Patients knowledge of hypertension and its control in Eastern Sudan.

OBJECTIVE: To describe the knowledge of hypertensive patients, in Kassala, eastern Sudan, about the disease, in relation to its control. DESIGN: Cross-sectional study. SETTING: Kassala Teaching Hospital, Kassala, Eastern Sudan. SUBJECTS: Patients with hypertension attending referred outpatient medical clinic. MAIN OUTCOME MEASURES: Blood pressure, control status and hypertension knowledge score. RESULTS: Two hundred and forty two patients were involved in this study, of whom 68 (73.6%) were females and were of middle age. The majority were of low education. One fifth (19.4%) was found to have controlled blood pressure. About two-thirds of patients showed a high score of knowledge about the aetiology and complications of hypertension. Half of the patients knew about treatment of hypertension. Patients have a very low score regarding knowledge of symptoms of hypertension (38.8%). CONCLUSION: This study showed good patients' knowledge about hypertension, but such knowledge did not seem to have a significant beneficial effect on blood pressure control. Health education is warranted by health care providers and other factors leading to poor control should be identified and managed.

Hepatitis C virus infection in hemodialysis patients in Sudan: two centers' report.

Prevalence of HCV seropositivity among the hemodialysis population in Sudan is estimated to be around 34%. We undertook a cross sectional study in two major HD centers in Khartoum, Sudan for the prevalence of HCV seropositivity among the hemodialysis patients, during January to March 2005. Testing for HCV antibodies was performed using 3rd generation enzyme linked immunoadsorption assay (ELISA). A total of 236 patients were included in the study: 218 adults and 18 children. The mean age was 43.6 +/- 15.6 years, and the majority was males: 71.6%. The cause of renal failure was unknown in 168 patients (71.2%). The mean HD duration was 36.6 +/- 35.1 months. Prevalence of HCV seropositivity was 23.7%. Among 170 patients who were previously HCV seronegative, 30 (17.1%) seroconverted to positive in one year (estimated incidence: 63 new cases per year). HCV seropositivity was associated with longer duration of dialysis (p < 0.00001), previous surgery (p= 0.026), age of over 30 and years (p = 0.008), and dialysis in multiple centers (p= 0.005). We conclude that although HCV seropositivity in our study was lower than previously reported, it was still high among HD patients in Sudan. Nosocomial transmission of HCV among hemodialysis patients is a contributing factor.

AIDS and HIV infection in Sudanese children: a clinical and epidemiological study.

HIV surveillance and screening programs were established at Khartoum Teaching Hospital (KTH) following the first identified HIV case diagnosed in a hemophiliac boy in November 1987. As of December 1995, 15 cases of symptomatic HIV infection have been observed in Sudanese children (< or = 16 years) at KTH. An HIV seroprevalence rate of 35.7% was documented in a group of 28 patients (adults and children) with various congenital coagulation defects. The postulated mode of transmission was through contaminated factor concentrate. Screening of 52,000 volunteer male blood donors (March, 1987-1989) showed an HIV-seroprevalence rate of 0.05%. Selected groups, including 1118 children admitted to KTH during the period 1985-1995, were screened for HIV infection. These included aseptic meningitis/encephalitis group (n = 52), high-risk group (n = 523), children with various chronic and malignant diseases (n = 181), and chronic blood recipients (n = 330). A group of 32 displaced homeless children who survived on the streets were also included. Overall, an HIV seroprevalence rate of 1.2% was established. Among the 15 children with symptomatic HIV infection, tuberculosis accounted for the majority of admissions (33.3%) followed by admission for recurrent infections (20.0%). Of the 13 children with nonparental mode of HIV transmission, a vertical mode was documented in 61.5%. The pattern of HIV infection in Greater Khartoum is similar to that in North Africa and the Middle East. However, the geographic influence of high endemicity in neighboring sub-Saharan countries might change it in the future.

The aetiology of chronic renal failure in adult Sudanese patients.

One hundred adult Sudanese patients who presented to Soba University Hospital (SUH) with established chronic renal failure (CRF) were studied to determine the aetiology. Thirty-eight had chronic glomerulonephritis, 12 renal calculi, nine diabetic renal disease, seven chronic pyelonephritis, five sequelae of acute renal failure (ARF), four renal vascular disease, three polycystic disease of the kidneys, and two obstructive uropathy. In 20 patients the aetiology was not determined because of late presentation to hospital. The results were compared with those of the developed countries, which differ greatly from Sudan in climate, diet, race, culture and social habits. The main differences were in the prevalence of renal calculi which, although being the second commonest cause of CRF in the Sudan, were rare in European countries. Also, diabetes mellitus was a much commoner cause of CRF in Sudan than Europe. Other aetiological factors were similar.

Eight years study of Sudanese renal allograft recipients at Soba University Hospital.

Forty sudanese renal allograft recipients were followed up at Soba University Hospital (SUH), Khartoum, Sudan, for varying periods between January 1978 and October 1985 accruing 1417 patient-months of observation. 21 transplant operations were done in United Kingdom, 11 in Kuwait, 1 in Sudan, while the rest were done in other European and Arab countries. There were 27 males and 13 females with the age ranging between 10 and 48 years with a mean of 30.15. Thirty eight patients received live related (LR) donor kidneys and two were transplanted with cadaver kidneys. Four patients had a second graft because of early loss of the first. Seven patients died, 3 because of chronic rejection, 3 had severe intractable diarrhoea and one died because of an unrelated cause. The 30 patients who had their transplantation 2 years ago or more were studied for the 2-year survival. Twenty seven of these were alive and well with functioning grafts giving a patient and graft survival of 90%. The complications encountered are discussed.

Chronic renal failure in Khartoum, Sudan.

A study of the clinical presentation and conceivable causes of chronic renal failure (CRF) in 61 Sudanese patients in Khartoum is presented. The clinical features involved almost all the systems, however, gastrointestinal and cardiovascular signs and symptoms predominated. The causes of chronic renal failure in Sudan and Sweden are also studied for comparison. The causes of CRF in Sudan are chronic glomerulonephritis, obstructive nephropathy (stone disease), hypertension and diabetes mellitus in that order. The main causes of CRF in Sweden are chronic glomerulonephritis, diabetes mellitus and chronic pyelonephritis. Of the 61 Sudanese patients 16 have kidney transplants, only one in Sudan, three patients are on regular hemodialysis, nine patients are on intermittent peritoneal dialysis, 16 are on conservative treatment and 17 died during the course of treatment.

Accumulation of silicone elastomer in regular dialysis.

A retrospective autopsy study of 78 patients treated by some form of dialysis for chronic renal failure in Newcastle 1964-1981 showed that: 1) Particles resembling silicone elastomer were present in 48 per cent of 61 patients haemodialysed with the use of silicone rubber pump inserts but in none of the 11 treated by haemodialysis with other pump inserts or of the six treated by peritoneal dialysis alone; 2) The prevalence of these particles and their density increased with time on haemodialysis; 3) There was little evidence of a tissue reaction to the particles and no association between their presence and histological evidence of liver disease; 4) There was a higher incidence of clinical and biochemical evidence of liver disease in patients with silicone deposits than in those without. Although there are other possible explanations for this higher incidence of hepatic dysfunction it would be safer to assume that silicone particle spallation is not innocuous.