The underlying aetiologies of coma in febrile Sudanese children.

BACKGROUND: Cerebral malaria, acute bacterial meningitis and viral encephalitis are the main causes of fever and altered consciousness in the tropics. In areas where reliable laboratory testing is unavailable, over diagnosis and misdiagnosis of these conditions is likely. In malaria endemic countries non-malarial contributors to coma may be overlooked, overburdening available resources. The aim of this study is to evaluate the underlying causes of altered mental state in children presenting with fever and coma to tertiary medical facilities in Sudan. METHODS: Children over one month of age admitted to the emergency departments of three main hospitals in Khartoum with fever and coma were investigated for cerebral malaria, acute bacterial meningitis and Herpes simplex encephalitis during April to November 2011. RESULTS: One hundred and four children presenting with fever and coma were evaluated. Cerebral malaria was clinically suspected in 38 patients and 5 were confirmed. Acute bacterial meningitis was suspected in 63 patients and confirmed in 15. Herpes encephalitis was confirmed in only one case. There were five cases of mixed infection and the remainder were unknown. CONCLUSION: The clinical diagnoses of cerebral malaria, acute bacterial meningitis and viral encephalitis are unreliable. Further studies to evaluate the underlying causes of coma in febrile Sudanese children are warranted.

Cigarette smoking among medical students in The National Ribat University, Sudan.

The problem of smoking among medical students is common worldwide, but the pattern and extent of the problem varies from place to place. Data from Sudanese medical students is limited. The aims of study was to know the extent of the problem of smoking among medical students, its routes and how it can be reduced. All students in the first and fifth year in the Faculty of Medicine, The National Ribat University were asked to fill a questionnaire regarding their knowledge and practice of smoking and when they started smoking. The questionnaire inquired about the role of their peers and the staff to help them stop smoking. Two hundred and forty (96%) of the first year students and 174 (94 %) of the fifth year students responded by filling the questionnaires. Around 10 % of all students smoke. Although non-smokers knew much about the problems of smoking, many of the smokers did not. The main influence on students to start smoking was from parents, siblings and friends. Eighty per cent of the smokers are willing to give up smoking and they tried many times. The study showed that little effort was made by the University Staff to help students stop smoking. Most students started smoking in the high secondary schools. There is a need for family community and institutional campaign to contain the problem of smoking.