Hepatitis B chronic infection among pregnant women attending the antenatal care in Bor State Referral Hospital, South Sudan

Introduction: Hepatitis B virus (HBV) is a major public health problem affecting 400 million people worldwide, and is a common cause of chronic liver failure (cirrhosis) and hepatocellular carcinoma. Sixty-eight percent of infected people are from the African and Pacific regions. Vertical transmission from mother to newborn baby is one of the mechanisms by which chronic hepatitis virus infection spreads, besides infections from contaminated needles and syringes and sexual contact. Hepatitis B chronic infection is endemic in many poor countries, especially in Africa. Method: A cross-sectional study was conducted between July and August 2021. Pregnant women attending the antenatal care (ANC) in Bor State referral hospital, South Sudan, were interviewed to collect information on their socio-demographic characteristics and risk factors for hepatitis B infection. The objective was to determine the seroprevalence of hepatitis B chronic infection through blood testing. Prevalence ratios for certain risk factors were calculated. Results: Two hundred pregnant women were enrolled. The Prevalence Rate for chronic infection with hepatitis B virus, diagnosed using the rapid immune-chromatographic assay for Hepatitis B surface antigen (HBsAg), was 8.5%. (95% CI; 4.7% - 12.3%). None of the suspected risk factors studied were found to be significantly associated with testing positive for HBV, except for a history of previous jaundice. Conclusion: The prevalence of HBV chronic infection among pregnant women in Bor, Jonglei State, is high hence there is a need for established public health interventions that can lead to a reduction of HBV vertical transmission. Treatment of pregnant women with HBV chronic infection using anti-viral medications during pregnancy might curb the vertical transmission rates.

Roles of local healthcare workers in the humanitarian response in South Sudan: a literature review

Introduction: Armed conflict is devastating to the health system, is a public health concern and recovery is an enormous challenge. The independence of South Sudan in 2011 brought much hope. However, eight years later, the country is still at conflict with itself. Although rich in resources, it is ranked among the poorest in the world and depends on donor funding for most service delivery, especially health. In an international context, promoting the localisation of humanitarian aid and the integration of health services, there is a lot to learn from the roles being played by healthcare workers (HCWs) throughout the conflict in South Sudan. Method: A literature review was conducted to identify the roles of local HCWs in South Sudan since 2011. Four databases were searched, grey literature sourced, and snowballing done to capture additional documents for a comprehensive analysis. Questions were adapted from the Critical Appraisal Skills Programme for qualitative and systematic reviews guided appraisals of the articles. Results were systematically coded, synthesised and summarised using a priori and emergent themes. Results: The health system in South Sudan is very fragmented with heavy dependence on humanitarian aid. There is serious shortage in health workforce with heavy reliance on unskilled workers to fill in the gaps, mainly in rural settings. Although close collaboration exists among different stakeholders to deliver integrated services, poor infrastructure, insecurity, lack of capacity and donor dependency still poses a challenge towards localisation of aid and sustainability. Conclusions: The literature reviewed for this study indicates that the road towards localisation of health care is possible but will depend highly on continued collaboration between the different contributors, integration of services, building capacity of the nationals, increased government funding and infrastructural development. Local involvement of HCWs by international agencies is paramount in ownership and sustainability of services.

Efficacy of sequential administration of artesunate and artesunate-amodiaquine for the treatment of falciparum malaria in South Sudan / 新乡医学院学报

Objective To investigate the efficacy of sequential administration of artesunate injection and artesunateamodiaquine tablets for the treatment of falciparum malaria in South Sudan.Methods The clinical data of thirty-one patients with falciparum malaria in Level One Hospital of the Chinese Peacekeeping Infantry Battalion from April 2016 to July 2017 were analyzed retrospectively.All patients were administered artesunate injection (120 mg for the first time,60 mg 4 h later,then 60 mg once daily) by intramscular injection for 1-3 d.The patients took orally artesunate-amodiaquine tablets (2 tablets) at 24,48,72 h after the body temperature restored to normal (totally 6 tablets).The efficacy of this sequential treatment for falciparum malaria was observed.Results The total cure rate of the 31 falciparum malaria patients was 100.0％ (31/31);the cure rate of patients after 3 days treatment was 90.3％ (28/31) and the cure rate of patients after 3-6 days treatment was 9.7％ (3/31).Mild side effects,such as nausea,vomiting,anorexia,abdominal distension,diarrhea or dizziness were observed in 4 patients (12.9％) and all these symptoms disappeared after the end of treatment.Conclusion The sequential administration of artesunate injection and artesunate-amodiaquine tablets has optimal curative efficacy on falciparum malaria in South Sudan,and the tolerance is well.

Study of thyroid and corticosteroid hormone in peacekeepers for South Sudan / 中国基层医药

Objective To observe level of thyroid and corticosteroid hormone of peacekeepers in South Sudan the harsh environment under stress and explore the changes of hormone and its related causes the body to suffer stress.Methods 25 peacekeepers were drawn blood before going abroad,after going abroad 1 months,4 months and 7 months,respectively.Methods of immune by magnetic separation were adopted and determined the changes of thyroid hormone and cortisol levels.They were compared with before going abroad.Results After going abroad 1 months T3 (1.780 ±0.345)ng/mL,T4 (88.609 ±14.486)ng/mL,FT3 (3.758 ±4.287)pg/mL,FT4 (15.152 ±6.422)pg/mL than before going abroad (1.458 ±0.206)ng/mL,(2.060 ±0.642)ng/mL,(11.672 ±3.627)pg/mL,(96.958 ± 12.286)pg/mL were significantly increased (t =3.670,2.410,2.019,2.798,all P <0.0 ).TSH (1.320 ± 0.518)μIU /mL after going abroad 4 months was lower than before going abroad(1.872 ±0.821)μIU /mL decreased significantly(t =3.175,P <0.05).Conclusion In the role of the environment change of stress factors,changes of thyroid hormone and cortisol levels of body were obvious.We suggest to make countermeasure as soon as possible and appropriate intervention.At the same time the peacekeepers are detected comprehensive hormone detection and psy-chological counseling before going abroad,it is significant for the successful completion of peace -keeping task.