Handheld echocardiographic screening for rheumatic heart disease in rural South Kordofan, Sudan by junior medicals: Supporting task shifting for control of a serious disease

Background Rheumatic heart disease (RHD) is a major and preventable cause of cardiac mortality in Sudan, particularly in Kordofan. It can be detected early with a handheld echocardiography machine. Methods A cross-sectional study was conducted in South Kordofan State, Sudan (as part of a medical convoy organized by Khartoum Medical Students Association). A team of shortly trained medical students and newly graduated doctors conducted a handheld echocardiographic screening using a simplified protocol. All suspected cases were recorded and reviewed later by a senior pediatric cardiologist. Demographic and clinical features of screened subjects were studied. Data analysis was performed using the Statistical Package for Services and Solutions (SPSS 25). Descriptive statistics were presented as “number (%)” or “mean ± SD”. RHD prevalence was expressed as cases per 1000, and Chi-Square test/Fisher’s Exact test was used to compare RHD findings between different groups. Results The disease frequency was found to be 50 per 1000. Out of 452 screened subjects (age 10-25 years), 23 were found to have RHD with a male to female ratio of 1:1.5. Echocardiographic quality was acceptable in 93% of studies. The disease was mild in 70% and moderate or involving 2 valves in 30% of patients. Patients were contacted, advised to start penicillin prophylaxis and referred to cardiologists. Risk factors for the disease included father's occupation and village of residence. Conclusion Shortly trained junior medicals can assist in RHD echocardiographic surveillance in remote areas. South Kordofan state is highly endemic for RHD and a control program needs to be implemented. Handheld echocardiography is of value for early detection and management.

Sudan’s military may play politics with peace talks

Significance With at least 10,000 fighters under its command across the ‘Two Areas’ (South Kordofan and Blue Nile), a deal with SPLM-N/al-Hilu is seen as critical for consolidating Sudan’s peace process. Impacts The military’s desire for a short-term political win may outweigh its fears of long-term political fallout from a peace deal. The transition period will likely be extended beyond 2023-24, with the military prolonging its leadership of the Sovereign Council. A peace deal would allow extractive industries to operate in the ‘Two Areas’, but ultimately uncertainty may deter serious investment.

Insecticide Residues in Cotton, Sorghum and Fallow Soil from the Nuba Mountains Cotton Corporation of South Kordofan State, Sudan

Background. Soil is the final depot of most environmental contaminants, including pesticides. Soil may be contaminated by pesticides as a result of direct application or drift during spray activities. Soil contamination with pesticide residues may affect the quality of food crops, animal products, and soil micro-organisms which may in turn negatively affect human health and the environment. Objectives. The main objective of the current study was to determine the soil residues of commonly used pesticides in rain-fed crops grown by the Nuba Mountains Cotton Corporation (NMCC) in South Kordofan state of Western Sudan. Methods. Four locations (representing the four directions around the state capital Kadugli) were chosen for sample collection: Alefain (East Kadugli), Elmashaish (West Kadugli), Ed Dalling uncultivated area (North Kadugli) and Lagawa (Southwest Kadugli). Nine soil samples were randomly taken from each location representing areas under cotton, sorghum, and uncultivated land covered with natural vegetation. Soil samples were analyzed by gas chromatography (GC) equipped with electron capture detector (ECD) and GC-mass spectrometry (MS). Results. The results generally indicated that organophosphate levels were greater than organochlorine and pyrethroids with heptachlor, malathion, and dimethoate present in all samples analyzed, while the level of p,p-dichlorodiphenyltrichloroethane (DDT) was below the detection limit. Endosulfan α and β isomers were detected in some samples. Dimethoate had the highest level (22.02 mg/kg), while β endosulfan was found at the lowest level (0.015 mg/kg). Generally, samples collected from cotton soils showed higher residue levels compared to sorghum soil with average concentrations of 307.25 mg/kg versus 58.63 mg/kg, respectively. Almashaish showed the highest residues levels followed by Alefain, Lagawa, and Ed Dalling with total residues of 57.56 mg/kg, 26.34 mg/kg, 22.63 mg/kg, and 17.07 mg/kg, respectively. Conclusions. The current study sheds light on the residue levels of some of the commonly used pesticides in the cotton rain-fed scheme in South Kordofan State, western Sudan. The study calls for regular residue monitoring in various environmental components in the area and suggests possible management measures. Competing Interests. The authors declare no competing financial interests.

