Nutritional Status of Adolescents in Eastern Sudan: A Cross-Sectional Community-Based Study.

BACKGROUND: Malnutrition among adolescents is a major public health issue. This problem is particularly pressing in Sudan, an African country where there is scarce published data on the nutritional status of adolescents. In this study, we aimed to assess the nutritional status of adolescents in eastern Sudan. METHODS: A community-based cross-sectional survey was carried out in Gadarif, eastern Sudan. A questionnaire was used to collect sociodemographic data, and the anthropometric measurements (weight and height) of adolescent participants were recorded. Height-for-age and body mass index-for-age Z-scores were calculated using the WHO anthropometric standards. Binary and multivariate multinomial regression analyses were performed. RESULTS: A total of 388 adolescents were included in this survey, 207 (53.4%) were female, and 181 (46.6%) were male. The median (interquartile) age was 13.9 (12.0-16.0) years. The results showed that a total of 29 (7.5%), 93 (24.0%), 33 (8.5%), and 16 (4.1%) adolescents were stunted, thin, overweight, and obese, respectively. None of the investigated factors (age, sex, parents' education levels, and occupation) were associated with stunting. In the multivariate multinomial analysis, the male sex was associated with thinness (OR = 2.41, 95.0% CI = 1.47-3.94). Moreover, adolescents whose mothers had an education lower than secondary level were at a lower risk of overweight/obesity (OR = 0. 0.35, 95.0% CI = 0. 0.35). CONCLUSIONS: While both undernutrition and overnutrition exist in eastern Sudan, undernutrition is more common. Male sex and mothers' education levels are associated with malnutrition.

Prevalence of and factors associated with placental malaria in the White Nile State: a cross-sectional study.

INTRODUCTION: Malaria during pregnancy can lead to maternal and perinatal adverse effects. Despite the preventive measures, recent research has shown that malaria during pregnancy is still a threatening health problem, especially in Sub-Saharan African countries. The current study was conducted to determine the prevalence of and factors associated with placental malaria in Rabak Hospital in central Sudan. METHODOLOGY: A cross-sectional study was conducted from September to October 2021. Pregnant women who delivered at the Rabak Maternity Hospital in Central Sudan were included. A questionnaire was used to gather both obstetric and socio-demographic information. Blood films for malaria were prepared using the maternal, placental, and cord blood, and a placental histology was performed. A logistic regression analysis was performed. RESULTS: For the 208 women, the medians (interquartile range) of their age and parity were 25 (21.0 ‒30.0) years and 2 (1‒4), respectively. Twenty-five (12.0%) of the women had used insecticide-treated nets. Active infection, active-chronic infection, and past-chronic infection were detected in four (1.9%), five (2.4%), and 35 (16.8%) placentas, respectively. One hundred and sixty-four (78.8%) placentas showed no signs of infection. Logistic regression analysis showed that none of the examined factors (age, parity, education, antenatal care level, use of insecticide-treated nets, and blood group) was associated with placental malaria. CONCLUSIONS: Malaria affects 20% of pregnant women, regardless of their age and parity. Preventative measures should therefore be encouraged in this area.

Clinical and genetic characteristics of disorders of sex development in Sudanese patients

Given the scarce data on DSD in Sudan, we aimed to characterize DSD's clinical and genetic profile in Sudanese patients. We studied 60 patients with DSD using clinical data, cytogenetics, and PCR for the SRY gene. The results showed that 65% grew up as females and 35% as males. There was a high percentage of consanguineous parents (85%). Female genital mutilation (FGM) was performed in 75% of females. Patients who presented after pubertal age were 63%, with ambiguous genitalia in 61.7%, followed by primary amenorrhea (PA) in 30%. The SRY gene was positive in 3.3% of patients with 46,XX karyotype and negative in 6.7% of patients with 46,XY karyotype. 5αR2D-DSD was seen in 43.3%, gonadal dysgenesis in 21.7%, Ovotesticular syndrome in 6.7%, Swyer and Turner syndrome in 5% each, and Androgen Insensitivity Syndrome (AIS) in 3.3%. In conclusion, DSD in Sudan has a distinct profile with late presentation, dominated by 5αR2D-DSD due to the increased consanguineous marriage, and FGM represents a significant risk for DSD patients.

