A bibliometric analysis of the research outcome of the Faculty of Medicine, University of Khartoum 2019-2023.

Using two databases, this bibliometric analysis was done for the papers published by the Faculty of Medicine, University of Khartoum (FMUK), from 2019 to 2023. Data were extracted from SCImago for all Sudan, and from PubMed for the publications by FMUK and its associated research centres, the Institute of Endemic Diseases, and the Mycetoma Research Center. The analysis of publications included the count and type of publications, the journals, and national and international collaboration assessment. The publications from FMUK show improvement over time in number and quality, a growth that is significantly influenced by national and international collaboration. These partnerships have proven to be a key driver of FMUK's research output, together with the valuable contributions of the specialized research institutions. However, there is room for improvement in the research output by increasing institutional capacity to support research and scientific communication. The Sudanese Journal of Paediatrics is an example where open access has a positive impact by allowing peripheral journals to be established despite the constraints.

Perspectives on repositioning chloroquine and hydroxychloroquine for the treatment of Covid-19.

Coronavirus disease 2019 (COVID-19) is now spreading as a pandemic ravaging the whole world. In the absence of a vaccine and an effective antiviral chemotherapy, there is currently an intense global interest in repositioning chloroquine (CQ) and its derivative hydroxychloroquine (HCQ) to combat the pandemic. CQ has been used for decades for the treatment and prophylaxis against malaria in endemic countries. It is readily available and has also been manufactured in these countries. CQ is cheap, stable under field conditions and has been well tolerated as an antimalarial. This experience could be adapted to deploy CQ or HCQ for prophylaxis or treatment of COVID19 if strong evidence could be generated for these uses. We believe that well-designed drug trials should be initiated in malaria-endemic countries, taking into account the local context of the epidemic and the capacity of the health system in combating it. In this paper, we are presenting the current status of evidence for using CQ and HCQ against COVID19.

Seroepidemiology of human toxocariasis in North Africa.

Seroprevalence studies on human toxocariasis help to assess the burden and the morbidity associated with this zoonosis. This review searched the seroprevalence studies and case reports in six North African countries: Algeria, Egypt, Libya, Morocco, Sudan and Tunisia, since 1990. The search also included studies on the environmental factors related to the risk of transmission. Most of the published epidemiological studies were done in Egypt. Cross-sectional and case-control studies in Egypt demonstrated that toxocariasis is a significant zoonosis that could be associated with conditions like bronchial asthma allergies and certain neuropsychiatric disorders. The population at risk of this infection includes all ages, both genders, in contact with dogs, resident in rural areas with poor housing conditions. The publications from Tunisia, Morocco and Algeria are limited to case reports and retrospective analyses of cases, but the disease is probably under-diagnosed in these three countries. There are no published reports on human toxocariasis in Libya and Sudan during the period covered by the review. Animal studies confirm high infection rates of dogs with Toxocara canis in North Africa. There is also evidence of wide-spread contamination of soil and water with Toxocara spp. eggs. Moreover, the use of untreated wastewater for irrigation in parts of North Africa could be a source of contamination of agricultural products with eggs of Toxocara spp. Population-based studies on human toxocariasis are recommended, using standardized diagnostic tests. These surveys should also assess risk factors to guide preventive measures.

Acute poisoning in a child following topical treatment of head lice (pediculosis capitis) with an organophosphate pesticide.

This is a case report of acute organophosphate poisoning in a child treated with topical application of Diazinon-60 (WHO Class II toxicity) for head lice (pediculosis capitis). The patient presented with neurological symptoms and signs. After emergency respiratory and circulatory resuscitation the patient underwent dermal decontamination and was treated with atropine, high flow oxygen and pralidoxime. Scanning electron micrographs of scalp hair specimens revealed both viable and empty head lice nits (lice eggs that attach to the hair shaft). The patient was hospitalized for seven days and discharged after full recovery. The case highlights the importance of raising the awareness of health workers and the community about the danger of misusing pesticides for the treatment of head lice.

A relic of the Wellcome Tropical Research Laboratories in Khartoum (1903-34).

This article explores the origins of an old brass monocular microscope in the Central Laboratory in Khartoum, which used to be the Wellcome Tropical Research Laboratory in Khartoum (1903-1934). Examination of the microscope and review of published literature gave clues to the historical background of this microscope. Identical microscopes were first manufactured by R and J Beck in 1898, and continued to be advertised in 1899. The microscope was probably among the instruments provided by Wellcome for the initial establishment of the laboratories in 1902-1903. The article includes a brief review of the development of light microscopy. The need for preservation and proper restoration of old relics of the Wellcome laboratories in Khartoum is emphasized.

Spinal cord schistosomiasis.

Acute myelopathy is increasingly being recognized as a common neurological complication of schistosomiasis. Schistosome eggs reach the spinal cord either as egg emboli or as eggs produced by ectopic worms. This leads to inflammatory reaction and granuloma formation around the eggs. Patients with spinal schistosomiasis may not have clinical evidence of schistosomiasis. The typical clinical picture is that of lumbar pain preceded by other symptoms by hours or up to 3 weeks. Patients may present with paraparesis, urinary retention or paraplegia. Definitive diagnosis of spinal cord schistosomiasis is by detection of the eggs in a spinal cord biopsy or at autopsy. However, most cases are diagnosed based on a presumptive diagnosis that depends on a suggestive clinical picture, history or evidence of active schistosomiasis and exclusion of other conditions. Investigations include stools and urine examination for schistosome eggs, blood tests, magnetic resonance imaging (MRI) and examination of the cerebrospinal fluid. Treatment of cases is mainly by praziquantel, corticosteroids, surgical intervention and rehabilitation.

