Search

Background: Medically unjustifiable caesarean section (CS) deliveries have been rising rapidly in many developed countries over the last three decades. While many developing countries show rates beyond optimal levels, few poorer countries appear to have sub-optimal obstetric care in relation to essential surgeries. The objective of this study is to document the rates of CS delivery, its time trend, and geographic and sociodemographic variability in Sudan.Methods: We utilized a number of Multiple Indicator Cluster Surveys (MICS) conducted in 2014, 2010, and 2006 to quantify CS rates per 1000 live births. We also documented absolute changes in rates over three-time points and variation in CS rates across geographic regions and areas of residence.Results: Over a decade, CS rates in Sudan increased steadily from 4.3% in 2006 to 6.7% in 2010 and 9.1% in 2014. During this period, CS rates varied considerably across regions showing higher rates in the Northern region (7-25%) and lower rates in Darfur (2-3%). Urban areas experienced rapidly increasing rates (6-14%), while rural areas showed negligible changes to absolute CS rates over time (5-7%). We also found geographic regions, maternal age, maternal education, receiving antenatal care, and birth order of the child were important determinants of CS in Sudan.Conclusion: Sudan may be facing a double burden of problems associated with surgical interventions for childbirth. While the wealthier parts of Sudan are experiencing a rapid surge in CS, some poor parts of rural Sudan may not be getting the essential surgical intervention for birth when mandated. Urgent improvement to obstetric care and the development of appropriate public health interventions that focus on regional disparities are warranted. [ABSTRACT FROM AUTHOR]

This study demonstrates the effect of cement dust on periodontal health among cement factory workers in Sudan. One-hundred exposed workers from Rabak Cement Factory and Algablain Quarry, besides 84 unexposed workers from Kosti River Transport Corporation were examined. The study was designed as retrospective cohort. The period of the study was three months. The exclusion and inclusion criteria were determined. A precoded pretested questionnaire was structured for collection of qualitative demographic and lifestyle characteristics. All objects were examined for the following clinical parameters: Tooth Wear (TW), Calculus (CAL), Plaque Index (PI), Gingival Index (GI), Probing Depth (PD), and Gingival Recession (GR). Significant differences (p < 0.05) in TW and CAL were recorded between the exposed and exposed groups. The exposed workers showed more TW (84.85%) and CAL (95.96%) than the unexposed workers (TW 46.43% and CAL 77.38%). For PI, GI, PD, and GR, no significant differences were observed. Poor utilization of protective measures was observed; the users of the exposed group represented 16.8–29.5%. Accordingly, statistically significant differences (p < 0.05) in clinical variables between users and nonusers of protective measures were observed. Among those who did not use protective measures, almost all the clinical variables tended to increase. The clinical results for nonusers in the exposed group were as follows: PI 0.93–1.03, GI 1.00–1.12, PD 0.35–0.38, GR 1.42–1.51, CAL 1.29–1.40, and TW 1.83–1.99. This was also true for oral hygiene methods used; where the increase in clinical variables were associated with users of methods other than the toothbrush and Miswak (twigs of Salvadora persica tree). Interestingly, smoking was observed to have synergistic effect with cement dust exposure, which is in agreement with the current opinions in this regard. [ABSTRACT FROM AUTHOR]

Background: In efforts to reduce neonatal mortality, the World Health Organization (WHO) has included breastfeeding among its recommended packages of interventions. Early initiation of breastfeeding and avoidance of prelacteal feeding are key contributors to optimal feeding practices. This study aims to assess the prevalence and associated factors of early breastfeeding practices in Sudan. Methods: This study utilises the cross-sectional nationally-representative Sudan Multiple Indicator Cluster Survey (MICS) conducted in 2014. The sample includes women who had a live birth in the two years before the survey and their self-report on early breastfeeding practices, namely early initiation and prelacteal feeding. Percentages of these early breastfeeding practices indicators were estimated accounting for the complex survey design. Multivariable logistic regression analyses were used to examine the factors associated with these outcomes. Results: Of 5622 mothers, 69% initiated breastfeeding within one hour of birth, 72% avoided prelacteal feeding in the first three days after birth, and 51% met the criteria for both (i.e. practised optimal early feeding practice). Optimal early feeding varied across regions of Sudan. Birth by caesarean section (Adjusted Odds Ratio [AOR] 0.34; 95% CI 0.25, 0.47) and at a health facility (AOR 0.75; 95% CI 0.60, 0.94) were negatively associated with optimal early feeding practice. Mothers with secondary education (AOR 1.62; 95% CI 1.30, 2.02), those who desired their pregnancy at the time (AOR 1.31; 95% CI 1.08, 1.60), those who were assisted by a skilled birth attendant at birth (AOR 1.48; 95% CI 1.19, 1.83), and those who gave birth to female infants (AOR 1.16; 95% CI 1.02, 1.33) had higher odds of use optimal early feeding practice. Similarly, the odds of optimal early feeding increased with parity and maternal age. Conclusions: Only half of Sudanese mothers practised optimal early feeding practice, with important differences between regions in the country. Early feeding practices in Sudan are associated with various maternal, child and community level factors. The findings suggest the need to develop breastfeeding promotion programs with consideration of regional variations and healthcare system interventions. [ABSTRACT FROM AUTHOR]