Compte tenu du peu de données sur le DSD au Soudan, nous avons cherché à caractériser le profil clinique et génétique du DSD chez les patients soudanais. Nous avons étudié 60 patients atteints de DSD en utilisant des données cliniques, cytogénétiques et PCR pour le gène SRY. Les résultats ont montré que 65 % ont grandi en tant que femmes et 35 % en tant qu'hommes. Il y avait un pourcentage élevé de parents consanguins (85 %). Des mutilations génitales féminines (MGF) ont été pratiquées chez 75 % des femmes. Les patientes qui se sont présentées après l'âge pubertaire étaient 63 %, avec des organes génitaux ambigus dans 61,7 %, suivis d'une aménorrhée primaire (AP) dans 30 %. Le gène SRY était positif chez 3,3 % des patients de caryotype 46,XX et négatif chez 6,7 % des patients de caryotype 46,XY. Le 5αR2D-DSD a été observé dans 43,3 %, la dysgénésie gonadique dans 21,7 %, le syndrome ovotesticulaire dans 6,7 %, le syndrome de Swyer et Turner dans 5 % chacun et le syndrome d'insensibilité aux androgènes (AIS) dans 3,3 %. En conclusion, le DSD au Soudan présente un profil distinct avec une présentation tardive, dominé par le 5αR2D-DSD en raison de l'augmentation des mariages consanguins, et les MGF représentent un risque important pour les patients DSD.

Metabolic syndrome and its association with physical activity in Sudanese early adolescents - Khartoum state, Sudan: An observational study.

The growing prevalence of overweight/obesity in adolescents highlights the significance of studying metabolic syndrome (MetS) in increasingly sedentary adolescents. To date, no study in Sudan has examined the association between MetS and physical activity (PA) among adolescents. This study aimed to assess the association between MetS and its components and PA among Sudanese early adolescents. A cross-sectional assessment was conducted from to 2018 to 2019 on a sample of 921 primary school students from Khartoum State, Republic of Sudan. MetS was defined according to the International Diabetes Federation criteria and a standardized questionnaire was used to assess PA. Metabolic equivalents of task were calculated, and levels of different intensities of PA (tertiles) were identified accordingly. The association between PA and MetS and its components was assessed using a logistic regression model. The participants comprised 388 boys and 533 girls with a mean age of 12.59 ±â€…1.21 years. The prevalence of MetS was significantly higher in subjects in the 1st PA tertile (least active) than in the 2nd and 3rd (most active) tertiles of PA, and this difference was observed in both boys and girls. After adjusting for other study factors, the odds of MetS among adolescents in the 1st PA tertile were 7 times higher than those in the highest PA tertile (adjusted odds ratio = 7.01, 95% confidence interval: 1.48, 32.99). A physically inactive lifestyle was associated with higher odds of MetS and its components, especially waist circumference and triglyceride levels, in Sudanese early adolescents. This study highlights the importance of promoting PA in this age group.

Intestinal Parasitic Infections and Associated Risk Factors Among Sudanese Psychiatric Patients.

BACKGROUND: Intestinal parasitic infections (IPIs) are considered to be a major health problem, particularly in the tropical countries, such as Sudan. Due to poor hygiene practices, the psychiatric patients may pick up parasitic infections. Until now, there exists no published data or available information regarding the prevalence rate of intestinal parasitic infections among Sudanese psychiatric patients. Therefore, our present study aimed to determine the prevalence of intestinal parasitic infections and the potential associated risk factors among Sudanese psychiatric patients. METHODS: A hospital based cross-sectional study was conducted from September 2021 to March 2022. A total of 422 stool samples were randomly collected from psychiatric patients attending the psychiatric section at Kosti Teaching Hospital in the White Nile State of Sudan. Socio-demographic data were gathered using structured questionnaires. All stool samples were examined using different parasitological techniques. RESULTS: The overall prevalence rate of intestinal parasitic infection among psychiatric patients was 120/211 (56.8%) and among non-psychiatric patients 66/211 (31.3%) The prevalence rate of intestinal parasites (IPs) among psychiatric patients were as follows: Entamoeba histolytica (29.9%), Giardia lamblia (19.4%), Entamoeba coli (5.2%), Ascaris lumbricoides (0.9%), Hymenolepis nana (0.9%), and Enterobius vermicularis (0.5%). There was no relationship between intestinal parasitic infection and age, sociodemographic features, sources of drinking water, contact with domestic animals, washing of hands, eating of raw vegetables/meats, or having psychiatric disorders (p > 0.05). CONCLUSIONS: Studying the prevalence rate of intestinal parasitic infections among psychiatric patients may help to assess their health condition or status, leading to better psychiatric healthcare services, diagnoses, and treatments.

