Awareness towards urinary schistosomiasis and its relation with active infection among primary school pupils and students in North Kordofan state, Sudan 2022.

Objectives: This study intends to evaluate the prevalence of active Schistosomiasis in school children, as well as their awareness, attitude, and behavior towards the illness in El-Rahad province. Methods: This facility-based analytical cross-sectional study among 495 primary school children aged seven to 13 in five villages; Structured and pre-tested questionnaires were used to collect the data in face-to-face interviews, in addition, urine samples were collected from each pupil and then assessed microscopically for S. Haematobium eggs Presence. Data was analyzed using SPSS version 25.0. Results: A total of 424 primary school students participated in the study. Almost all the students (96%) had poor knowledge about urinary schistosomiasis. In general, 100% of the students had poor practices. Attitude revealed that females have lower chance of having the infection than their male counterparts. About 27% (n = 115) of them had active urinary schistosomiasis infection at the time of the study. Conclusion: The study revealed poor level of awareness and knowledge, positive attitude, and poor practices among primary school students. There was also high level of active infection among participants.

Assessment of the Implementation of Global Initiative for Asthma (GINA) 2019 Guidelines for Treatment of Mild Asthma Among Pediatric Registrars: A Quasi-Interventional Study.

Background and Aims: It is essential to have proper treatment and management for asthma in order to minimise symptoms, lessen the burden, and lower the chance of exacerbations. To better control asthma, the purpose of this study was to evaluate and enhance paediatric registrars' understanding and application of asthma treatment. Methods: The Sudan Medical Specialisation Board (SMSB) paediatric registrars provided data for this quasi-interventional study between April and September of 2021. Twice, both before to and following the intervention education sessions, the questionnaire was delivered. SPSS version 28 was used to analyse the data after it had been cleaned up in an Excel document. Results: 203 (or 77.8%) of the 261 were women. A substantial rise from 8.1 ± 4.12 SD to 18 ± 5.03 SD in the mean overall knowledge score of registrars between the pre-and post-intervention periods. A significant difference (p=0.001) was observed in the post-intervention phase, with first-year registrars (R1) demonstrating higher scores than their senior colleagues. The registrars' total knowledge scores did not differ significantly from one another during the pre-intervention period. The Global Initiative of Asthma (GINA) guidelines of management were implemented to a certain extent, according to the study. Of the registrars, 148 (56.7%) and 203 (77.8%) evaluated step one management in children ages 5 and under; 66 (25.3%) and 213 (81.6%) evaluated step one management in children ages 6 to 11; and 66 (25.3%) and 213 (81.6%) evaluated step one management in children ages 6 to 11 in pre- and post-intervention, respectively. Conclusion: Given that the intervention in this study greatly increased registrars' knowledge, doctors should obtain training on the GINA 2019 recommendations through conferences, workshops, and academic programmes. To find out why R1 outperforms their older counterparts, more investigation has to be done.

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.

The unbroken chain of female genital mutilation: a qualitative assessment of high school girls' perspectives.

BACKGROUND: Female Genital Mutilation (FGM) is defined as any procedure that involves damage to the female external genitalia. This practice is majorly prevalent in Sudan, as it is estimated that over 12 million Sudanese women are circumcised. This study uncovers rural females' knowledge and insights about FGM domestically. METHODS: A qualitative, deductive study with thematic analysis was conducted. A total of 42 female high school students were recruited and divided into five focus groups, each of which included girls from four different high school classes in the main school of the study area. A topic guide was prepared and used to lead the focus groups. Thematic analysis was used, and the study data had been categorized into four themes: knowledge, procedure and performance, experience, and practice. The condensed meaning units of each theme were identified, then classified to formulate sub-themes. RESULTS: All the participants indicated that FGM is a traditional practice in the village. The vast majority have heard about it from family members, mainly mothers and grandmothers. Regarding the procedure, all the participants agreed that midwives perform FGM, but most of them don't know what exactly is being removed. According to all participants, mothers and grandmothers are the decision-makers for FGM. The majority of the participants stated that they do not discriminate between the circumcised and uncircumcised women and most of them agreed that circumcision has negative side effects. They have mentioned pain, difficult urination, and walking as early side effects, while psychological impacts and labor obstruction as late ones. Generally, the majority of the participants agreed that circumcision is not beneficial and should stop. CONCLUSION: Knowledge regarding the dangers of FGM among high school girls is better than expected given the high prevalence of the practice. Generally, the process is well understood, the performers are known, the experience is universal, and the side effects are acknowledged. Nevertheless, a majority still showed an intent to circumcise their daughters in the future.

