The genus Madurella: Molecular identification and epidemiology in Sudan.

Eumycetoma (mycotic mycetoma) is the fungal form of mycetoma, a subcutaneous infection occurring in individuals living in endemic areas of the disease. The Sudan is hyperendemic for mycetoma, with the highest incidence being reported from Gezira State, Central Sudan. The present study was conducted at the Gezira Mycetoma Center and aimed to determine the cause of black-grain eumycetoma in the state and describe its epidemiology. Black-grain specimens were collected during the surgical operation and direct detection of the causative agent was performed using M. mycetomatis species-specific PCR and ITS PCR followed by sequencing. Black-grain was reported from 93.3% of all confirmed mycetoma cases (n = 111/119), with a prevalence in young males. Of the 91 samples subjected to direct PCR, 90.1% (n = 82) gave positive results. The predominant species (88.2%) was Madurella mycetomatis. One sample was identified as M. fahalii, one as M. tropicana, and one matched the phytopathogenic species Sphaerulina rhododendricola. The highest endemic zones were Southern Gezira (76.6%) and Northern Sinnar (23.4%). The study confirmed that direct molecular detection on grains provides rapid and specific diagnosis of agents of eumycetoma.

Nonspecific Colitis a Forgotten Entity in Central Sudan

Background: Nonspecific colitis is an inflammatory Bowel Disease (IBD) that runs a clinically benign course. Histopathologically it is characterized by superficial mucosal erosions with lymphocytic infiltration in the lamina propria with no granuloma. Aim of this study: is to describe the clinical presentation of Non-Specific Colitis (NSC); and to evaluate its response to 5-aminosalicylic acid (5-ASA) in Sudanese patients. Setting and Design: This study is a prospective cohort. A total of 26 patients presenting with bloody; mucoid diarrhoea; lower abdominal pain or colonic mass were included in the study. Methods and Materials: A total of 26 patients presenting with bloody mucoid diarrhoea; lower abdominal pain with or without colonic mass were included in the study. All patients underwent colonoscopy. Statistical analysis: A descriptive statistical analysis was done using SPSS. Results: 19 () of patients were males and 7 were females with male to female ratio of 3:1. The majority of patients 16 (61.6) had bloody diarrhea while 18 (69.2) opened their bowel 4-6 times a day. The majority 10 (38.8) had rectum and sigmoid involvement. All patients showed a good response to 5-ASA. Conclusions: This study showed that NSC has clinical features that are very much similar to mild UC with a rather good clinical response to oral 5-ASA

Evaluation of the direct agglutination test based on freeze-dried Leishmania donovani promastigotes for the serodiagnosis of visceral leishmaniasis in Sudanese patients.

The direct agglutination test (DAT) based on freeze-dried (FD) Leishmania donovani antigen was evaluated for the serodiagnosis of kala-azar in a rural setting in eastern Sudan. The performance of the FD-DAT was compared with standard liquid antigen (LQ) by testing serum samples and blood samples collected on filter paper of microscopically and PCR-confirmed VL patients, apparently healthy endemic controls and patients with other relevant infectious diseases for the region. In the present study, the FD-DAT had a sensitivity of 96.8% and a specificity of 96.2%. The LQ-DAT had a sensitivity of 91.0% and a specificity of 96.6%. A high degree of agreement (97.3%; r-value 0.94) was observed between the FD-DAT and the LQ-DAT, as well as between the FD-DAT performed on serum samples and corresponding blood samples collected on filter paper (agreement 97.8%; r-value 0.79). The FD-DAT is very suitable as diagnostic test for kala-azar in remote rural conditions as it is sensitive, specific and stable. The antigen is affordable, reproducible and available, which contributes to the sustainability of the DAT as a diagnostic test for VL.