ABSTRACT
Children and adolescents account for a small proportion of confirmed COVID-19 cases, with mild and self-limiting clinical manifestations. The distribution and determinants of COVID-19 among this group in Sudan are unclear. This study used national COVID-19 surveillance data to study the epidemiology of COVID-19 among children and adolescents in Sudan during 2020-2021. A cross-sectional study was performed to estimate the reported incidence of children and adolescents with COVID-19; the clinical features; and the mortality among those who tested positive for COVID-19. A total of 3150 suspected cases of COVID-19 infection fulfilled the study criteria. The majority of cases were above 10 years of age, 52% (1635) were males, and 56% (1765) were asymptomatic. The reported incidence rates of COVID-19 among children and adolescents in Sudan was 1.3 per 10,000 in 2021. Fever, cough, and headache were the most frequent symptoms reported among the suspected cases. The case fatality rate was 0.2%. Binary logistic regression revealed that loss of smell was the most significantly associated symptom with a positive test. We recommend further study to identify risk factors. Additionally, we recommend including these age groups in the vaccination strategy in Sudan.
ABSTRACT
INTRODUCTION: Interleukin-18 (IL-18) is a pro-inflammatory cytokine that is induced by hepatitis C virus (HCV) infection. Inter-individual variations of IL-18 gene expression may alter HCV-associated liver injury. Variable single nucleotide polymorphisms (SNPs) have been detected within IL-18 gene sequence. Quantitative assessment of IL-18 plasma level and detection of genotype frequencies of 2 functional polymorphisms of its gene (-607 C/A and -137 G/C) were done to assess their impact on the severity of chronic hepatitis C (CHC). METHODOLOGY: Cases group (I) comprised 110 treatment naïve CHC Egyptian patients (78 Males and 32 Females, mean age = 40.7 ± 11.8 years) who underwent routine laboratory investigations. Assessment of plasma level of IL-18 was done by enzyme-linked immunosorbent assay (ELISA), detection of IL-18 gene polymorphisms at positions -607 C/A and -137 G/C by polymerase chain reaction sequence specific polymorphism (PCR-SSP) analysis and Liver biopsy with METAVIR scoring were done. The control group (II) comprised 90 healthy participants. RESULTS: Plasma levels of IL-18 were significantly higher in cases than the control group. We found a statistically highly significant (p < 0.001) positive correlation between IL-18 plasma level and both METAVIR necro-inflammatory grade and fibrosis stage. The A/A allele at -607 position was significantly more frequent (p < 0.05) in patients with F ≤ 1. CONCLUSIONS: Higher IL-18 plasma levels are found in CHC patients and positively correlate with the severity of liver disease. The presence of A/A allele at -607 position of IL-18 gene promoter is associated with milder liver disease.