Intra- and interspecies variation and population dynamics of Fasciola gigantica among ruminants in Sudan.

Fasciola gigantica is a widespread parasite that causes neglected disease in livestock worldwide. Its high transmissibility and dispersion are attributed to its ability to infect intermediate snail hosts and adapt to various mammalian definitive hosts. This study investigated the variation and population dynamics of F. gigantica in cattle, sheep, and goats from three states in Sudan. Mitochondrial cytochrome c oxidase subunit I (COI) and NADH dehydrogenase subunit 1 (ND1) genes were sequenced successfully to examine intra and interspecific differences. ND1 exhibited higher diversity than COI, with 15 haplotypes and 10 haplotypes, respectively. Both genes had high haplotype diversity but low nucleotide diversity, with 21 and 11 polymorphic sites for ND1 and COI, respectively. Mismatch distribution analysis and neutrality tests revealed that F. gigantica from different host species was in a state of population expansion. Maximum likelihood phylogenetic trees and median networks revealed that F. gigantica in Sudan and other African countries had host-specific and country-specific lineages for both genes. The study also indicated that F. gigantica-infected small ruminants were evolutionarily distant, suggesting deep and historical interspecies adaptation.

Assessment of the impact of COVID-19 and political instability on mental health of university students in Sudan.

Background: The mental health of students plays a crucial role in their learning and performance. The COVID-19 pandemic, the political turmoil and a coup in Sudan has exacerbated stress and anxiety among university students in Sudan due to uncertainty about their academic activities. Aim: To assess post-traumatic stress disorder (PTSD) occurrence and coping strategies adopted by university students in Sudan. Methods: This cross-sectional survey was conducted from March to June 2022. It used the Coping Orientation to Problems Experienced (Brief-COPE) and Impact of Event Scale-Revised (IES-R) questionnaires to assess the occurrence of PTSD and coping strategies among 596 university students in Sudan. Descriptive statistics were used to determine the frequency and percentage, Student's t test was used to compare the means of 2 groups and one-way analysis of variance to compare the means of ≥ 3 groups. Results: There was a high prevalence of PTSD among the students, with a score of 31.2 (SD 16.4). The total score of PTSD was higher among female students. Around 36% of the students had a PTSD score > 37, which is considered high enough to suppress immune function. The most widely adopted coping strategies were religion and acceptance of the situation, while substance use was the least. Students who had COVID-19 infection during the pandemic differed significantly from uninfected students in the application of coping strategies. In contrast, students whose family members or friends had COVID-19 were not significantly different from students with uninfected family members or friends in the application of the coping strategies, such as self-blame, denial, substance use, and behavioural disengagement. Conclusion: We recommend the initiation and implementation of psychological counselling programmes for university students in Sudan onsite or remotely. Further research should be carried out to assess the long-term effects of the pandemic and the political conflicts so as to design and implement appropriate and efficient interventions.

Time to care and factors influencing appropriate Sudan virus disease care among case patients in Uganda, September to November 2022.

OBJECTIVES: Early isolation and care for Ebola disease patients at Ebola Treatment Units (ETU) curb outbreak spread. We evaluated time to ETU entry and associated factors during the 2022 Sudan virus disease (SVD) outbreak in Uganda. METHODS: We included persons with RT-PCR-confirmed SVD with onset September 20-November 30, 2022. We categorized days from symptom onset to ETU entry ("delays") as short (≤2), moderate (3-5), and long (≥6); the latter two were "delayed isolation." We categorized symptom onset timing as "earlier" or "later," using October 15 as a cut-off. We assessed demographics, symptom onset timing, and awareness of contact status as predictors for delayed isolation. We explored reasons for early vs late isolation using key informant interviews. RESULTS: Among 118 case-patients, 25 (21%) had short, 43 (36%) moderate, and 50 (43%) long delays. Seventy-five (64%) had symptom onset later in the outbreak. Earlier symptom onset increased risk of delayed isolation (crude risk ratio = 1.8, 95% confidence interval (1.2-2.8]). Awareness of contact status and SVD symptoms, and belief that early treatment-seeking was lifesaving facilitated early care-seeking. Patients with long delays reported fear of ETUs and lack of transport as contributors. CONCLUSION: Delayed isolation was common early in the outbreak. Strong contact tracing and community engagement could expedite presentation to ETUs.

