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1.  Poor adherence to the World Health Organization guidelines of treatment of severe pneumonia in children at Khartoum, Sudan 
BMC Research Notes  2014;7(1):531.
Community-acquired pneumonia (CAP) is as a major cause for childhood morbidity and mortality worldwide. This study was conducted to investigate the adherence and response of the WHO guidelines for treatment of severe pneumonia.
A cross-sectional study was conducted in the period of June 2009 to July 2010 at Khartoum Hospital, Sudan. Children admitted and treated for severe pneumonia were enrolled.
Only 39 (18.8%) out of 208 enrolled children received prescriptions that were adherent to the WHO guidelines of treatment of severe pneumonia. In logistic regression none of the investigated variable (age, gender, and clinical presentations) was associated with the adherence to the WHO guidelines. There was no significant difference in the response between adherent and non-adherent prescriptions. There was no association between the demographic, clinical data, treatment-adherence to the guidelines and the patients’ response.
There is a poor (18.8%) adherence to the WHO guidelines of the treatment of severe pneumonia in the region regardless to the age, gender and clinical presentation.
PMCID: PMC4138373  PMID: 25123047
Pneumonia; Treatment; Adherence; Penicillin; Sudan
2.  Antenatal iron and folic acid supplementation use by pregnant women in Khartoum, Sudan 
BMC Research Notes  2014;7:498.
Anaemia during pregnancy can lead to adverse maternal and perinatal outcomes. The WHO recommends that all pregnant women in areas where anaemia is prevalent receive supplements of iron and folic acid. However, due to many factors, the use of iron and folic acid supplementation is still low in many countries. This study was conducted to assess the rates of iron-folic supplementation and the associated factors during pregnancy and the effects of taking iron-folic acid supplementation on rates of maternal anaemia and low birth weight (LBW) infants.
A cross-sectional study was conducted at Khartoum Hospital, Sudan. Enrolled women answered a questionnaire on socio-demographics characteristics, their pregnancy and delivery.
Of 856 women, 788 (92.1%) used iron-folic acid supplementation during pregnancy and 65.4% used folic acid. While place of residence, occupation and level of education were not associated with iron-folic acid usage, older age (OR = 3, CI = 1.4–6.3) and use of antenatal care (OR = 14.3, CI = 7.4–27.5) were associated with iron-folic acid use. Primiparity (OR = 3.8, CI = 1.9–7.6), maternal employment (OR = 3.9, CI = 2.25–6.77) and use of antenatal care (OR = 7.9, CI = 4.1–15) were the factors associated with folic acid. Using iron-folic acid was protective against anaemia (OR = 0.39, CI = 0.2–0.7) and LBW infants (OR = 0.3, CI = 0.17–0.68).
There was a high rate of iron-folic acid supplementation use among pregnant women in Khartoum, Sudan, which was beneficial in preventing anaemia in expectant mothers and infants of LBW.
PMCID: PMC4132242  PMID: 25099760
Folic acid; Iron; Pregnant women; Sudan
3.  Zinc and copper levels in low birth weight deliveries in Medani Hospital, Sudan 
BMC Research Notes  2014;7:386.
Low birth weight (LBW) is a worldwide health problem, especially in developing countries. We conducted a case–control study at Medani Hospital, Sudan. Cases were women who delivered a LBW (<2500 g) newborn and consecutive women who delivered a normal weight (>2500 g) newborn were controls. Questionnaires were used to collect clinical data. Zinc and copper levels were measured by an atomic absorption spectrophotometer.
The two groups (50 in each arm) were well matched in their basic characteristics. Median (25–75th interquartile range) maternal zinc (62.9 [36.3–96.8] vs. 96.2 [84.6–125.7] μg/dl; P <0.001) and copper (81.6 [23.7–167.5] vs. 139.8 [31.9–186.2] μg/dl; P = 0.04) levels were significantly lower in cases than in controls. Cord copper levels in cases were significantly lower than those in controls (108 [55.1–157.9] vs. 147.5 [84.5–185.2] μg/dl; P = 0.02). There were significant direct correlations between birth weight and maternal copper levels and maternal and cord zinc levels.
Maternal zinc and copper levels, as well as cord copper levels, are lower in LBW newborns than in those with normal weight.
PMCID: PMC4081538  PMID: 24958541
Zinc; Copper; Low birth weight; Sudan
4.  Low dose aspirin and low-molecular-weight heparin in the treatment of pregnant Libyan women with recurrent miscarriage 
BMC Research Notes  2014;7:23.
