood samples were collected from the patients and shipped to Khartoum where they were tested for dengue virus (DENV), chikungunya virus (CHIKV), and Rift Valley fever virus (RVFV) using real-time qPCR. Fifty percent (3/6) of them tested positive for RVFV and neither DENV or CHIKV was detected. All patients were males between 20 and 48 years old who had no history of recent travel. This finding describes the first emergence of RVFV in Gedaref state. Considering that the state hosts a major market of livestock, and it has one of the largest-seasonal open pastures in the country that is usually flooded with herds from the neighbouring states and countries during the rainy season, this emergence could represent a major threat to public health in the region and countries importing animals and/or animal products from east Africa. Therefore, we urge the policymakers of the health and animal resources sectors to implement a one health strategy with a well-established early warning surveillance and response system to prevent the establishment of the disease in the area.
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Affiliation(s)
- Ayman Ahmed
- Institute of Endemic Diseases, University of Khartoum, Khartoum 11111, Sudan
- World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, TX 77550, USA;
- Institute for Human Infections and Immunity, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77550, USA
- Correspondence: ; Tel.: +249-123997091
| | - Iman Mahmoud
- National Public Health Laboratory, Sudan Federal Ministry of Health, Khartoum 11111, Sudan; (I.M.); (M.E.); (R.M.E.)
| | - Mawahib Eldigail
- National Public Health Laboratory, Sudan Federal Ministry of Health, Khartoum 11111, Sudan; (I.M.); (M.E.); (R.M.E.)
| | - Rehab M. Elhassan
- National Public Health Laboratory, Sudan Federal Ministry of Health, Khartoum 11111, Sudan; (I.M.); (M.E.); (R.M.E.)
| | - Scott C. Weaver
- World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, TX 77550, USA;
- Institute for Human Infections and Immunity, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77550, USA
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