Knowledge, attitude, and ethical concepts of Sudanese medical students regarding stem cells and its application.

One of the major challenges that stem cell transplantation faces is a lack of donors due to a lack of knowledge and awareness of the importance of stem cell transplantation, this implies that health care providers should arm themselves with sufficient knowledge to contribute positively to raising awareness. This is an analytical cross-sectional study of 1040 medical students from 10 universities from various Sudanese states, through an online self-administered pre-tested and structured questionnaire formulated by the authors with a particular focus and/or reflection on the knowledge and attitudes of medical students. The median knowledge score among all students was 8.0 (6-9) with the majority of students confirming that stem cells are capable of dividing and can self-renew for a long period (88.6%). Regarding attitude, the median score among the participants was 23 (17-27) with (47.9%) agreeing that competency in stem cell knowledge is important for them as future health care providers. In terms of ethical attitude; the majority of the students (59, 2%) think there's a need to obtain ethical approval before conducting research. Moreover, (45.9%) of students believe that health practitioners have the right to use stem cells in treatments if those treatments have been scientifically proven to be effective on animals and on human cells in the laboratory. It is important to promote educational programs that inform medical students about the full range of possibilities offered by stem cell research. Furthermore, more studies is required to determine how society and religion affect medical students' attitudes toward stem cells.

Accessibility crisis of essential medicines at Sudanese primary healthcare facilities: a cross-sectional drugs' dispensaries assessment and patients' perspectives.

BACKGROUND: Access to essential medicines is a critical component of universal health coverage. However, the availability of essential medicines in Sudan isn't well studied. As well, most Sudanese people lack health insurance, making out-of-pocket spending the primary source of drug financing. Therefore, the affordability of medicines in Sudan is questionable, with only 30% of the total population being covered by a public health service or public health insurance. We undertook this study to assess the availability and prices of essential medicines in public-sector health facilities in Khartoum state. Moreover, this study aims at assessing patients' perceived affordability of essential medicines, and accommodation and acceptability of the public facility. METHODS: A cross-sectional study was carried out at 30 primary healthcare facilities' drug dispensaries across three districts in Khartoum state. Within each Centre's dispensary unit, a standardized checklist evaluated the availability and affordability of 21 essential medicines selected from Sudan's national essential medicines list and assessed their storage conditions. Furthermore, 630 patients were selected from all dispensary units for an exit interview that assessed their perceived accessibility, acceptability, accommodation, and affordability of essential medicines. Data were collected through the Kobo toolbox and analyzed using SPSS version 26. RESULTS: Participants' ratings of accessibility, affordability, accommodation, and acceptability were 3.7/5, 1.5/4, 5/6, and 5.4/6, respectively, with a 26.7% full access and weak correlation between some of the indices. The overall availability of adults and pediatric medicines was 36.8% 6.7%, respectively. Cost of a single course of treatment for 10 and 16 drugs out of the 19 drugs consumed exceeds the daily wage of insured and uninsured patients, with a median price ratio of 16.4 and 62.8, respectively. Moreover, the dispensary area conditions were found to be of good quality, yet the storerooms were not functioning in 40% of the outlets. CONCLUSION: Patients had limited access to their needed drugs due to high prices and physical unavailability, and primary healthcare capacities are not meeting the demands of citizens. The outcomes for the patients' access variables (accessibility, accommodation, acceptance, and affordability) are comparable to those in countries with low incomes. Ensuring access to free medicines is likely to improve patients' satisfaction with healthcare services and reduce private expenditure on medicines, which is a long-term, sustainable way towards universal health coverage in Sudan.

