Management of Helicobacter pylori among medical doctors working in Khartoum, Sudan 2019: a cross-sectional study

Background: Various international guidelines have been developed regarding Helicobacter pylori (H. pylori) management, as it is infecting more than half of the world's population. Sudan's health system lacks guidelines regarding H. pylori management, leading to a discrepancy in practice. Investigating the current approach could be a step forward in the formulation of a national consensus in the management of H. pylori. Methods: A cross-sectional study was conducted among medical doctors currently working in Khartoum, Sudan. Participants were enrolled from platforms of medical associations through an online questionnaire. The questionnaire was scored out of 25 points, and scoring 13 or above considered a good approach. Data analysis was carried out using Statistical Package for Social Sciences (SPSS). Results: A total of 358 medical doctors participated in the study. The mean (±SD) score was 12.9(±4.5). Those who were using textbooks, campaigns, symposiums or general medical information to their primary Source of knowledge significantly scored higher. The most selected indication for both diagnosis (76.8%) and treatment (67.6%) was an active peptic ulcer. Stool antigen test (SAT) was the most preferred test (70.7%). The majority of respondents selected triple therapy (82.1%) as a first-line regimen. Only 37.7% confirmed the eradication after four weeks of stopping the treatment. They ensure eradication mainly through SAT (29%). Conclusion: A suboptimal approach was noted among medical doctors of Khartoum, Sudan, regarding H. pylori management. Efforts should be invested in forming national guidelines and the implementation of continuous medical education programs.

Characterization of the type of response to different hcv antigens and quantification of viral load in newly diagnosed hepatocellular carcinoma patients

Background: Hepatitis C virus (HCV) is a blood born virus that is considered a major cause of chronic liver disease and hepatocellular carcinoma (HCC) worldwide. HCV is thought to induce HCC either indirectly or directly by the effect of its viral proteins on different host cell proteins and signaling pathways.Objective: The aim of the study was to characterize the type of response to different HCV antigens, quantify HCV viral load, transforming growth factor- beta and miRNA 122 in patients with newly diagnosed Hepatocellular Carcinoma.Patients and methods: This study was done on three groups: the first group consisted of 40 newly discovered hepatocellular carcinoma patients with HCV infection. The second group consisted of twenty HCV infected patients with other types of cancer (other than HCC). The third group consisted of 20 healthy individuals served as a control group. Serum was separated for detection of the four parameters. Results: TGF-ß showed a very weak negative correlation with the miRNA 122 serum levels that is statistically non-significant. Results also showed that miRNA 122 may not be useful in differentiating between liver cirrhosis from HCC patients and it is associated with the severity of the disease rather than the viremia count. Conclusion: Study showed no correlation between the four investigated parameters (HCV antigens, HCV viral load, TGF-ß- serum levels of miRNA 122) in an attempt for early diagnosis of HCV induced HCC

Evaluation of Virologic Methods for Early Detection of HIV-1 in a Resource-limited Setting: Performance and Cost Analysis

Introduction : Rapid testing and detection of acute HIV infection are two important arms in the prevention of HIV infection. Virologic testing for HIV remains the mainstay for early diagnosis of the infection. Nucleic acid-based testing for HIV however; requires expensive laboratory infrastructure and well-trained personnel; thereby making it not easily accessible in Low- Middle- Income Countries (LMIC). HIV DNA polymerase chain reaction is currently used by few laboratories in many LMIC to detect HIV in children born of HIV-positive mothers before 18 months. Challenges relating to timely result notification can be reduced if the Early Infant Diagnosis (EID) Programme is decentralized and with easy access to laboratory facilities using other tests with high performance characteristics. Methods: We evaluated the performance of five assays to identify HIV antibodies; p24 antigen; proviral DNA or viral RNA in 109 infants born to HIV-positive mothers in Yaounde; Cameroon. Results: The test performance (using plasma) of the HIV p24 antigen ELISA by Perkin Elmer; Roche Amplicor HIV-1 DNA PCR and the Abbott Realtime HIV-1 assay was 100 identifying 12 positive cases. A positive and significant correlation between the HIV-1 RNA viral load and HIV p24 antigen level was found (p0.05). Conclusion: Therefore; HIV p24 antigen detection by ELISA can be used for early diagnosis of HIV and thus recommended for a decentralized EID Programme in LMIC

Diagnosis and Monitoring of HIV Infection

The latest statistics indicate that the number of people infected with human immunodeficiency virus type 1 (HIV-1) worldwide is 40.3 million; 25.8 million of whom live in sub-Saharan Africa. In 2004; 29.5 of South African women attending antenatal clinics were infected. The virus infects people of all ages and social classes. A diagnosis of HIV has serious physical; emotional and social implications for the patient. HIV-infected patients are susceptible to numerous opportunistic and other infections; as well as to non-infectious backdiseases such as tumours. They eventually require lifelong treatment with potentially toxic medication. It is therefore essential that a timeous and correct diagnosis be made. An understanding of the tests available for the diagnosis and monitoring of HIV is essential for all clinicians working in South Africa. Tests available for the diagnosis of HIV in patients older than 18 months include HIV-specific antibody assays; fourth-generation combination antibody-antigen assays and Western Blot. The diagnosis of HIV infection in infants younger than 18 months requires detection of the virus itself by means of p24 antigen detection or HIV DNA PCR. The CD4+ T lymphocyte count and HIV viral load are used for monitoring disease progression and response to therapy

Diagnostic de la tuberculose par immunocapture du bacille tuberculeux (sur billes magnetiques)