Background:Data on childhood epilepsy in Sudan are scarce and the only published study on its prevalence was published in 1983. This study aimed to determine the current prevalence of epilepsy in school children in Khartoum State. Methods:This is an analytical population-based, cross-sectional study conducted in Khartoum State, Sudan. The study included students in the basic (primary) schools aged 6–14 years. Simple random sampling was used to draw a cluster of four of the seven localities comprising Khartoum State. The sample frame consisted of 1609 public schools (808,624 pupils) and 787 private schools (194,613 pupils), a total of 2396 schools (1,003,237 pupils). A sample size of 75 940 pupils was estimated and 250 schools were drawn from a sample frame of 2396 schools using a stratified random sampling technique. Consent was obtained from the headmaster/head teacher of the selected schools who arranged a meeting with the tutor/teacher responsible for each class. The study team asked whether any of the pupils was ever noticed or known to have had any kind of seizures, and a confidential letter was sent to the parents of each identified pupil. The letter included an explanation of the aims of the study, information on the research group and the kind of help the research group could offer; contact numbers and email addresses were made available if they wished to participate in this study. Those who consented to participate were then given an appointment at the Epilepsy Outpatient Department, Gaafar Ibnauf Children’s Hospital, Khartoum where they were evaluated by the paediatric neurologist. Results:Altogether, 74,949 pupils were enrolled for the study, 398 of whom were identified initially as having seizures and 332 of whom (83.4%) were identified by a paediatric neurologist. Of the 332, 303 (91.3%) proved to have epileptic seizures, 250 (82.5%) were known to have epilepsy, and 53 (17.5%) were newly diagnosed during the survey. The male to female ratio was 1.5:1. The total prevalence of epilepsy in Khartoum State was estimated to be 4/1000. The highest prevalence was in Jabal Awliya Locality (4.87/1000) and the lowest was in Khartoum Locality (3.35/1000). Twenty-nine (8.7%) patients proved to have non-epileptic seizures. The majority (15, 51.6%) had psychogenic non-epileptic seizures, and four (13.6%) had syncope. The majority (171, 56.43%) of patients had generalised epilepsy, 109 (35.97%) had focal epilepsy, and 23 (7.6%) had unclassified epilepsy. Conclusion:The prevalence of epilepsy in school children in Khartoum State (4/1000) is higher than that reported previously from Khartoum Province in 1983 (0.9/1000). [ABSTRACT FROM PUBLISHER]

Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A study was conducted to determine the degree of tooth loss, factors influencing tooth loss, and the extent of prosthodontic rehabilitation in Sudanese adults (≥ 16 years old) attending outpatient clinics in Khartoum State. Pearson and multivariate analyses were used to examine the relationships between tooth loss and specific characteristics determined through interviews and clinical examinations. The mean number of missing teeth was 3.6 (SD, 4.9) and the prevalence of edentulism was 0.1%. The prevalence of tooth loss (missing at least one tooth) was 78%; 66.9% of tooth loss was due to caries, and 11.2% was attributable to other reasons. Prosthetic replacement of missing teeth was evident in 3%, whereas a need for prosthetic replacement was evident in 57%. Having < 20 teeth was associated with age, gender, and socioeconomic status; tooth loss due to caries was associated with age, tribe, frequency of tooth-brushing, and a low rate of dental consultation. Tooth loss due to other reasons was associated with age, tribe, education, periodontal pocketing, tobacco use, tooth wear, and prosthetic status. The results of the present study indicated that the major cause of tooth loss was dental caries, thus emphasizing the importance of a public prevention-based healthcare program. Replacement of missing teeth was uncommon in the study subjects, which may reflect lack of access to this type of oral healthcare. [ABSTRACT FROM AUTHOR]

Abstract: Complete cure of mycetoma is difficult to achieve and recurrence is common. The study objective was to determine the predictors of cure, amputation and follow-up dropout among the studied individuals with mycetoma. This prospective study included 1544 patients with confirmed mycetoma, of whom 1242 had eumycetoma and 302 actinomycetoma. They were treated and followed up regularly. Data were collected and analysed using logistic regression models to determine the predictors. In the eumycetoma group, longer treatment duration (OR=1.9; 95% CI 1.2–3.1) and absence of history of disease recurrence (OR=24.2; 95% CI 7.7–76.3) were significant predictors of increased odds of cure from mycetoma. A lesion size of 5–10cm (OR=0.5; 95% CI 0.3–0.8) or >10cm (OR=0.7; 95% CI 0.4–1.0) and combined medical treatment and surgery (OR=0.004; 95% CI 0.001–0.011) were each significant predictors of reduced odds of cure. Follow-up dropout among this group was high (54%). Large lesions (5–10cm, OR=0.5, 95% CI 0.4–0.7; >10cm, OR=0.6; 95% CI 0.5–0.9), amputations (OR=0.3; 95% CI 0.1–0.6) and longer treatment duration (OR=0.5; 95% CI 0.4–0.7) were significant predictors of reduced odds of follow-up dropout. In the actinomycetoma group, medical treatment was the only significant predictor of cure. Follow-up dropout among this group was also high (55.6%). Long treatment duration was a significant predictor of reduced odds of dropout (OR=0.5; 95% CI 0.3–0.8). There is a great demand for effective and efficient mycetoma treatment. Counselling and health education of patients is badly needed to encourage early reporting and treatment to reduce mycetoma''s medical, social and economic impacts. [Copyright &y& Elsevier]