Identification of an area predominantly endemic for childhood and adolescent visceral leishmaniasis in central Sudan

Mahamoud, Abdelhafeiz; Osman, Hussam A.; Abass, Elfadil; Agib, Atif el; Madi, Rubens Riscala; Semião-Santos, Saul J.; Harith, Abdallah el

doi:10.1016/j.actatropica.2017.11.010

Cited by 11 publications

(15 citation statements)

References 15 publications

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Section: Communicable Diseasesmentioning

confidence: 99%

“…Cutaneous leishmaniasis is widespread with 93% of the population considered at risk, but visceral disease is more geographically restricted to southern, eastern and central regions, with about 25% of the population considered at risk 30 31. Despite the large number of individuals at risk, the incidence is relatively low, and the WHO estimates there are approximately 3000 cases per year of visceral leishmaniasis and 3500 of cutaneous leishmaniasis 31. There have historically been outbreaks of cases associated with population movements from endemic parts of the country into previously non-endemic regions, although densities of both vector sandflies and reservoir animals (Nile rats) are additional determinants of incidence 31.…”

Section: Communicable Diseasesmentioning

confidence: 99%

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In transition: current health challenges and priorities in Sudan

et al. 2019

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A recent symposium and workshop in Khartoum, the capital of the Republic of Sudan, brought together broad expertise from three universities to address the current burden of communicable and non-communicable diseases facing the Sudanese healthcare system. These meetings identified common challenges that impact the burden of diseases in the country, most notably gaps in data and infrastructure which are essential to inform and deliver effective interventions. Non-communicable diseases, including obesity, type 2 diabetes, renal disease and cancer are increasing dramatically, contributing to multimorbidity. At the same time, progress against communicable diseases has been slow, and the burden of chronic and endemic infections remains considerable, with parasitic diseases (such as malaria, leishmaniasis and schistosomiasis) causing substantial morbidity and mortality. Antimicrobial resistance has become a major threat throughout the healthcare system, with an emerging impact on maternal, neonatal and paediatric populations. Meanwhile, malnutrition, micronutrient deficiency and poor perinatal outcomes remain common and contribute to a lifelong burden of disease. These challenges echo the United Nations (UN) sustainable development goals and concentrating on them in a unified strategy will be necessary to address the national burden of disease. At a time when the country is going through societal and political transition, we draw focus on the country and the need for resolution of its healthcare needs.

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Section: Communicable Diseasesmentioning

confidence: 99%

Section: Communicable Diseasesmentioning

confidence: 99%

In transition: current health challenges and priorities in Sudan

et al. 2019

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“…Sudan and South Sudan are dominated by VL and CL, with a man being a reservoir host [36] quite unique from the Indian type where canine act as reservoirs [7,37]. African Kala-azar, engulf South Sudan and Sudan with rare epidemiological characteristics of disease manifestation from other global types of Kala-azar [38], the distinctive feature is a primary initiation phase in the skin (Leishmanoma) [39] takes time before the onset of clinical symptoms [37].…”

Section: Ld Epidemiology and Disease Occurrence In South Sudan And Smentioning

confidence: 99%

“…Utmost importance for epidemiological identification of Sudanese kala-azar [38,39]. L. Donovani occurs in South Sudan, Sudan, and South Western Arabia with 2 forms of VL, CL or MCL [7]. Define by the reservoir of infection of animal or man sometimes both.…”

Section: Ld Epidemiology and Disease Occurrence In South Sudan And Smentioning

confidence: 99%

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Visceral Leishmaniasis: Evaluation of Diagnostic Tools, Therapeutic Regimens, and Associated Risk Factors in Areas with Frequent Outbreaks in South Sudan and Sudan: Case Reports and Review of Literature

Amanya¹,

Peng²

2018

J Trop Dis

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Introduction: Visceral leishmaniasis of genus Leishmania donovani is a known cause of Kala-azar, with an agent of Phlebotomus species. Other species of public health importance include Phlebotomus-martini that engulfed South Sudan bordering counties with Kenya whereas Phlebotomus-orientalis dominates northern parts of South Sudan and Sudan. It exhibits rare behavioral characteristics of outer door bites. Among Eastern African countries, South Sudan is a highly endemic area where more than 1/3 of the population is at risks of infections. This review aimed to evaluate the current diagnosis, treatment and risk factors associated with epidemics and mortality due to Visceral Leishmaniasis in Sudan and South Sudan. Methodology and Objective:Literatures published in SCI Journals, pub med, and science direct, Google, WHO reports, MSF, and CDC websites were searched starting from 1945 to 2018. Visceral leishmaniasis/VL diagnostic tools, treatment regimens, and associated risk factors were the keywords used during browsing. Details referred to Given Figures in the methodology section.Findings: Several risk factors contributed to the frequency of VL outbreaks. Chronic wars, malnutrition and settlement in areas infested by the sand fly, co-infections with either HIV or Hepatitis an emerging public health concern. Government efforts to control and eliminates the vectors of VL are lacking with negligible resources allocation. Acacia trees are proved to harbor sand fly as resting and hiding places. K39/K26 or rk39/rk28 dipstick is a field base diagnostic tool commonly used. Treatments with liposomal AmporicinB, sodium stibogluconate plus paromomycin are recommended for use in South Sudan. This review also revealed that areas formerly free from Kala-azar had experience recurrent epidemic.Conclusion: VL in South Sudan remains highly isolated from clinical diagnosis, treatment, and control strategies. Routine data for surveillance is also an absence. National guidelines and protocols for treatment, and vector control remain at standstill. The level of resistance of visceral Leishmania parasites to the available anti-leishmanial drugs required more researches. There is a close relationship between frequent VL outbreaks and internal conflicts, poor malnutrition, poverty and displacement to high transmission zones, individuals who are new in sand fly infested areas are at greater risks, including children, elderly and pregnant women.

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Are We Now Well Prepared for Another Major Visceral Leishmaniasis Epidemic in Sudan?

Harith

Mahamoud

Awad

et al. 2019

Open Forum Infectious Diseases

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To minimize the chance for future visceral leishmaniasis (VL) epidemics such as the 1988–1991 epidemic in Sudan, several VL detection tools have been introduced. There are many VL diagnostics with excellent sensitivities, specificities, and ease of use reported. However, additional test characteristics should be considered for use in the detection of future VL epidemics. The potential for local production or uninterrupted availability, low production and application costs, and stability at ≥45°C are of the utmost importance. Of the antibody-, antigen-, or DNA-based methods introduced, only a liquid direct agglutination test (LQ-DAT) remains in routine use. The LQ-DAT test may be the ideal diagnostic for detection of VL epidemics due to its low cost ($0.50/patient), stability under frequent and long-duration electric failures, and high level of reproducibility. The improved reliability for VL detection achieved locally through incorporating autochthonous L. donovani strains in antigen processing and precluding toxicants in test execution provides optimal sensitivity and safety for routine and mass application.

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Identification of an area predominantly endemic for childhood and adolescent visceral leishmaniasis in central Sudan

Cited by 11 publications

References 15 publications

In transition: current health challenges and priorities in Sudan

In transition: current health challenges and priorities in Sudan

Visceral Leishmaniasis: Evaluation of Diagnostic Tools, Therapeutic Regimens, and Associated Risk Factors in Areas with Frequent Outbreaks in South Sudan and Sudan: Case Reports and Review of Literature

Are We Now Well Prepared for Another Major Visceral Leishmaniasis Epidemic in Sudan?

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