When history was made in Khartoum Civil Hospital: First introduction of chemotherapy for schistosomiasis.

John Brian Christopherson (1868-1955) was one of the first doctors to be recruited to serve in the Sudan under the British colonial rule. During his work in Sudan (1902-1919) he was key in establishing the civilian medical services in Sudan, including establishing Khartoum Civil Hospital (opened in 1909). The present article focuses on the work of Dr Christopherson in Khartoum Civil Hospital in which he introduced tartar emetic for the first time for the treatment of schistosomiasis. To validate this treatment, Christopherson conducted a series of clinical trials and published his findings in leading medical journals. He had to respond to priority claims over this discovery and to deal with skepticism about the safety of this new treatment. The publications of Christopherson covered not only the therapeutic efficacy of the drug but also discussed the epidemiology of the disease, the possible role of mass chemotherapy and also envisioned chemotherapy in school-age children as a possible strategy for future elimination of the disease.

Albert Chalmers: Perpetual honours for a prominent tropical medicine career in the Sudan.

This article starts with brief review of Albert Chalmers' early career in tropical medicine until he was appointed Director of the Wellcome Tropical Research Laboratories in Khartoum (WTRLK) in 1913, succeeding Andrew Balfour. Then the article explores how Chalmers faced the challenges and managed to establish a solid research base under very harsh conditions. Most of his directorship was during the First World War, with shortage of staff and increased routine work load. In spite of these constraints, Chalmers managed to establish a base for research in tropical medicine in WTRK. Chalmers' research concentrated on the taxonomy and pathogenicity of bacteria and fungi but he also worked on miscellaneous dermatological disorders and on sleeping sickness. His papers reflect a wide range of knowledge and deep understanding of the topics he was covering. His work on the classification of pathogenic fungi was widely recognized. He tried different preparations of vaccines for cerebrospinal meningitis but with the technology available at the time he could not produce a potent vaccine. Chalmers' papers reflect the tremendous effort exerted in their production. Chamers resigned from WTRLK in 1920 and died of acute infective jaundice in the same year. In 1921 his widow, gave £500 to the Royal Society of Tropical Medicine and Hygiene (RSTMH) in memory of her husband. The RSTMH Council decided to devote this money to the foundation of the Chalmers Memorial Medal.

Henry Solomon Wellcome: A philanthropist and a pioneer sponsor of medical research in the Sudan.

Henry Solomon Wellcome, the famous drug manufacturer had a fascinating association with the Sudan. Besides supporting tropical medicine research in this country, he established an extensive project in the Sudan that aimed at combining archeological excavations, philanthropy and social reform. This article is an archives-based account on this side of Wellcome's association with the Sudan. The article starts with Wellcome's early years in the American Midwest and the evolution of his career and his rise as a world-renowned drug manufacturer. After the battle of Omdurman, Wellcome visited Sudan in 1900 - 1901 where he offered to support the establishment of the research laboratories which later came to be known as the Wellcome Tropical Research Laboratories in Khartoum. He then became directly involved in the planning and running of extensive archeological excavations in the central Sudan. This project served as a field in which Wellcome found an outlet for his philanthropy. More than 4000 labourers were employed in Jebel Moya. Professional archeologists and anatomists were recruited by Wellcome to supervise the work, and all the requirements in terms of equipment were catered for. Wellcome devised a Savings Bank System whereby part of the earnings of each labourer were saved to him till the end of the season. He also introduced one of his innovations: aerial photography using box kite which was used for the first time in archeology. Wellcome made it a rule that no applicant should be turned away. The Camp Commandant had to find suitable work for each applicant, including the handicapped who were assigned to appropriate jobs like mending baskets or cutting grass for building huts. Wellcome's welfare work had a significant impact on the local inhabitants of Jebel Moya. Henry Solomon Wellcome, 1906. Oil painting by Hugh Goldwin Riviere. Credit: Wellcome Library.

Drug-resistant malaria in Sudan: A review of evidence and scenarios for the future.

Resistance of falciparum malaria to chloroquine (CQ) has gradually emerged in the late 1970s, reaching unacceptably high proportions over the following three decades of use as frst line treatment in Sudan. By 2004-2006 CQ was replaced by artemisinin-based combination treatment (ACTs), with combination of sulfadoxine-pyrimethamine (SP) and artesunate (AS) deployed as frst-line drug against falciparum malaria. The present review follows the evolution of CQ resistance in Sudan and the available evidence on the response to the present frst-line drugs. The fndings in Sudan are analyzed in view of developments in other African countries and at the global level, with the hope of elucidating possible scenarios for the course of events in the Sudan. Northern Sudan has been one of the areas where signals indicating the emergence of drug resistant malaria parasites have frst originated in Africa. The pattern of low endemicity and low population immunity to malaria, together with massive deployment and improper use of anti-malarial drugs created the ideal environment for creation of anti-malarial drug resistance. Such an environment existed in certain areas in South East Asia that had historically been the epicenter from which falciparum malaria parasites resistant to pyrimethamine and chloroquine have spread to the rest of the world. The alarming recent reports about the emergence of artemisinin (ART) resistance in South East Asia have lead WHO to take specifc measures for prevention, early detection and containment of drug resistance. What could be applicable in Sudan in these measures is discussed here.