Experience with Tetanus in a Tertiary Care Hospital in Sudan: A Retrospective Review

Introduction. Tetanus is still a major health issue, especially in rural areas, and is associated with high morbidity and mortality rate. This study was conducted to describe the pattern of presentation and treatment outcome among adult patients infected with tetanus in our environment. Materials and Methods. This is a descriptive retrospective hospital-based study conducted in Wad Medani teaching hospital, central Sudan. A total of thirty-one patients were enrolled in this study in the period between January 2018 and December 2020. Results. Thirty-one patients were infected with tetanus during the study period. They were 23 (74.2%) males and 8 (25.8%) females with a male-to-female ratio of 2.875 : 1. Their ages ranged from 20 to 70 years, and most of them (48.4%) were free workers. Acute injuries were the most common portal of entry (64.51%), and commonly involved the lower limbs (48.38%). Lock jaw (54.8%), muscle spasm (51.6%), and neck pain and stiffness (45.2%) were the most common presentation. Supportive measures along with surgical toilet and debridement, human tetanus immunoglobulin, antibiotics, and muscle relaxants were initiated in all patients. The most common antibiotics used were Penicillin V and Ceftriaxone. A muscle relaxant was administered to aid in relieving the spasms. Complication rate was 61.29% and included pulmonary and cardiovascular complications. Fifteen patients died accounting for an overall mortality rate of 48.4%. Conclusions. Tetanus remains a disease with high morbidity and mortality. The unknown/incomplete vaccination status among study participants, inadequate management, and lack of equipped resources lead to a devastating outcome as in Sudan.

Comment on: Emergence of the invasive malaria vector Anopheles stephensi in Khartoum State, Central Sudan

This letter comments on the article “Emergence of the invasive malaria vector Anopheles stephensi in Khartoum State, Central Sudan” published in Parasites and Vectors 2021, 14:511. Here we aim of provide a response to this paper in the broader context of the invasion and spread of An. stephensi in the Horn of Africa, and the required response to it. We agree with the authors that the arrival of this invasive vector in Khartoum State is of high public health concern. Equally concerning, however, we found that the detection of the vector by the authors in 2018 seemingly took 3 years to communicate to the Ministry of Health and World Health Organization (WHO), and was reliant on an academic journal. We consider that this short report sets a poor example of how public health threats should be reported. Suitable communication alternatives to alert public health authorities to such threats have been put in place by the WHO and its Member States, and are well known to at least some of the authors of the short report. We would like to encourage all readers not to follow the example of Ahmed et al. but instead act as responsible public health professionals by drawing on the established reporting mechanisms and escalate potential threats as soon as they are identified. Graphical Abstract

Emergence of the invasive malaria vector Anopheles stephensi in Khartoum State, Central Sudan

The emergence of the Asian invasive malaria vector, Anopheles stephensi, has been identified in Khartoum, the capital city of Sudan. This is the first report that confirms the geographical expansion of this urban mosquito into Central Sudan. We urgently recommend the launch of a national entomological survey to determine the distribution of this invasive disease vector and to generate essential information about its bionomics and susceptibility to available malaria control measures. Graphical Abstract

Holocene resource exploitation along the Nile: diet and subsistence strategies of Mesolithic and Neolithic societies at Khor Shambat 1, Sudan

The subsistence practices of Holocene communities living in the Nile Valley of Central Sudan are comparatively little known. Recent excavations at Khor Shambat, Sudan, have yielded well-defined Mesolithic and Neolithic stratigraphy. Here, for the first time, archaeozoological, palaeobotanical, phytolith and dental calculus studies are combined with lipid residue analysis of around 100 pottery fragments and comparative analysis of faunal remains and organic residues. This holistic approach provides valuable information on changes in adaptation strategies, from Mesolithic hunter-gatherers to Neolithic herders exploiting domesticates. A unique picture is revealed of the natural environment and human subsistence, demonstrating the potential wider value of combining multiple methods.

Analysis of Physico-chemical and Macro Element Concentration in Soils of Six Farmlands in Khartoum State, Central Sudan

Analysis of some selected physico-chemical parameters and macro-elements in soil samples collected from six farmlands (Agricultural schemes) in Khartoum State, Central Sudan : EL-Gomouya, Wad Ramli, Umm Arda, EL-Waha, EL-Silait and EL-Shaab schemes) were carried out The soil characterization was carried out for parameters like pH, organic carbon, moisture content, electrical conductivity , soil texture , potassium, sodium, magnesium, calcium and phosphorus in the soil samples. The physicochemical analysis of soil samples understudy showed different concentrations of various parameters at different farmlands. Correlation analysis was employed to examine the relationship between the various parameters in the soil samples.