Sudan's armed rivalry: A comment on the vulnerable healthcare system catastrophe.

The Sudan War 2023 is a military conflict that erupted in the heart of a paralyzed state system. A total of 68% of hospitals are presently closed, with the remainder operating just partially owing to a lack of staff, medical supplies, and pharmaceuticals. Furthermore, due to power outages, Sudan's vaccination and insulin stocks are under jeopardy. Additionally, patients with chronic conditions have difficulty receiving their prescriptions. This unaccounted-for conflict is expected to degrade Sudan's already-weak healthcare sector by the recent COVID-19 pandemic and 2018 revolution. Humanitarian emergency care is being offered by numerous non-for-profit organizations and civilians initiatives; but, more measures, notably aimed at preventing political upheaval, are required to save the country's future.

Prevalence and reasons to seek traditional healing methods among residents of two localities in North Kordofan State, Sudan 2022: A cross-sectional study.

Background and Aims: Traditional medicines are one of Africa's primary response mechanisms to medical emergencies, while, in other communities, all healthcare decisions are based on indigenous traditions and beliefs. For millions of individuals who reside in rural areas throughout low- and middle-income nations, those healers serve as their only primary healthcare practitioners. This study intends to examine the availability, preferences, and practices of traditional medicine seeking among the Sudanese of North Kordofan state. Method: A descriptive cross-sectional study was carried out in two conveniently chosen localities in North Kordofan state, namely Barrah, and Shaikan. A structured questionnaire with three sections-sociodemographic, attitudes, and forms of traditional medical practices-was used for face-to-face interviews with the residents. The frequency (n) and percentage (%) of categorical data are presented. The Chi-square and Fischer exact tests were performed to determine characteristics related to traditional medicine practice and the preferred type of medicine among participants; a p value of.05 was considered significant. Results: A total of 302 residents took part in the study, with the 15-30 age group constituting the majority. The majority of participants (89.1%) used traditional medicine, and the majority of them (92.4%) learned about it from their families. The major type of traditional medicine (60.3%) used was a medical herbs-herb practitioner. Cultural influences (57%) and the effectiveness of traditional medicines (48.3%) were the most common reasons for seeking those medicines. Conclusion: Most participants seek traditional medicine, with traditional herbs and holy recitation commonly used. Affordability, therapeutic effectiveness, and cultural and religious influence were reasons for preferring traditional medicine.

Efficacy and safety of inhaled nitric oxide administered during cardiopulmonary bypass for pediatric cardiac surgery: a systematic review and meta-analysis.

Cardiopulmonary bypass (CPB) utilized for cardiac surgeries has been associated with significant mortality and adverse outcomes. The benefits of incorporating nitric oxide (NO) into the CPB circuit have been reported in terms of reduced inflammation, enhanced dynamic circulation, oxygenation, and end-organ function. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of inhaled NO introduced to the CPB circuit among pediatric patients undergoing various cardiac surgeries. Methods: A systematic literature search was conducted on 26 July 2022, using the electronic databases of PubMed, Cochrane, Scopus, and Web of Science to include randomized controlled trials, with no restriction regarding the date of study conduction. The quality of studies was assessed using the Cochrane tool. RevMan 5.3 software was used to analyze data in the inverse variance method, with pooling data as mean difference (MD), risk ratio, and 95% CI. Results: Six trials were included comprising 1666 children who had undergone the interventions of interest. All studies amenable to assessment were of good quality. NO was significantly superior to the control treatments regarding ventilation time (MD=-8.34; 95% CI [-14.50 to -2.17], P=0.008), postoperative interleukin-6 (IL-6) levels (MD=-0.50; 95% CI [-0.54 to -0.46], P<0.001), 24-h IL-6 levels (MD=-0.30; 95% CI [-0.32 to -0.20], P<0.001), and 24-h tumor necrosis factor-alpha (TNF-α) levels (MD=-1.72; 95% CI [-3.44 to -1.00], P=0.05). The side effects of NO and the control treatments were comparable (P=0.9). Conclusion: NO administered as part of the CPB circuit during cardiac surgeries is efficacious in terms of reducing ventilation time, postoperative IL-6, and TNF-α levels compared to control, with a comparable safety profile.

