BRUCELLOSIS IN TEREKEKA COUNTY, CENTRAL EQUATORIA STATE, SOUTHERN SUDAN.

OBJECTIVES: To identify factors associated with Brucellosis in patients attending Terekeka Health Facility, Terekeka County, Central Equatoria State, Southern Sudan and to evaluate the utility of the rapid test kit Euracil®. DESIGN: A facility based case-control study. SETTING: Terekeka Health Facility, Terekeka County, Central Equatoria State, Southern Sudan. SUBJECTS: Cases were patients presenting at the Terekeka Health Facility with clinical symptoms suggestive of Brucellosis and tested positive for Brucellosis by rapid antigen test while controls were selected from individuals attending Terekeka Health facility with health problems unrelated to brucellosis or febrile illness. RESULTS: A total of fifty eight cases with clinical symptoms suggestive of and tested positive for Brucellosis by rapid antigen test presented. A total of 116 consented controls were recruited into the study. Males accounted for 52% of the cases and 53% of the controls. The mean age was 31 years for both groups. Cases without formal education were 84% while 40% had no source of income, 20% of the cases and 14% of the controls were cattle keepers while 5% of the cases and 13% of the controls were students. In multivariate analysis there were many factors associated with Brucellosis like consumption of raw meat, living with animals at the same place, raising of goats, farm cleaning contact, eating of aborted and wild animals. Logistic regression revealed two factors associated with the disease; consumption of raw milk (OR=3.9, P-value 0.001, 95% CI 1.6666-9.0700) was a risk factor while drinking boiled milk was protective (OR = 0.09, p-value 0.000, 95% CI, 0.1-0.2). CONCLUSIONS: The main age-groups affected were 20-30 years with males being affected more than females. Drinking of raw milk was significantly associated with Brucellosis while drinking boiled milk was protective. There should be active public health education on the benefits of boiling milk before consumption. Further studies to elucidate the extent and epidemiology of brucellosis in humans and animals in Southern Sudan are recommended.

Preventing malaria during pregnancy: factors determining the use of insecticide-treated bed-nets and intermittent preventive therapy in Juba

The study was carried out among 334 pregnant and newly delivered women seen at Juba Teaching Hospital in 2009. The objective was to assess the coverage of insecticide-treated bed-nets (ITN) and Intermittent Preventive Therapy (IPT) among these women and the factors associated with their use. Overall 87of the women used ITN and 61used IPT. ITN use was positively associated with buying nets; indoor spraying of insecticide and higher household income. IPT use was positively associated with more frequent antenatal clinic visits; indoor spraying and buying ITN

Risk factors for severe Rift Valley fever infection in Kenya, 2007.

A large Rift Valley fever (RVF) outbreak occurred in Kenya from December 2006 to March 2007. We conducted a study to define risk factors associated with infection and severe disease. A total of 861 individuals from 424 households were enrolled. Two hundred and two participants (23%) had serologic evidence of acute RVF infection. Of these, 52 (26%) had severe RVF disease characterized by hemorrhagic manifestations or death. Independent risk factors for acute RVF infection were consuming or handling products from sick animals (odds ratio [OR] = 2.53, 95% confidence interval [CI] = 1.78-3.61, population attributable risk percentage [PAR%] = 19%) and being a herds person (OR 1.77, 95% CI = 1.20-2.63, PAR% = 11%). Touching an aborted animal fetus was associated with severe RVF disease (OR = 3.83, 95% CI = 1.68-9.07, PAR% = 14%). Consuming or handling products from sick animals was associated with death (OR = 3.67, 95% CI = 1.07-12.64, PAR% = 47%). Exposures related to animal contact were associated with acute RVF infection, whereas exposures to mosquitoes were not independent risk factors.

Syphilis among pregnant women in Juba, Southern Sudan.

OBJECTIVE: Determine factors associated with syphilis among pregnant women. DESIGN: Cross-sectional study. SETTING: Antenatal clinics of Juba Teaching Hospital, Malakia National Health Insurance Centre and Munuki Primary Health Care Centre in Juba, Southern Sudan. SUBJECTS: Consenting pregnant women not on syphilis treatment. MAIN OUTCOME MEASURES: Socio-demographic and clinical data, knowledge and behavioural characteristics. RESULTS: Of the 231 pregnant women participants, 51 (22.1%) were positive for syphilis with the rapid plasma reagin test and 79 (34.2%) were positive with the treponema pallidum Haemagglutination assay. Risk factors for syphilis were: housewife (OR 2.808; P= 0.0116), abortion (OR 2.654; P= 0.0116) and partner travel (OR 2.149; P= 0.028). Attending antenatal clinic for previous pregnancy was protective (OR 0.281; P= 0.0004) for syphilis. CONCLUSIONS: This is the first study to determine the prevalence and associated factors in the three clinics in Juba, South Sudan. There is a high prevalence of syphilis in pregnant women attending the selected health facilities. Treponema Pallindum Haemagglulination Assay can be used as a field test for syphilis due to its high sensitivity and specificity. Health education, screening and treating positive expectant mothers can reduce the prevalence of syphilis.