Recurrent miscarriage is a major women’s health problem. Aspirin and heparin have been shown to have potentially beneficial effects on trophoblast implantation. However, few published data on this issue are available from developing countries.
An open clinical trial was conducted at the Department of Obstetrics and Gynecology at Misurata Teaching Hospital in Libya from January 2009 to December 2010 to investigate the effects of treatment with low dose aspirin (LDA) versus treatment with low-molecular-weight-heparin (LMWH) in combination with LDA on patients with a history of recurrent miscarriages. A total of 150 women were enrolled in the study. Women were eligible for the study if they had a history of three or more consecutive miscarriages. Participants were randomly assigned to receive either LDA (75 mg daily) alone or a combination of LDA and LMWH (75 women per treatment group). The primary outcomes were the rate of miscarriages and live births for each group.
Compared with the group who received LDA alone, the combination group had a significantly lower number of miscarriages (22/75 [29%] vs. 43/75 [47%], P < 0.001) and had a significantly higher number of live births (53/75 [71%] vs. 32/75 [42%], P < 0.001). Two preterm infants in the LDA group and three in the combination group were admitted to the neonatal intensive care unit. There were no significant differences in the mean (SD) birth weights of neonates born in either group (2955.4 ± 560 vs. 3050 ± 540 g for the LDA and combination groups, respectively, P = 0.444). There were no congenital abnormalities detected in either group.
The combination of LDA and LMWH is better than LDA alone for the maintenance of pregnancy in patients with recurrent first trimester miscarriage.
Trial registration
PMCID: PMC3892062  PMID: 24405979
Low-molecular-weight heparin; Enoxaparin; Low dose aspirin; Recurrent miscarriage
5.  Accuracy of tympanic temperature measurement using an infrared tympanic membrane thermometer 
BMC Research Notes  2013;6:194.
During investigation and diagnosis of patients, accurate temperature measurement is of great importance. The advantages of tympanic membrane thermometry are speed (temperature reading available within seconds), safety, and ease of use. The aim of this study was to compare the accuracy of infrared tympanic thermometers in comparison to mercury thermometers in measurement of body temperature.
Axillary and tympanic temperature was measured simultaneously in consecutive patients using mercury glass and infrared tympanic thermometers at Omdurman Hospital, Sudan during October 2012.
In total, temperature was measured in 174 patients, 95 of whom (54.6%) were male. The mean (SD) patient age and weight was 33.18 (25.07) years and 52.13 (69.85) kg. There was no significant difference in mean (SD) temperature measurement between mercury and infrared tympanic membrane thermometers, 37.29°C (0.91) versus 37.38°C (0.95), P = 0.373, respectively. There was a significant positive correlation between axillary and tympanic body temperature measurements (r = 0.697, P < 0.001). The mean difference between the two readings (with limits of agreements) was - 0.093 (−0.20; 0.02) °C.
In this study, tympanic membrane thermometry is as reliable and accurate as axillary mercury glass thermometry. Thus, tympanic thermometry can be used in clinical practice, especially in the emergency setting, where ease of use and speed of obtaining the temperature reading are important.
PMCID: PMC3658932  PMID: 23663659
Tympanic membrane; Axillary temperature; Sudan; Infrared; Thermometry
6.  Intra-partum fever and cerebral palsy in Khartoum, Sudan 
BMC Research Notes  2013;6:163.
Cerebral palsy (CP) is a major cause of childhood disability. There are various maternal and neonatal predictors associated with the development of CP, and they are variable across different populations. This case–control study was designed to investigate maternal and neonatal predictors of CP at Khartoum pediatric neurology clinics. Data (maternal sociodemographic characteristics and neonatal expected predictors) were collected from mothers of children with CP and healthy controls using questionnaires.
One hundred and eleven cases of CP and 222 controls were included. Spastic CP was the most common type (69.4%). In logistic regression, maternal age, parity, birth weight, and sex were not associated with CP. However, maternal fever (OR = 8.4, CI = 2.3–30.5; P = 0.001), previous neonatal death (OR = 5.4, CI = 1.8–16.2; P = 0.003), and poor sucking (OR = 30.5, CI = 10.0–93.1; P < 0.001) were predictors of CP.
Fever during labor is a significant risk factor for developing CP in children. Further efforts are required for labor management to prevent CP in this setting.
