Prevalence and Risk Factors of Hepatitis B among the Population at Algamosi Locality, Gezira State, Sudan

Background: The local population in developing countries is at higher risk of contracting hepatitis B (HBV) due to some of the factors they practice which promote its establishment and distribution within their communities and may constitute a burden for them. Objective: This study aimed to determine the prevalence and risk factors associated with the hepatitis B virus in populations of the Algamosi region, Gezira State, central Sudan. Method: A cross-sectional study was conducted among 492 people, populations of the Algamosi region, Gezira state in central Sudan. A questionnaire was used to collect information on socio-demographic factors, transmission, and prevention of hepatitis B infections. As well, blood samples were taken from each participant, and serum was used for rapid tests for HBsAg. Positive samples were then tested by the ELISA method for confirmation. Data were obtained using SPSS version 21 and a P value of less than 0.05 was considered statistically significant. Results: The prevalence of hepatitis B was 16.10% and was higher in men than in women (05.7 - 1.00). People aged 31 to 45 had the highest prevalence of 27 (20,600%) for HBV infection. There was a significant association between HBV and age groups (X2 = 7.816 and P value = 0.05). This study also found that there was a significant association between viral hepatitis and knowledge about transmission and prevention (P value Conclusion: Although most people who live in developing countries are at high risk for transmission of hepatitis B, this indicates the need to implement the screening policy and integrate it with other health services and create awareness such as proper treatment and surveillance for hepatitis infection in all nations.

Assessing Drug Use Indicators in Health Insurance Facilities, Gezira State, Sudan, 2017-2018

Background: Inappropriate use of medicines is a global concern with serious consequences related to prescribing, dispensing, and use. WHO estimated that 50% of medicines are not used correctly on their journey from the facility to home. Objective: To assess medicines use using WHO drug core indicators regarding prescribing, patient, and facilities. Setting: Outpatients, Health centers in Wadmadani locality (Urban area) in Gezira State, Sudan. Method: A cross-sectional, prospective, analytical study was conducted in 30 health centers and 60 patients from each center were selected using a simple random sampling technique. WHO indicators form was used to collect data containing different variables. T-test at a level of confidence of 95% was used to test differences between indicators. Statistical Package for Social Science (SPSS) was used for data analysis. Results: The main prescribing indicators were 2.5 ± 0.6 for drugs per encounter, 44.1% ± 14.2%. Generic 54 ± 18.0 antibiotics, 12.0% ± 9.3% injectable, and 95.2% ± 11.5% of drugs were prescribed according to the NHIF-EML. The main patient’s indicators were, 2.9 ± 0.8 minutes for consultation time, 99.5 ± 36.8 seconds for dispensing time, and 72.5% ± 16.0% for medicines actually dispensed, 49.0% ± 18.0% for medicines adequately labeled, and 22.5% ± 7.3% of the patient’s knowledge about the correct dose. The Facility specific indicators were 66.7% for the availability of a copy of EML, while the percentage of key drugs in the stock was 75.3% ± 11.6%. No statistically significant differences were found between direct and indirect facilities except in generic prescribing. Main Outcome Measure: • Interventions to improve Generic and antibiotics prescribing indicators. • The patient-to-physician ratio should be revised to optimize consultation time. • The availability of key drugs should be improved to make sure effective treatment. • The pharmacy cadre should be oriented and trained to improve patients’ compliance. Conclusion: The study concluded that there was irrational use of medicines when investigated by WHO drug core indicators. So, the study recommended interventions to improve the rationale prescribing, dispensing, and use of medicines.

Characterisation of larval habitats,species composition and factors associated with the seasonal abundance of mosquito fauna in Gezira,Sudan

Background:Larval source management(LSM),which requires an understanding of the ecology and composition of the local mosquito fauna,is an important parameter in successful vector control programmes.The present study was conducted to understand the distribution of larval habitats,species composition and factors associated with the seasonal abundance of mosquito larvae in Gezira irrigation Scheme in Gezira state,central Sudan.Methods:Cross-sectional larval surveys were carried out in the communities of Barakat(urban)and El-Kareiba(semi-urban),in Wad Madani,Gezira.A standard dipper was used for sampling larvae in all possible breeding sites and enamel bowls were employed for larvae sorting.Habitats were characterised using physical features and all larvae specimens were identified morphologically.Results:A total of 331 larval habitats were surveyed,out of which 166 were found to be positive breeding sites for Anopheles(56.78%),Culicinae(29.67%)and Aedes(13.55%)species.A total of 5525 larvae collected were categorised as Culex(2617,47.37%),Anopheles(2600,47.06%)and Aedes(308,5.57%).There was a high number of positive habitats during the rainy season,while the lowest proportion was reported during the hot dry season,in both study sites(Barakat[χ^(2)=10.641,P=0.0090],El-Kareiba[χ^(2)=23.765,P=0.0001]).The main breeding site for Anopheles larvae was leaking water pipes(51.5%),followed by irrigation channels(34.2%),hoof prints(6.4%),tyre tracks(5.5%)and water tanks(2.4%).A logistic regression analysis showed that the abundance of Anopheles larvae was reduced by the presence of predators(backswimmers,tadpoles)and grass cover.Adult productivity(number of adult females emerged/m2)was not homogeneousfor all habitats;the highest productivity was found in irrigation channels(0.78 females/m2)for Anopheles,and in septic tanks(2.86 females/m2)for Culicinae and(0.86 females/m2)for Aedes.Anopheles arabiensis was found to be the dominant Anopheles species.This study documented the presence of An.funestus in central Sudan for the first time.Conclusions:Maintaining leaking water pipes and adopting intermittent irrigation are recommended for LSM,as these surveyed habitats represent the main source of maintaining the local mosquito population during the hot dry season.