Delays in presentation, diagnosis, and treatment in Sudanese women with breast cancer: a cross-sectional study.

BACKGROUND: The poor prognosis of breast cancer in Sudan could be due to delayed treatment and diagnosis at an advanced stage. Our study aimed to assess the extent of delays from onset of symptoms to treatment in Sudanese women with breast cancer, as well as identify factors contributing to these delays. MATERIALS AND METHODS: We conducted a multi-center cross sectional study between March and April 2023. Data were collected from the medical records and interviews with women with breast cancer in the two main oncology centers in Sudan. Linear regression was used to identify the predictors of delayed presentation. RESULTS: We interviewed 601 women with breast cancer. The majority of women (50.1%) were diagnosed at locally advanced or metastatic disease. The median interval from the onset of symptoms to receiving oncologic treatment was 221 days (IQR = 92, 496). The longest delay was the presentation delay 61 (31 244) days. The median duration for diagnosis delay and treatment delay was 21 (10.57) days and 27 (10.64) days, respectively. Predictors of early presentation included, being young (ß = -5.3; 95% CI = 0.06 to 10), married (ß = -264; 95% CI = -427 to -101), divorced (ß = -306; 95% CI = -549 to -63), or widowed (ß = -320; 95% CI = --543 to -97), urban residence (ß = -107; 95% CI = -213 to -2.3), and seeking traditional healer (ß = -204; 95% CI = -383 to -26). CONCLUSION: Most Sudanese women with breast cancer experience significant patient delays, often presenting at advanced stages. Factors like being single, older, and living in rural areas contribute to these delays. Increasing breast cancer education, improving healthcare access and addressing sociodemographic barriers can potentially expedite diagnosis and improve outcomes.

Snoring is associated with hypertension and diabetes mellitus among adults in north Sudan: a cross-sectional study.

BACKGROUND: Different levels of association between snoring, hypertension, and diabetes mellitus (DM) are reported. There are few published studies on this topic in African countries, and no investigation was conducted in Sudan. This study aimed to assess the prevalence and factors associated with snoring and the association between snoring, hypertension, and type 2 DM (T2DM) in northern Sudan. METHODS: A community-based cross-sectional study using a multistage sampling technique was conducted in four villages in the River Nile state of northern Sudan from July to September 2021. Sociodemographic characteristics were collected using a questionnaire. Body mass index (BMI) was measured using standard methods, and a multivariate analysis was conducted using the Statistical Package for the Social Sciences® (SPSS®) for Windows, version 22.0. RESULTS: Of the 384 adults, 193 (50.3%) were males and 191 (49.7%) were females. Of the adults, 38 (9.9%) were underweight, 121 (31.5%) had average weight, 113 (29.4%) were overweight, and 112 (29.2%) were obese. One hundred and six (27.6%) adults were snorers. Multivariate analysis showed that increasing age (adjusted odds ratio [AOR] = 1.02, 95% confidence interval [CI] = 1.01‒1.04), increasing BMI (AOR = 1.04, 95 CI = 1.01‒1.08), obesity (AOR = 2.0, 95% CI = 1.10‒3.69), and alcohol consumption (AOR = 2.32, 95% CI = 1.14‒4.74) were positively associated with snoring. Of the 384 adults, 215 (56.0%) had hypertension. Multivariate analysis showed that increasing age (AOR = 1.04, 95% CI = 1.02‒1.06), increasing BMI (AOR = 1.08, 95% CI = 1.04‒1.13), female sex (AOR = 1.7, 95% CI = 1.08‒2.73), and snoring (AOR = 1.69, 95% CI = 1.02‒2.82) were positively associated with hypertension. One hundred and six (27.6%) adults had T2DM. Multivariate analysis showed that increasing age (AOR = 1.03, 95% CI = 1.01‒1.05) and snoring (AOR = 1.78, 95% CI = 1.09‒2.91) were associated with T2DM. CONCLUSION: Around one-fourth of the adults in Northern Sudan are snorers. Snoring is more common among obese adults. Snoring is associated with increased odds of hypertension and T2DM. Adults who snore must pay close attention to their blood pressure and blood glucose levels to prevent hypertension and DM.