COVID-19 in conflict border regions: a case of South Kordofan, Sudan

The novel coronavirus disease (COVID-19) was first reported in Sudan on 13 March 2020. Since then, Sudan has experienced one of the highest rates of COVID-19 spread and fatalities in Africa. One year later, as per 22 March 2021, Sudan had registered 29,661 confirmed cases and 2,028 deaths with a case fatality rate (CFR) of 6.8 %. By 12 December 2020, of the 18 states in Sudan, South Kordofan had the fifth highest CFR of 17.4 %, only surpassed by the other conflict affected North (57.5 %), Central (50.0 %) and East (31.8 %) Darfur States. By late March 2021, just three months from December 2020, the number of cases in South Kordofan increased by 100 %, but with a significant decline in the CFR from 17.4 to 8.5 %. South Kordofan is home to over 200,000 poor and displaced people from years of destructive civil unrests. To date, several localities such as the Nubba mountains region remain under rebel control and are not accessible. South Kordofan State Ministry of Health in collaboration with the federal government and non-governmental organizations set up four isolation centres with 40 total bed capacity, but with only two mechanical ventilators and no testing centre. There is still need for further multi-sectoral coalition and equitable allocation of resources to strengthen the health systems of rural and conflict affected regions. This article aims at providing insight into the current state of COVID-19 in South Kordofan amidst the second wave to address the dearth of COVID-19 information in rural and conflict affected regions.

COVID-19 in Conflict Border Regions: A Case of South Kordofan, Sudan

The novel coronavirus disease (COVID-19) was first reported in Sudan on 13 March 2020. Since then, Sudan has experienced one of the highest COVID-19 spread and fatalities in Africa. As per 12 December 2020, Sudan had a total of 21,591 cases, 1,355 cumulative deaths at a case fatality rate (CFR) of 6.28%. South Kordofan State has 17.4% COVID-19 case fatality rate, the fifth highest rate among the 18 States. The State is home to over 200,000 poor and displaced people from years of destructive civil unrests. To date, several localities such as the Nubba mountains region remain under rebel control and are not accessible. South Kordofan State Ministry of Health in collaboration with the federal government and non-governmental organizations set up four isolation centres with 40 total bed capacity, but with only two mechanical ventilators and no testing centre. There is still need for further multi-sectoral coalition and equitable allocation of resources to strengthen the health systems of rural and conflict affected regions. This article aims at providing insight into the current State of COVID-19 in South Kordofan amidst the second wave to address the dearth of COVID-19 information in rural and conflict affected regions.

Malaria epidemic in humanitarian crisis settings the case of South Kordofan state, Sudan

Introduction: Malaria remains one of the most common public health problems worldwide, especially in Sudan. With this short communication we aimed at reporting on the latest malaria epidemic that had occurred in the humanitarian settings in South Kordofan state, south-western Sudan, during 2018 and 2019. Methodology: This is a cross-sectional study analyzing malaria surveillance reports between February 2018 to September 2019. Malaria was reported from febrile patients with confirmed malaria diagnosis using Giemsa stain. According to age, patients were distributed across three categories: less than 5 years, 5 to 15 years, and more than 15 years. Results: In 2019 and 2018, 63,214 and 63,224 cases of malaria were reported, respectively, constituting around 5.5% of the state population (1,152,900). In 2018, 3,571 malaria cases were reported in February, then they decreased in August followed by increase in September-October. In 2019, 15,610 malaria cases were reported in September. Malaria cases aged less than 5 years were 21,848 and 23,561 cases in 2018 and 2019, respectively. Conclusions: The reported sudden epidemic of malaria is alarming. Therefore, identifying the risk factors associated with this epidemic is crucial to malaria prevention and control, and hence successful achievement of malaria elimination.

Word Order and Agreement in Tagoi

This study provides a detailed description of word order types, agreement patterns and alternations found in Tagoi, a Kordofanian language traditionally spoken in South Kordofan. After a brief presentation of the language (section 1), the noun class system is introduced (section 2) and the word order and agreement patterns are examined at the noun phrase level (section 3). Section 4 gives information about the constituent order at clause and sentence level, while Section 5 summarizes the findings and conclusion of the paper. All in all, the paper aims at contributing to a better understanding of the grammar, structure and typological features of Tagoi.