Recurrent malaria infection in Khartoum state, Sudan

The study aimed to investigate the underlying causes of recurrent malaria infection in Khartoum State. This study was conducted in El Haj Yousif a pen-urban area in the northeast border of Khartoum state in the period August 1998 -December 2000, it was a prospective, clinically based study. Three hundred patients presenting with recurrent malaria were studied. Eighty three percent of the patients were found to have P. falciparum, 10% have mixed infection [P. falciparum and P. vivax], 5% have P. vivax only and 2% of cases have P. ovale. Unlike what is generally believed not all recurrent malaria in Khartoum State was due to recrudescence of the primary infection, [incomplete treatment or drug resistance or re-infection]. A significant proportion was due to relapse from persistent hypnozoites [P. vivax and P. ovale] in the liver, relapses of which can be prevented by eradication of the liver hypnozoites by primaquine therapy. This was confirmed by the malaria parasite identification and count which was done on the blood samples

Quinine therapy in severe Plasmodium falciparum malaria during pregnancy in Sudan

A prospective study was carried out in an area of unstable malaria transmission in central Sudan to determine the efficacy and toxicity of quinine in pregnancy. Thirty-three pregnant women with severe Plasmodium falciparum malaria at mean 28.8 weeks gestational age were treated with quinine for 7 days. The mean body temperature on presentation for 3 patients who delivered prematurely was significantly higher than for those who delivered at term [39.2 +/- 0.7 degrees C versus 38.7 +/- 1.3 degrees C]. There were no significant difference between the 2 groups in other clinical or biochemical parameters. There were no clinically detectable congenital malformations and no auditory, visual or other neurological deficits in the babies at birth or 6 months later. Quinine may be safe in the treatment of severe falciparum malaria during pregnancy

Approaches to the control and elimination of the clinically important filarial diseases

Mass drug administration programs are the mainstay of current attempts to control and rid the globe of the two major filarial diseases of humans, onchocerciasis and lymphatic filariasis. There are a number of important components to developing and maintaining a treatment program; these include advocacy, communication, financial support, and the presence of local "champions" to lead the program. Two active country programs -lymphatic filariasis elimination in Tanzania and onchocerciasis control in Sudan -provide practical examples of these program needs. There are a number of positive consequences of a successful program that extend outside the primary goal of disease control or elimination; these include national infrastructure and personnel development. The challenges and consequent actions that could be taken to ensure the success of control programs are discussed