The critical pharmaceutical situation in Sudan 2023: A humanitarian catastrophe of civil war.

The situation in Sudan have deteriorated since the ongoing war outbreak in April 2023. This article sheds light on the pharmacological status in Sudan in terms of shortage of supply, rising demands, and regulatory issues. The ongoing civil war has acutely impacted the dilapidated pharmaceutical status of Sudan, patients have suffered from the paucity of medical services forcing an out-of-control rise in underreported morbidity and mortality. To mitigate this uprising issue, an increase in stakeholder communication is crucial to deal with this national threat and establish a system for reporting the shortage.

Cost effectiveness of malaria vector control activities in Sudan.

BACKGROUND: Malaria vector control activities in Sudan rely largely on Long-Lasting Insecticidal Nets (LLINs), Indoor Residual Spray (IRS) and Larval Source Management (LSM). The present study attempted to determine cost effectiveness of inputs and operations of vector control interventions applied in different environmental settings in central and eastern Sudan, as well as their impact. METHODS: The inputs utilized and cost of each vector control activity, operational achievements and impact of the applied malaria vector control activities; IRS, LLINs and LSM were determined for eight sites in Al Gazira state (central Sudan) and Al Gadarif state (eastern Sudan). Operational costs were obtained from data of the National Malaria Control Program in 2017. Impact was measured using entomological indicators for Anopheles mosquitoes. RESULTS: The total cost per person per year was $1.6, $0.85, and $0.32 for IRS, LLINs and LSM, respectively. Coverage of vector control operations was 97%, 95.2% and 25-50% in IRS, LLINs and LSM, respectively. Vectorial capacity of malaria vectors showed statistically significant variations (P < 0.034) and ranged 0.294-0.65 in areas implemented LSM in comparison to 0.097-0.248 in areas applied IRS and LLINs, respectively. Both indoor and outdoor biting Anopheles mosquitoes showed noticeable increase that reached 3-12 folds in areas implemented LSM in comparison to areas implemented IRS and LLINs. Annual malaria prevalence was 13.1-21.1% in areas implemented LSM in comparison to 3.20%, 4.77% in areas implemented IRS and LLINs, respectively. CONCLUSION: IRS and LLINs are cost effective control measures due to adequate inputs and organized process. However, the unit cost of LSM intervention per outcome and subsequently the impact is hugely affected by the low coverage. The very weak support for implementation of LSM which includes inputs resulted in weakness of its process and consequently its impact. Implementation of LSM by local government in urban settings is challenged by many factors the most important are maintenance of adequate stable level of funding, un-adequate number of well trained health workers, unstable political and administrative conditions and weak infrastructure. These challenges are critical for proper implementation of LSM and control of malaria in urban settings in Sudan.

The role of the Field Epidemiology Training Program in the public health emergency response: Sudan armed conflict 2023.

Background: On April 15, 2023, the armed conflict between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) started in Khartoum state, Sudan. This conflict was complicated by the preexisting complicated epidemiological situation and fragile health system in Sudan. This study endeavors to illuminate the pivotal role essayed by the Sudan FETP (SFETP) in enhancing the nation's public health response, particularly amidst the tumultuous backdrop of armed conflicts that have left their indelible mark on the region. Methods: Employing a blend of quantitative and qualitative methodologies, we investigated the SFETP's contributions to the public health response during the initial 4 months of the conflict (April-July 2023). Sixty-four SFETP residents and graduates were invited to participate, and data were gathered through semi-structured questionnaires. Results: A total of 44 (69%) SFETP residents and graduates were included in this study. Out of 38 SFETPs present in the states, 32 have considerably contributed to the crisis response at state and locality levels. Three-quarters of them have played key leadership, planning, and management roles. In essence, 38% (n = 12) of them have contributed to public health surveillance, particularly in data management, reports, Early Warning Alert and Response System (EWAR) establishment, and epidemic investigation. SFETPs have made special contributions to crisis response at the community level. The involved SFETPs supported WASH interventions (n = 4), and almost one-third of them strengthened risk communication and community engagement (n = 9). Despite their physical presence at the subnational level, 27% of graduates were not deployed to the crisis emergency response. Notably, throughout this time, half of the total SFETPs were formally retained during this response. Conclusion: The study highlighted the importance of FETP engagement and support during public health crises. SFETP residents and graduates played diverse roles in the various levels of public health emergency response to the crisis. However. Strategies to improve the deployment and retention of FETP residents are necessary to ensure their availability during crises. Overall, FETP has proven to be an asset in public health crisis management in Sudan.

