Malaria Parasite Density Estimation using Actual and Assumed White Blood Cells Count in Children in Eastern Sudan.

BACKGROUND: Estimating malaria parasite count is needed for estimating the severity of the disease and during the follow-up. OBJECTIVE: This study was conducted to determine the malaria parasite density among children using actual white blood cell (WBC) and the assumed WBC counts (8.0 × 10(9)/l). METHODS: A cross-sectional study was conducted at New Halfa Hospital, Sudan. WBC count and count of asexual malaria parasite were performed on blood films. RESULTS: One hundred and three children were enrolled. The mean (SD) WBCs was 6.2 (2.9) cells × 10(9)/l. The geometric mean (SD) of the parasite count using the assumed WBCs (8.0 × 10(9)/l cells/µl) was significantly higher than that estimated using the actual WBC count [7345.76 (31,038.56) vs. 5965 (28,061.57) rings/µl,p = 0.042]. CONCLUSION: Malaria parasitemia based on assumed (8.0 × 10(9)/) WBCs is higher than parasitemia based on actual WBCs.

Omega 3 (n-3) fatty acids down-regulate nuclear factor-kappa B (NF-κB) gene and blood cell adhesion molecule expression in patients with homozygous sickle cell disease.

Chronic inflammation and reduced blood levels of omega-3 fatty acids (n-3) are known characteristics of sickle cell disease (SCD).The anti-inflammatory properties of n-3 fatty acids are well recognized. Omega-3 treated (n = 24), hydroxyurea (HU) treated (n = 18), and n-3 untreated (n=21) homozygous SCD patients (HbSS) and healthy (HbAA) controls (n = 25) matched for age (5-16 years), gender and socioeconomic status were studied. According to age (5-10) or (11-16) years, two or three capsules containing 277.8 mg docosahexaenoic (DHA) and 39.0mg eicosapentaenoic (EPA) or high oleic acid placebo (41%) were assigned to n-3 treated and n-3 untreated groups, respectively. Hydroxyurea treated group was on dosage more than 20 mg/kg/day. The effect of supplementation on systemic and blood cell markers of inflammation was investigated. The n-3 treated group had higher levels of DHA and EPA (p < 0.001) and lower white blood cell count and monocyte integrin (p < 0.05) compared with the n-3 untreated. No difference was detected between the two groups regarding C-reactive protein, granulocytes integrin and selectin, plasma tumour necrosis factor-α and interleukin-10. The n-3 treated group had lowered nuclear factor-kappa B (NF-κB) gene expression compared to n-3 untreated and HU treated groups (p < 0.05). This study provides evidence that supplementation with n-3 fatty acids may ameliorate inflammation and blood cell adhesion in patients with SCD.

Estimating malaria parasite density among pregnant women at central Sudan using actual and assumed white blood cell count.

BACKGROUND: Microscopic examination using Giemsa-stained thick blood films remains the reference standard for detection of malaria parasites and it is the only method that is widely and practically available for quantifying malaria parasite density. There are few published data (there was no study during pregnancy) investigating the parasite density (ratio of counted parasites within a given number of microscopic fields against counted white blood cells (WBCs) using actual number of WBCs. METHODS: Parasitaemia was estimated using assumed WBCs (8,000), which was compared to parasitaemia calculated based on each woman's WBCs in 98 pregnant women with uncomplicated Plasmodium falciparum malaria at Medani Maternity Hospital, Central Sudan. RESULTS: The geometric mean (SD) of the parasite count was 12,014.6 (9,766.5) and 7,870.8 (19,168.8) ring trophozoites /µl, P <0.001 using the actual and assumed (8,000) WBC count, respectively. The median (range) of the ratio between the two parasitaemias (using assumed/actual WBCs) was 1.5 (0.6-5), i e, parasitaemia calculated assuming WBCs equal to median (range) 1.5 (0.6-5) times higher than parasitaemia calculated using actual WBCs. There were 52 out of 98 patients (53%) with ratio between 0.5 and 1.5. For 21 patients (21%) this ratio was higher than 2, and for five patients (5%) it was higher than 3. CONCLUSION: The estimated parasite density using actual WBC counts was significantly lower than the parasite density estimated using assumed WBC counts. Therefore, it is recommended to use the patient`s actual WBC count in the estimation of the parasite density.

Maternal and Umbilical Cord Blood Levels of Zinc and Copper in Active Labor Versus Elective Caesarean Delivery at Khartoum Hospital, Sudan.

A case-control study was conducted in Khartoum Hospital Sudan to determine maternal and umbilical cord blood levels of zinc and copper in active labor versus elective cesarean delivery. Cases were women delivered vaginally and controls were women delivered by elective cesarean (before initiation of labor). Paired maternal and cord zinc and copper were measured using atomic absorption spectrophotometry. The two groups (52 paired maternal and cord in each arm) were well matched in their basic characteristics. In comparison with cesarean delivery, the median (interquartile range) of both maternal [87.0 (76.1-111.4) vs. 76.1 (65.2-88.3) µg/dL, P = 0.004] and cord zinc [97.8 (87.0-114.1) vs. 81.5(65.2-110.2) µg/dL P = 0.034] levels were significantly higher in the vaginal delivery. While there was no significant difference in the maternal copper [78.8 (48.1-106.1) vs. 92.4 (51.9-114.9) µg/dL, P = 0.759], the cord copper [43.5(29.9-76.1) vs. 32.2(21.7-49.6) µg/dL, P = 0.019] level was significantly higher in vaginal delivery. There was no significant correlation between zinc (both maternal and cord) and copper. While the cord zinc was significantly correlated with maternal zinc, there was no significant correlation between maternal and cord copper. The current study showed significantly higher levels of maternal and cord zinc and cord copper in women who delivered vaginally compared with caesarean delivery.

Red blood cell distribution width and iron deficiency anemia among pregnant Sudanese women.

BACKGROUND: Iron deficiency anemia (IDA) is a major health problem during pregnancy and it has adverse effects on the mother and the newborn. Red cell distribution width (RDW), which is a quantitative measure for red cell size variation (anisocytosis), is a predictor of IDA. Little is known regarding RDW and IDA during pregnancy. METHODS: A cross sectional study was conducted at the antenatal clinic of Khartoum Hospital, Sudan, to determine the performance of RDW in the diagnosis of IDA using serum ferritin as a gold standard. RESULTS: Among 194 pregnant women with a gestational period of 21.4 ± 6.5 weeks, 57 (29.4%) had IDA according to serum ferritin levels (<15 µg/l) and 61 (31.4%) had IDA according to RDW (>14.5). The sensitivity, specificity, positive predictive value, and negative predictive value of RDW where serum ferritin was the gold standard were 43.8% (95% CI: 31.4-57.0%), 73.7% (95% CI: 65.8-80.5%), 41.0% (95% CI: 29.2-53.6%), and 76.0% (95% CI: 68.1-82.6%), respectively. CONCLUSIONS: In this study, we found that RDW has a poor performance in diagnosing IDA among pregnant women compared with serum ferritin as the gold standard.