Concomitant Outbreaks of Yellow Fever and Hepatitis E Virus in Darfur States; Sudan; 2012

Introduction: Yellow fever (YF) is a vector-borne disease transmitted to humans by infected Aedes mosquitoes; while hepatitis E virus (HEV) is a waterborne disease that is transmitted through the fecal-oral route. Both diseases have very close clinical presentation; namely fever; jaundice; malaise; and dark urine; they differ in severity and outcome.Methodology: In this cross-sectional; laboratory-based study; an attempt was made to measure the correlation of concomitant YF and HEV infection in Darfur States during the previous YF outbreak in 2012.Results: Results found concomitant outbreaks of YF and HEV at the same time with very weak statistical correlation between the two infections during the outbreak period; with Cramer's V correlation 0.05 and insignificant p value of 0.86.Conclusions: This correlation indicates that clinicians and care providers in tropical areas have to deal with clinical case definitions used for disease surveillance very carefully since prevalence of HEV infection is relatively common and this increases the possibility of misclassification and missing YF cases; particularly initial index cases; in a season or outbreak

Sero-prevalence of dengue infections in the Kassala state in the eastern part of the Sudan in 2011

Dengue fever is a vector-borne disease that is transmitted to humans by infected Aedes aegypti mosquitoes. The eastern part of the Sudan is one of the regions that is affected by dengue virus circulation. In this study, we estimated the prevalence of dengue infections in the Kassala state in the eastern part of the Sudan. The study objective was to estimate the sero-prevalence of dengue IgG/IgM antibodies in the Kassala locality in 2011. This was a cross sectional community-based study that utilized a multi-stage cluster sampling technique regarding the probability sampling the study participants. Capture ELISA serological techniques were used for both IgM and IgG, with the specific cut-offs for each set by the manufacturer. The prevalence of dengue infection was found to be 9.4% [95% CI: 7.1-12.3]. In conclusion, there is evidence that the dengue virus is being transmitted in Kassala. Disease surveillance, including the clinical, serological and entomological components, should be strengthened, and additional epidemiological studies are needed to better understand of the disease burden and effects in the area

Factors associated with dengue fever IgG sero-prevalence in south Kordofan state, Sudan, in 2012: Reporting prevalence ratios

Dengue fever [DF] is a vector-borne virus transmitted to humans by infected Aedes mosquitoes. In this study, we identified the most important factors associated with the prevalence of IgG antibodies in a border state between Sudan and the new republic of South Sudan. To quantify the association of specific factors with the prevalence of DF IgG antibodies in Lagawa among subjects aged 16-60 years in 2012. Analytical cross-sectional community-based study conducted in Lagawa in 2012. Indoor mosquito breeding was the most significant predictor affecting DF IgG serology. Household water storage was also strongly associated with the presence of IgG antibodies. Residence in urban areas, younger age and a history of travel to the Red Sea State were significant predictors of DF IgG seroprevalence in South Kordofan state. Indoor [household] behaviors associated with DF infection should be modified to mitigate the infection risk in the study area. Awareness should be raised regarding DF in Lagawa to ensure community participation in all control measures, and the surveillance system at the border between Sudan and the republic of South Sudan should be strengthened

Yellow Fever outbreak in Darfur, Sudan in October 2012; the initial outbreak investigation report

Sudan is subject to repeated outbreaks, including Viral Hemorrhagic Fever [VHF], which is considered to be a very serious illness. Yellow Fever [YF] outbreaks in Sudan have been reported from the 1940[s] through 2005. In 2012, a new outbreak of YF occurred in the Darfur region. To identify the potential for an outbreak, to diagnose the disease and to be able to recognize its cause among the initial reported cases. >This is a descriptive and investigative field study that applies standard communicable disease outbreak investigation steps. The study involved clinical, serological, entomological and environmental surveys. The field investigation confirmed the outbreak and identified its cause to be YF. National surveillance systems should be strong enough to detect VHF[s] in a timely manner. Local health facilities should be prepared to promptly treat the initial cases because the case fatality ratios [CFRs] are usually very high among the index cases