Challenges and epidemiological implications of the first outbreak of dengue and chikungunya in Sudan.

Background: Dengue and chikungunya are mosquito-borne infections that are spreading rapidly worldwide. The highest burden lies in tropical and subtropical countries. In 2022 Sudan encountered the most widespread infection of both diseases. Aim: To describe the magnitude of the first outbreak of dengue and chikungunya infections in Tandalti Town, White Nile State, southern part of Sudan. Methods: Following the report of a high number of undifferentiated febrile illnesses in 32 health clinics in Tandalti Town, an area with high densities of Aedes aegypti, we collected blood samples from symptomatic suspected cases. The samples were tested for major arboviral infections using arboviral-specific enzyme-linked immunosorbent assays (IgM capture ELISA), and serologically positive samples were confirmed using commercially available Real Time RT-PCR Kits. Results: Out of 773 suspected cases, 63 (8.15%) were confirmed. Eleven (17.46%) of the confirmed cases were DENV, 49 (77.77%) were CHIKV, and 3 (4.76%) were DENV and CHIKV co-infections. The outbreak started at the beginning of October and ended by mid December 2022. Both dengue and chikungunya infection was higher (41(65.08%)) among young females than males (22 (34.92%)). Conclusions: White Nile State may experience larger outbreaks of dengue and chikungunya in the future, there is, therefore, an urgent need for proper vector control interventions in the state and nearby states.

Periconceptional folic acid usage and its associated factors in eastern Sudan: A cross-sectional study.

BACKGROUND: Several countries poorly adhere to the World Health Organization's recommendation of folic acid supplementation in the periconceptional period, especially in limited-resource settings. OBJECTIVE: The objective of this study was to investigate the prevalence of and the factors associated with folic acid usage in the periconceptional period among pregnant women at Gadarif Maternity Hospital in eastern Sudan. STUDY DESIGN: This is a cross-sectional study. METHODS: This study was conducted in eastern Sudan from April to September 2022. A total of 720 pregnant women in their first trimester were enrolled. The sociodemographic characteristics and clinical and obstetrical data of pregnant women in their first trimester were assessed using a face-to-face questionnaire. In addition, multivariate regression analysis was performed. RESULTS: In this study, the median (interquartile range) of the age and gravidity of the enrolled women was 26.3 (24.14-29.52) years and 2 (1-4), respectively. Of these 720 women, 423 (58.8%) used folic acid during the periconceptional period, while 27 (3.7%) women used folic acid in the preconceptional period. None of the investigated factors (age, residence, education, employment, body mass index, or gravidity) were associated with periconceptional use of folic acid. CONCLUSION: The study revealed a low prevalence of folic acid usage in preconceptional period among pregnant women in eastern Sudan. Additional efforts are needed to promote folic acid usage in the preconceptional period as well as in the first trimester.

Mental health consequences among Sudanese due to the armed conflicts and civil unrest of 2023: a cross-sectional study.