Renal Function in Preeclamptics versus Normal Pregnant Women

Background: Pregnancy is implicated in notable physiological changes and the extraordinary kidney physiology during pregnancy is believed to have an effect on kidney functions. However, during pregnancy the glomerular filtration rate (GFR) increases its work rate up to 50%, on the contrary, in preeclampsia the GFR turns back to decline. Objectives: This study aims to measure and compare kidney function between preeclamptic and normal pregnant women. Materials and Methods: A cross-sectional hospital-based study was conducted in the period from March to May 2021 in Wad Medani Obstetrics and Gynecology Teaching Hospital. A total of 100 pregnant women, 50 apparently healthy pregnant women and 50 pregnant ladies proved to have preeclamptic toxemia, their ages ranged from 18 to 44 years old and at the third trimester of pregnancy. Blood samples were taken and serum was separated, then urea, creatinine, uric acid, sodium and potassium were determined. Data were analyzed using Statistical Package for Social Science (SPSS). Results: The results of this study revealed that 92% of preeclamptic pregnant women had the first time of the incidence and 8% were family inherited preeclampsia and injured multiple times. The preeclamptic pregnant women showed elevation in both systolic and diastolic blood pressure compared to the normal pregnant women. Although the creatinine values of all study subjects were in the normal range, the mean of its serum level was found to be higher in normal pregnant women than that in preeclamptic women. The study also showed urea level was elevated in the preeclampsia group in comparison to the normal one, while all values were in the normal range. In addition to the significant difference that observed in the uric acid mean between preeclamptic (higher) and normal pregnant groups, abnormal values were only noticed with many preeclamptic patients. The levels of electrolytes (sodium and potassium) were elevated in the preeclampsia women group, whereas all values were in the normal range. Conclusion: This study concluded that preeclamptics showed significant elevation in the urea, uric acid, sodium and potassium levels and a significant decrease in creatinine level compared to normal pregnant women, although all parameters values for both groups were in the reference values for non-pregnancy.

Urosepsis among Sudanese Patients: A Paradigm from Limited Resources Country

Background: Urosepsis is life-threatening sepsis that leads to organ dysfunction and results from a defective response to a urinary tract infection;the major precipitating is obstructive uropathy in the upper or lower urinary tract (UT). The magnitude and burden of bacteria that caused uropathy were reported to increase annually. In 30% of all septic patients who were diagnosed with urosepsis, 1.5% of them were found in urology and a quarter due to hospital-acquired urinary tract infections (HAUTIs). This study aims to determine the clinical pattern and the frequency of commonly used antibiotics against bacteria associated with urosepsis among Sudanese patients. Methods: This was a cross sectional laboratory-based study, study subjects were recruited from patients attended to Gezira Hospital for Renal diseases and surgery (GHRDS) and was diagnosed, on clinical and laboratory basis, to have urosepsis. Hundred (n = 100) urine samples were collected and inoculated on cysteine lactose electrolyte deficient agar (CLED) media and identify using the suitable biochemical test and performed antimicrobial susceptibility testing (AST) by Kirby Bauer disc diffusion technique for selected antimicrobial agents, according to clinical laboratory standard institute (CLSI) guidelines. Results: Amongst urosepsis infection the frequency of E. coli, S. aureus, Proteus mirabilis, Klebseilla pneumonia and Pseudomonas aeruginosa were (37%, 21%, 10%, 6%, 4% respectively). Resistance to commonly prescribed antibiotics was high, ranging from 17% for meropenem to 100% for cefepime. P. aeruginosa was multidrug resistant compared with other isolates. Conclusions: There was high rate of antibiotic resistance against the common causes of urosepsis in GHRDS, and this reflects the importance of culture and sensitivity test and necessitates adoption of guidelines for selection of suitable antibiotic.