PMCID: PMC3641995  PMID: 23618409
Cerebral palsy; Labor; Pregnancy; Sudan
7.  Prophylactic ceftizoxime for elective cesarean delivery at Soba Hospital, Sudan 
BMC Research Notes  2013;6:57.
A prophylactic antibiotic is recommended to reduce infection-related complication following cesarean delivery. There is a current debate on the time of prophylactic antibiotic in cesarean delivery.
An opened randomized, controlled clinical trial was conducted at Soba hospital, Sudan to investigate the timing (pre-incision or after clamping of the umbilical cord) of ceftizoxime for elective cesarean delivery. The outcome measures were; the incidence of post-cesarean febrile and infection-related morbidity and neonatal outcomes between the two groups.
Hundred –eighty women (90 women in each arm of the study) received intravenous injection of 1 g of ceftizoxime as single dose either at pre-incision or after clamping of the umbilical cord. None of the women in either group had endometritis. One woman in the pre-incision group had chest infection. There was no significant difference in the incidence of wound infection between the two groups, 8 (6.7%) vs. 3 (3.3%); P = 0.2. Two babies in the pre-incision group (P = 0.497) had a low Apgar score (< 8) at 1 min. Similar number of neonate (15 in each arm) was admitted to nursery. There were no significant difference in the neonatal jaundice between the two groups, 5 (5.5%) vs. 4 (4.4%), P = 0.2. There was no perinatal death.
There was no difference in the two regimens (pre-incision or post-clamping of the umbilical cord) of ceftizoxime as prophylactic for elective cesarean delivery.
Trial registration
PMCID: PMC3598675  PMID: 23394621
Prophylactic antibiotics; Ceftizoxime; Cesarean delivery; Sudan
8.  Anaemia among adults in Kassala, Eastern Sudan 
BMC Research Notes  2012;5:202.
The increased heterogeneity in the distribution of social and biological risk factors makes the epidemiology of anaemia a real challenge. A cross-sectional study was conducted at Kassala, Eastern Sudan during the period of January — March 2011 to investigate the prevalence and predictors of anaemia among adults (> 15 years old).
Out of 646, 234 (36.2%) adults had anaemia; 68 (10.5%); 129 (20.0%) and 37 (5.7%) had mild, moderate and severe anaemia, respectively. In logistic regression analyses, age (OR = 1.0, CI = 0.9–1, P = 0.7), rural vs. urban residency (OR = 0.9, CI = 0.7–1.3, P = 0.9), female vs. male gender (OR = 0.8, CI = 0.6–1.1, P = 0.3), educational level ≥ secondary level vs. < secondary level (OR = 1.0, CI = 0.6–1.6, P = 0.8) and Hudandawa vs. non-Hudandawa ethnicity (OR = 0.8, CI = 0.6–1, P = 0.1) were not associated with anaemia.
There was a high prevalence of anaemia in this setting, anaemia affected adults regardless to their age, sex and educational level. Therefore, anaemia is needed to be screened for routinely and supplements have to be employed in this setting.
PMCID: PMC3393610  PMID: 22537662
9.  Severe anaemia is associated with a higher risk for preeclampsia and poor perinatal outcomes in Kassala hospital, eastern Sudan 
BMC Research Notes  2011;4:311.
Anaemia during pregnancy is major health problem. There is conflicting literature regarding the association between anaemia and its severity and maternal and perinatal outcomes.
This is a retrospective case-control study conducted at Kassala hospital, eastern Sudan. Medical files of pregnant women with severe anaemia (haemoglobin (Hb) < 7 g/dl, n = 303) who delivered from January 2008 to December 2010 were reviewed. Socio-demographic and obstetric data were analysed and compared with a similar number of women with mild/moderate anaemia (Hb = 7-10.9 g/dl, n = 303) and with no anaemia (Hb > 11 g/dl, n = 303). Logistic regression analysis was performed separately for each of the outcome measures: preeclampsia, eclampsia, preterm birth, low birth weight (LBW) and stillbirth.
There were 9578 deliveries at Kassala hospital, 4012 (41.8%) women had anaemia and 303 (3.2%) had severe anaemia. The corrected risk for preeclampsia increased only in severe anaemia (OR = 3.6, 95% CI: 1.4-9.1, P = 0.007). Compared with women with no anaemia, the risk of LBW was 2.5 times higher in women with mild/moderate anaemia (95% CI: 1.1-5.7), and 8.0 times higher in women with severe anaemia (95% CI: 3.8-16.0). The risk of preterm delivery increased significantly with the severity of anaemia (OR = 3.2 for women with mild/moderate anaemia and OR = 6.6 for women with severe anaemia, compared with women with no anaemia). The corrected risk for stillbirth increased only in severe anaemia (OR = 4.3, 95% CI: 1.9-9.1, P < 0.001).