AIM: To investigate depression, anxiety, PTSD, and insomnia levels among Sudanese citizens during the 2023 Armed Forces conflict in Sudan. METHODS: An online survey was distributed. It is composed of five parts, covering the following areas: (a) sociodemographic data; (b) depression assessment; (c) generalized anxiety disorder assessment; (d) post-traumatic stress disorder assessment; and (e) insomnia assessment.Statistical Package for Social Sciences version 27 was used for data analysis; frequency and percentage were used to describe the qualitative variables. The Pearson correlation coefficient and Chi-square test were used for correlation and association analysis; a p-value equal to or less than .05 was considered statistically significant. RESULTS: The study included 221 participants, whose ages were 35.02 ± 11.83 years. Among the participants, 57.5% were female. The length of stay in the war zone was 39.29 ± 31.71 days. The sound of gunfire, bombs, or explosions was the most frequent war violence personally experienced by participants or their family members, friends, or acquaintances, in 203 (91.8%) and 221 (100%), respectively. Moderate-severe and severe depression were present in 25.3% and 62.0%, respectively. Moderate and severe anxiety were present in 36.2% and 52.9%, respectively. 58.8% had PTSD. Sub-threshold insomnia was present in 57.5%. There was a negative correlation between sex (female) and depression (correlation coefficient = -.183, p-value = .006), which indicates that depression is more likely to be in females. For PTSD, there was a negative correlation between age and PTSD (correlation coefficient = -.150, p-value = 0.026), which indicates that younger age groups were more likely to experience PTSD. Additionally, there was a negative correlation between marital status (married) and PTSD (correlation coefficient = -.175, p-value = .009), which indicates that married participants were more likely to experience PTSD. CONCLUSIONS: Exposure to war-related trauma can also lead to mental health issues. These findings emphasize the urgent need for proper mental health support and interventions in war-affected areas to address the prevalent mental disorders.

The nutritional status of mycetoma affected patients seen at the Mycetoma Research Center, Sudan.

Nutrition plays a critical and crucial role in addressing neglected tropical diseases (NTDs) and their complications, as they often contribute to malnutrition, which can worsen the impact of these conditions. Therefore, it is necessary to investigate the nutritional status of mycetoma patients, which has not been explored previously. This descriptive cross-sectional hospital-based study was conducted at the Mycetoma Research Center (MRC), University of Khartoum, Sudan. The study included 179 confirmed mycetoma patients and an equal number of age- and sex-matched normal controls. The nutritional status of the mycetoma patients was assessed and compared with that of the control group. The majority of the patients were young adults with varying educational levels, predominantly from Central Sudan. The foot was the most commonly affected part; most patients had lesions more than 10 cm in diameter. The Body Mass Index (BMI) was calculated for both study groups, revealing that 43.5% of the patients and 53.6% of controls had a normal BMI. Furthermore, 36% of patients were underweight, contrasting with only 11% in the control group. Correlation analyses indicated no significant associations between BMI and age groups, educational levels, daily meals, food quantity, and appetite in the study population (p > 0.05). Similarly, no significant differences were observed in BMI concerning disease duration and affected sites (p = 0.0577). The Kruskal-Wallis test did not reveal significant differences in BMI means among the groups. The study revealed that most participants consumed three meals daily, and the control group showed a more robust appetite and consumed more food than the patient group (p = 0.005). Nevertheless, there were no significant differences in the consumption of different food types between the patient and control groups and among different BMI categories (p = 0.025 and 0.040, respectively).

Effective partnership and in-country resource mobilization in Sudan for cVDPV2 outbreak response amid multiple emergencies in 2020-2021.

BACKGROUND: During 2020 and immediately prior to the COVID-19 pandemic, Sudan was experiencing multiple emergencies including violence, seasonal flooding, and vector-borne disease outbreaks. After more than ten years since its last case of wild poliovirus, Sudan declared a circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreak on 9 August 2020. METHODS: cVDPV2 outbreak response data and programme documents of the Federal Ministry of Health and WHO were reviewed. Surveillance data was verified through WHO-recommended procedures for detecting and characterizing polioviruses from stool and sewage samples collected from acute flaccid paralysis (AFP) cases and the environment. RESULTS: This outbreak in Sudan led to a total of 58 confirmed cases of cVDPV2 from 15 of the 18 states. Two nationwide vaccination campaigns were held to increase immunity of children under-five against poliovirus type 2. Funding challenges were overcome by intense additional resource mobilization from in-country sources. The funding gap was bridged from domestic resources (49%) sourced through GPEI partners, and in-country humanitarian funding mechanisms. CONCLUSIONS: During an outbreak response and challenge of funding shortfall, mobilizing in-country resources is possible through coordinated approaches, regular communication with partners, disaggregation of needs, and matching in-kind and financial support to fill gaps. A cVDPV2 outbreak requires a fast, resourced, and quality response to stop virus circulation.