"Detection of Mycobacterium tuberculosis by use of immunocapture technique"" : Tuberculosis is worldwide considered as a major health problem with high morbidity and mortality rates. Diagnosis of tuberculosis can be problematic. Microscopy; as the basic diagnostic method; stands inadequately alone due to a low sensitivity; and culture suffers from being time-consuming. A rapid; sensitive and simple diagnostic test; applicable in the field is therefore highly needed. A diagnostic method for the detection of M. tuberculosis by immunocapture technique has been developed using magnetic beads coated with polyclonal anti-M. tuberculosis. The detection of captured bacilli using biotinylated anti-APA monoclonal antibody (APA is a minor secreted antigen) was found more sensitive than microscopy. The results suggest that the development of a rapid strip test to detect major antigen could be a useful tool for the control of tuberculosis."

The ParasightTMF-Test : sensitivity; specificity and possible usefulness in common practice : a review

This article deals with the ParasightTMF-Test which is a chromatographic immuno assay that detects histidine rich protein II (HRP II) antigen of Plasmodium in whole blood

Independent divergences in the CD4 binding site and V3 loop encoded in two seroprevalent Ugandan HIV-1 clinical isolates

"Two major epitopes expressed in HIV-1 have been recently shown to play a central role in virus neutralization. One of these important specificities is a type-specific or group-specific; principal neutralizing determinant (PND) located in the V3 loop of gp120. The other is a more broadly neutralizing determinant associated with the CD4 binding site. Structural and serological studies of the variation in these epitopes have become important in vaccine research. This report describes the analysis of the DNA clones encoding a region of gp120 that overlaps the V3 loop and the putative CD4 recognition site in two new African isolates; UG06c and UG23c. Phylogenetic analyses of the DNA sequences showed that the new African isolates clustered with two very distinct subtypes of HIV-1. UG06c was grouped with U455; D687; and Z321; previously classified as ""HIV-1 subtype A"" in the AIDS and human retroviruses database; and UG23c was grouped with MAL; JY1; NDK; ELI; and Z2Z6 classified as ""HIV-1 subtype D."" Considerable variation was apparent in the V3 loop. The divergence included the presence of the hexapeptides GP-GRSF and GLGQAL at the cap of the loop in UG06c and UG23c; respectively. The GPGR tetrapeptide in UG06c formed a beta-turn configuration similar to that of MN or IIIB. The beta-turn was not found to be a likely conformation for GLGQ. The amino acids previously implicated in CD4 binding and the associated neutralizing activity were relatively conserved. To assess a possible impact of the sequence and conformational variations on serological reactivity; UG06c and UG23c were subjected to neutralization assay.(ABSTRACT TRUNCATED AT 250 WORDS)"

Extensive genetic diversity in the HLA class II region of Africans; with a focally predominant allele; DRB1*1304

Molecular HLA class II typing of greater than 1700 individuals from The Gambia in West Africa and Malawi in South-Central Africa revealed a striking diversity of HLA DRB-DQB haplotypes as defined by restriction fragment length polymorphism (RFLP); this diversity is twice as extensive as that found in northern Europeans. Despite this diversity; sequence and PCR/oligonucleotide analysis showed that the recently described variant DRB1*1304 is the commonest DRB1 allele in The Gambia. The sequence; geographical distribution; and RFLP association of this allele; together with homozygosity test results; suggest that DRB1*1304 may have arisen from DRB1*1102 and have reached its remarkably high frequency as a result of recent directional selection. The prevalence of this unusual allele has implications for trials of subunit vaccines in this area. The extensive and distinctive HLA class II region polymorphism in sub-Saharan Africans is consistent with evidence from other genetic loci implying an African origin of modern Homo sapiens

Circurating trypanosomal antigen levels in sleeping sickness patients under going treatment at Alupe

Sera from 99 sleeping sickness patients admitted to Alupe Hospital were analyzed for circulating trypanosomal antigens using a sandwich antigen-trapping enzyme immunosorbent assay. Trypanosomal antigens were detected in 83 (84) of the patients. Post-treatment antigen profile in 67 patients showed five distinct patterns: in 48 of the patients antigen levels remained elevated thoughout; in 31 of the patients antigens dropped to the; negative value; and became elevated afterward; in 6.0 of the patients antigen levels were negative initially; but became elevated later; in 7.5 of the patients antigen levels remained below the negative value thoughout. The significance of these observations in the clinical management of sleeping sickness is discussed

Glutamate rich Plasmodium falciparum antigen GLURP

We have characterized a glutamate rich Plasmodium falciparum antigen; GLURP; which by immunoassays appears to be present in both the preerythrocytic and erythrocytic stages of the vertebrate life cycle. The gene which is located on chromosome 10 encodes a polypeptide of 1271 residues with a predicted molecular mass of 145 kDa. Rabbit antiserum against a fusion protein expressing the C-terminal end of the molecule detects a protein with a molecular mass os 220 kDa. The sequence includes two hydrophobic regions; 23 residues near the N-terminus; which may act as a signal peptide; and a second located at the C-terminus consisting of 33 predominantly hydrophobic residues. Except for these hydrophobic regions the protein is hydrophilic and highly charged. The sequence has two tandem repeats designated R1 and R2 these regions are found to be conserved in isolates from different geographical areas. High levels of anti-GLURP antibodies have been shown to correlate with low parasite density. The indication of GLURP being expressed in all stages of the parasite in the human host raises significantly the prospects of the potential of this molecule