Measles vaccination in severely malnourished Sudanese children.

The clinical and serological responses to attenuated measles virus vaccine were compared in 35 severely malnourished and 35 well-nourished children. A third group of severely malnourished children, who received an injection of vitamin B12, served as controls. The children were observed for three weeks following vaccination. Paired sera were collected from each child before and after administration of the vaccine or vitamin B12 and measles antibody titres were estimated using HAI technique. The malnourished children who received measles vaccine developed higher fever of longer duration and had more lower respiratory tract disease than the other two groups but had fewer skin rashes than the well-nourished group. Sero-conversion rates were 96% had 92.6% in the malnourished and well-nourished vaccinated children, respectively. Antibody titres were lower in children who had marasmic/kwashiorkor than in the marasmic children.

Serum immunoglobulin levels in normal Sudanese children.

Immunoglobulin levels were estimated in 138 infants, of whom 33 were normal newborn and 105 were healthy infants one to 24 months of age. Most of the newborn were delivered after a normal pregnancy. In all the infants relatively high levels of cord IgM were found. Similarly, relatively high levels of IgA were found in cord blood in 72% of the subjects studied. Physiological hypogammaglobulinaemia was not found in the early months of life. Adult levels of IgM were developed by six months of age while 36% of the adult levels of IgA and 57% of the adult levels of IgG were reached by two years of age.

Fetal immune response following maternal diphtheria during early pregnancy.

A pregnant Sudanese woman contracted pharyngeal diphtheria during the first trimester of gestation. She had a severe diphtheritic toxaemia and paralysis of all four limbs but made a full recovery from these manifestations. Pregnancy, apart from vaginal bleeding, was not interrupted. At term she was delivered of a female baby who was physically normal but had a very high level of IgA in cord blood. Diphtheria in adults is a rare disease and the occurrence of diphtheria in a pregnant woman has not, as yet, been reported. Accordingly it is not known how fetal growth and development progress in the presence of diphtheria toxin in the maternal circulation. Similarly the effects on fetal immune responses of an acute maternal infection like diphtheria occurring in early pregnancy are not known.

Proteinuria in Sudanese children.

One thousand, eight hundred and forty-six apparently healthy nursery and school children living in the Khartoum area and belonging to different socio-economic classes were studied. Nine hundred and thirty-seven were boys, 909 girls. Their ages ranged from three to 16 years. N-multistix strips were used to test for proteinuria and haematuria, the former being also checked by the sulphosalicylic acid test. Children with proteinuria of 1+ or more were further investigated by examining their urinary sediment for abnormal deposits and by testing for orthostatic proteinuria using day and night specimens of urine with specific gravity of 1.018 or more. Children who had no proteins on orthostatic testing were rescreened for proteinuria 10-14 days after the initial screening. The prevalence rate for proteinuria was 7.2% with no significant difference between boys and girls. In both sexes the prevalence rate increased significantly with age but was not influenced by the socio-economic status. Of the children with proteinuria, haematuria occurred in 27% and abnormal urinary deposits in 14.8%. Orthostatic testing showed a negative result for proteins in 44%, orthostatic proteinuria in 40%, of whom a third had either abnormal urinary sediments or haematuria, and continuous proteinuria in 15.6% of whom the majority had abnormal deposits.

Cryptosporidium as a cause of gastro-enteritis in Sudanese children.

Stool samples from 83 Sudanese children with gastro-enteritis were examined using a safranin-methylene blue stain. Five children (6.1%) were excreting cryptosporidium oocysts but no other potential enteropathogens. The clinical features of anorexia, vomiting and pyrexia and the profuse green watery offensive stool were similar to those reported previously. All of the children were dehydrated. None of 37 children studied who did not have gastro-enteritis was excreting oocysts.