Climatic variables and transmission of falciparum malaria in New Halfa, eastern Sudan

The study investigated the role of climatic variables and irrigated agricultural on the seasonality of malaria transmission in New Halfa, eastern Sudan. A time-series analysis was performed using monthly climatic variables, monthly water available for irrigation of crops and monthly slide positive rate of malaria during the period 1986-2002. Cases of malaria were reported every month of the year with a mean of 13.0/100 persons/month [95% CI: 11.9-14.2], and bimodal annual pattern in autumn and winter seasons. Rainfall was the significant climatic variable in the transmission of the disease, whereas heavy rainfall was found to initiate epidemics. Temperature, relative humidity and irrigation water were not significant factors

Epidemiology of malaria in New Halfa, an irrigated area in eastern Sudan

A prospective study investigated the epidemiology of malaria in an agricultural area in eastern Sudan from November 1999 to June 2000 [1 irrigation and 1 dry season]. In monthly parasite surveys, 99/ 1539 blood films from 190 individuals were positive for malaria: 95% for Plasmodium falciparum, 3% P. vivax and 2% P. ovale. The slide positive rate [SPR] of malaria episodes ranged from 3.7% to 12.8% in different months of the survey, with a peak in January. There was no significant difference in SPR between irrigation and dry seasons [7.2% versus 5.1%]. SPR differed significantly by age group and was highest in under 5-year-olds. However, there was no significant difference in SPR between males and females. Transmission and intensity of malaria in this area is perennial and moderate rather than low

Quinine therapy in severe Plasmodium falciparum malaria during pregnancy in Sudan

A prospective study was carried out in an area of unstable malaria transmission in central Sudan to determine the efficacy and toxicity of quinine in pregnancy. Thirty-three pregnant women with severe Plasmodium falciparum malaria at mean 28.8 weeks gestational age were treated with quinine for 7 days. The mean body temperature on presentation for 3 patients who delivered prematurely was significantly higher than for those who delivered at term [39.2 +/- 0.7 degrees C versus 38.7 +/- 1.3 degrees C]. There were no significant difference between the 2 groups in other clinical or biochemical parameters. There were no clinically detectable congenital malformations and no auditory, visual or other neurological deficits in the babies at birth or 6 months later. Quinine may be safe in the treatment of severe falciparum malaria during pregnancy

Efficacy of sulfadoxine/pyrimethamine for uncomplicated Plasmodium falciparum malaria in a small sample of Sudanese children

A prospective clinical trial was carried out to determine in vivo efficacy of sulfadoxine/pyrimethamine for the treatment of uncomplicated Plasmodium falciparum malaria in children in New Halfa. Forty patients were enrolled; 31 completed the 28-day follow-up. Six [19.4%] patients showed recurrence of parasitaemia during follow-up, while the rest [80.6%] cleared the parasites and responded fully to treatment. All the failures were late treatment failures. Parasite genotyping showed that 1 [16.7%] of the 6 cases of late parasitaemia was due to reinfection while the rest [83.4%] were due to true recrudescence. During the follow-up period 22.6% of patients showed gametocytaemia. The high level of treatment failure as well as gametocytaemia necessitates the introduction of artesunate in this combination therapy

Low-dose quinine for treatment of chloroquine-resistant falciparum malaria in Sudanese pregnant women

Pregnant Sudanese women who presented at a hospital in eastern Sudan with chloroquine-resistant falciparum malaria were randomly allocated to one of two quinine regimens: low-dose [10 mg/kg 2 times/day] [18 patients] or st and ard [10 mg/kg 3 times/day] [24 patients]. Treatment was for 7 days and follow-up for 28 days. Significantly fewer patients in the low-dose group reported vomiting and abdominal pain than the st and ard regimen group. Hypoglycaemia, preterm labour and recrudescence were slightly but not significantly higher in patients in the st and ard group than low-dose group. There were no significant differences between the groups in the mean time from admission to remission of fever and parasite clearance. We tentatively advocate the use of quinine 2 times/day to reduce side-effects and improve compliance

Quinine for chloroquine-resistant falciparum malaria in pregnant Sudanese women in the first trimester

A prospective clinical study in eastern Sudan described the efficacy and toxicity of quinine in early pregnancy in mothers with chloroquine-resistant falciparum malaria. Twenty-six pregnant Sudanese women in their first trimester [mean gestational age 8.5 weeks] were given quinine 10 mg/kg 3 times per day for 7 days and followed up every 2 weeks until delivery. One patient aborted [3.8%] and 2 patients [7.7%] experienced threatened abortion but delivered term babies. Recrudescence or re-infection was observed on day 21 in 1 patient. One baby died aged 6 months. There were no detectable congenital malformations, no auditory or visual defects or any other neurological deficits in the remaining infants at birth or 1 year later. Quinine may be safe in the first trimester of pregnancy

Plasmodium falciparum infection during pregnancy in an unstable transmission area in eastern Sudan

A 1-year prospective community-based study of malaria during pregnancy was conducted in an area of seasonal and unstable malaria transmission in eastern Sudan. At a village antenatal clinic, 89 non-pregnant controls and 86 pregnant women were enrolled and followed every 2 weeks until 6 weeks after delivery. The incidence of Plasmodium falciparum infection was significantly higher among pregnant than control women [17.4% versus 5.6%] with no difference between primigravidae and multigravidae [22.2% versus 15.2%].There was no significant difference in the mean haemoglobin concentration between infected and uninfected mothers [9.1 +/- 1.3 versus 9.5 +/- 0.6 g/dL] but the mean birth weight of their babies was significantly lower [2.72 +/- 0.26 versus 2.95 +/- 0.05 kg] despite prompt case management of infected women

Effects of a monophasic oral contraceptives containing 30 ug ethinyl estradial and 150 ug desogestrel on lipid metabolism in Sudanese women

This study was conducted to determine the effects of a monophasic oral contraceptive containing 30[Mmicro]g ethinyl estradiol and 150[micro]g desogestrel [Marvelon] on serum concentration of triacylglycerols, total cholesterol, and lipoprotein cholesterol fractions in 50 Sudanese women aged 18-30 years. Six treatment cycles were compared with the cycle prior to the first treatment cycle [pretreatment cycle]. Serum concentration of the studied lipid parameters increased progressively. Increase in serum concentration of triacylglycerols, high density lipoprotein cholesterol [HDL-C] and very low density lipoprotein cholesterol [VLDL-C] was not statistically significant [P>0.05] after the last treatment cycle, when compared with the pretreatment cycle. Increase in serum concentration of total cholesterol and low density lipoprotein cholesterol [LDL-C] was statistically significant [P<0.05]. HDL-C/LDL-C ratio decreased non significantly after the last treatment cycle. Marvelon showed high effectiveness as a contraceptive agent, exhibited better cycle control. Menstrual complaints were minor. Reported side effects tended to subside by the last treatment cycle