The greater the severity of the anaemia during pregnancy, the greater the risk of preeclampsia, preterm delivery, LBW and stillbirth. Preventive measures should be undertaken to decrease the prevalence of anaemia in pregnancy.
PMCID: PMC3224576  PMID: 21867566
10.  Use of family planning methods in Kassala, Eastern Sudan 
BMC Research Notes  2011;4:43.
Investigating use and determinants of family planning methods may be instructive in the design of interventions to improve reproductive health services.
Across sectional community-based study was conducted during the period February-April 2010 to investigate the use of family planning in Kassala, eastern Sudan. Structured questionnaires were used to gather socio-demographic data and use of family planning. The mean ± SD of the age and parity of 613 enrolled women was 31.1 ± 7 years and 3.4 ± 1.9, respectively. Only 44.0% of these women had previously or currently used one or more of the family planning methods. Combined pills (46.7%) and progesterone injection (17.8%) were the predominant method used by the investigated women. While age, residence were not associated with the use of family planning, parity (> five), couple education (≥ secondary level) were significantly associated with the use of family planning. Husband objection and religious beliefs were the main reasons of non-use of family planning.
Education, encouragement of health education programs and involvement of the religious persons might promote family planning in eastern Sudan.
PMCID: PMC3056802  PMID: 21356106
11.  Epidemiology of underweight and overweight-obesity among term pregnant Sudanese women 
BMC Research Notes  2010;3:327.
The increasing prevalence of obesity in young women is a major public health concern. Few data are available concerning the epidemiology of malnutrition especially obesity among pregnant women in the developing countries. A cross sectional study was conducted at Khartoum hospital during February-April 2008, to investigate prevalence of underweight, obesity, and to identify contemporary socio-demographic predictors for obesity among term pregnant women in Khartoum Hospital, Sudan. After taking an informed consent, a structured questionnaire was administered to each woman to gather information on educational level, age and parity. Maternal weight and height were measured and expressed as body mass index (BMI - weight (kg)/height (m) 2).
Out of 1690 term pregnant women, 628 (37.1%) were primigravidae, 926 (54.8%) had ≥ secondary educational level (minimum of 8 years) and 1445 (85.5%) were housewives. The mean (SD) of the age and parity were 27.2 (6.3) years and 2.0 (2.1) respectively. Out of these 1690 women, 94(5.5%) were underweight (BMI of ≤ 19.9 Kg/m2), 603 (35.6%) were overweight (BMI of 25 - 29.9 Kg/m2) and 328 (19.4%) were obese (BMI of ≥ 30 Kg/m2).
In multivariate analyses, obesity was positively associated with age (OR = 1.2, 95% CI = 1.0-1.1; P< 0.001), and with women's education (OR = 1.8, 95% CI = 1.2-2.7; P = 0.001). Obesity was positively associated with parity in univariate analyses only (OR = 1.1, 95% CI = 1.0-1.2; P = 0.02)
The high prevalence of obesity in these pregnant women represents a competing public health problem in Sudan. More research is needed.
PMCID: PMC3004927  PMID: 21134264
12.  Anaemia and low birth weight in Medani, Hospital Sudan 
BMC Research Notes  2010;3:181.
Reducing the incidence of Low birth weight (LBW) neonates by at least one third between 2000 and 2010 is one of the major goals of the United Nations resolution "A World Fit for Children". This was a case-control study conducted between August-October 2009 in Medani Hospital, Sudan to investigate the risk factors for LBW. Cases were mothers who delivered singleton baby < 2500 gm. Controls were mothers delivered singleton baby of ≥ 2500 gm.
Out of 1224 deliveries, 97 (12.6%) of the neonates were LBW deliveries. While maternal socio-demographic characteristics (age, parity and mother education) and anthropometrics measurements were not associated with LBW, lack of antenatal care (OR = 5.9, 95% CI = 1.4-24.4; P = 0.01) and maternal anaemia (OR = 9.0, 95% CI = 3.4-23.8; P < 0.001) were the main risk factor for LBW.
Thus, more care on antenatal care and nutrition may prevent LBW.
PMCID: PMC2907404  PMID: 20584294

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