Knowledge, attitude and practice of medical students towards COVID19 in Sudan: A cross sectional study among 19 universities.

Background: Since December 2019, an outbreak of severe respiratory infection (COVID-19) emerged in the city of Wuhan in China. The knowledge, awareness and practice of medical students toward COVID-19 pandemic is of most importance as it demonstrates their preparedness to deal with this pandemic. The objective of this study is to assess the knowledge, awareness and practice of medical students in Sudan universities about COVID 19. Methodogy: This is a cross-sectional study conducted on 19 universities that have medical schools in Sudan. Data from at least 100 medical students from each university were included in the study. Data were collected using an online questionnaire in April 2020. Statistical analysis was conducted using the Statistical Package for Social Science software, version 25. Results: About 2603 medical students from 19 universities were included. Overall good knowledge and practice were demonstrated by the medical students (88.9%) and (78.6%), respectively. Respondents who answered that the most common clinical symptoms of COVID-19 were the main combination of dry cough, fatigue and fever were (27.7%), and the first initial symptom was headache were (48.3%.). (60.2%) Wear medical masks, (95%) said that avoiding crowded places protects against the spread of COVID-19, and (50.7%) have confidence that Sudan can win the battle against the COVID-19. Finally, (68.8%) agreed that COVID-19 will finally be successfully controlled. Conclusion: This study has found that medical students in Sudan demonstrated good knowledge and good practice toward Covid19.

Third wave of COVID-19 pandemic in Africa: Challenges and recommendations.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has evolved in different waves and is currently in its third wave for the majority of countries around the world. Each wave emanated with its own set of challenges. Lower- and middle-income countries such as most African countries have faced additional challenges compared to high-income countries. This paper highlights the challenges faced by Africa during the third wave of COVID-19 and proposes recommendations and strategies to contain the spread. We conducted a mini-review for the newly released articles and researches about the challenges faced by Africa during COVID-19. Fragmented healthcare sectors, limited healthcare resources and emergence of co-infections in COVID-19 patients, inadequate vaccination rollout and political conflicts are the major challenges faced by the African countries. Our recommendations to defeat this outbreak and subsequent pandemics is to raise the public's awareness about vaccines through campaigns and social media in order to lessen vaccine hesitancy. Governments as well should focus on under-served and vulnerable populations, patients with comorbidities, and communities living in endemic-striking settings as these people are more prone to the severe form of the disease. Moreover, by adopting socio-ecological perspectives, one can implement multi-level integrated interventions to help control COVID-19 more effectively.

Identifying SARS-CoV2 transmission cluster category: An analysis of country government database.

BACKGROUND: As a result of the high contagiousness and transmissibility of SARS-CoV-2, studying the location of the case clusters that will follow, will help understand the risk factors related to the disease transmission. In this study, we aim to identify the transmission cluster category and settings that can guide decision-makers which areas to be opened again. METHODS: A thorough review of the literature and the media articles were performed. After data verification, we included cluster data from eight countries as of 16th May 2020. Clusters were further categorized into 10 categories and analysis was performed. The data was organized and presented in an easily accessible online sheet. RESULTS: Among the eight included countries, we have found 3905 clusters and a total number of 1,907,944 patients. Indoor settings (mass accommodation and residential facilities) comprised the highest number of both number of clusters (3315/3905) and infected patients (1,837,019/1,907,944), while the outdoor ones comprised 590 clusters and 70,925 patients. Mass accommodation was associated with the highest number of cases in 5 of the 7 countries with data available. Social events and residential settings were responsible for the highest number of cases in the two remaining countries. In the USA, workplace facilities have reported 165 clusters of infection including 122 food production facilities. CONCLUSIONS: Lockdown could truly be a huge burden on a country's economy. However, with the proper knowledge concerning the transmissibility and the behaviour of the disease, better decisions could be made to guide the appropriate removal of lockdown across the different fields and regions.