Mefloquine in the treatment of falciparum malaria during pregnancy in Eastern Sudan

To test the efficacy and toxicity of mefloquine therapy both on expectant mothers and the outcome of their pregnancies. We performed a prospective non-comparative clinical trial in New Halfa Teaching Hospital, Eastern Sudan, during the period October 1998 to June 2001. Pregnant Sudanese women were given mefloquine 25 mg/kg for treatment of falciparum malaria following chloroquine failure. The women were followed every 2 weeks in the antenatal clinic until delivery. The babies were followed until the age of one year. Forty pregnant women were enrolled in the second and third trimesters. Itching which occurred in 17.5% and nausea which occurred in 35% were the cardinal side effects of the patients. Recrudescence or re-infection occurred on day 14 in one patient [2.5%]. One patient that received mefloquine at 34 weeks gestational age delivered low birth weight [2.1 kg] at 39 weeks gestational age. One child died at the age of 7 months due to unexplained febrile illness. There was no abortion, no stillbirth and no congenital abnormality in the newborn children and no maternal death. This relatively small study reported that mefloquine could be used safely for the treatment of malaria in the second and third trimester of pregnancy and a larger study is recommended

Manifestations of falciparum malaria in pregnant women of Eastern Sudan

This study was conducted to investigate the morbidity pattern of malaria during pregnancy in New Halfa Teaching Hospital, Eastern Sudan, where malaria transmission is unstable. Pregnant [or in the puerperium] women presented with symptoms of falciparum malaria to the hospital during the period of November 2002 to March 2003 were enrolled to the study. Their socio-demographic characters, physical examinations, especially manifestations of severe falciparum malaria were performed and data were recorded. Blood films for malaria, urine, hemoglobin and blood glucose were tested. Fifty-nine pregnant [or in the puerperium] women with falciparum malaria were presented in this study. The mean +/- SD gravidity was 3.3 +/- 2.1. Fourteen [23.7%] out of 59 patients presented with one or more manifestations of severe malaria according to the World Health Organization criteria. Severe anemia [5], pulmonary edema [4], jaundice [3], hypoglycemia [3] and hypotension [1] were the manifestations of the severe illness. In comparison to non-severe group, patients with severe illness have significantly higher temperature and significantly lower hemoglobin level. The other parameters were not significantly different between the 2 groups of patients. In the severe cases, one patient was presented with missed second trimester abortion and the 6/59 [10.2%] patients delivered prematurely 4 were in the severe form. There were 4 perinatal deaths all in the severe group and there was one maternal death due to pulmonary edema. In this locality not only primigravidae but all parities were infected with falciparum malaria and different manifestations of severity were detected. Higher perinatal mortalities were documented

Toxoplasmosis in pregnant Sudanese women

The aim of this study was to conduct a sero-epidemiological survey of toxoplasmosis in pregnant Sudanese women. Four hundred and eighty-seven pregnant women attending antenatal clinics in Khartoum and Omdurman, Maternity Hospitals, Sudan during the period June through to December 2000 were counselled for socio-demographic and obstetrical risk factors for toxoplasmosis, and screened for immunoglobin G [IgG] and IgM anti-toxoplasma antibodies using enzyme linked immunoassay. Immunoglobin G anti-toxoplasma antibodies were positive [titre > 11 IU/ml] in 166/487 [34.1%], while 321/487[65.9%] were sero-negative. The sera of 35 women showed very high titres [>100 IU/ml], 5/35 [14.3%] were IgM-positive. The risk factors for IgG anti-toxoplasma seropositivity were; Southern ethnic origin and consumption of raw meat. Thirty [18.1%] out of 166 women who were IgG anti-toxoplasma seropositive gave history of intrauterine fetal death, while 31 [9.7%] out of 321 women who were sero-negative gave history of intrauterine fetal death, the difference was statistically significant [P < 0.05]. Over 65% Sudanese women screened for anti-toxoplasma IgG antibodies were sero-negative and they were at risk of sero-conversion during pregnancy. Southers and eating raw meat were the risk factors for toxoplasmosis in Sudanese pregnant women