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Ebogo-Belobo JT, Kenmoe S, Mbongue Mikangue CA, Tchatchouang S, Robertine LF, Takuissu GR, Ndzie Ondigui JL, Bowo-Ngandji A, Kenfack-Momo R, Kengne-Ndé C, Mbaga DS, Menkem EZ, Kame-Ngasse GI, Magoudjou-Pekam JN, Kenfack-Zanguim J, Esemu SN, Tagnouokam-Ngoupo PA, Ndip L, Njouom R. Systematic review and meta-analysis of seroprevalence of human immunodeficiency virus serological markers among pregnant women in Africa, 1984-2020. World J Crit Care Med 2023; 12:264-285. [PMID: 38188451 PMCID: PMC10768416 DOI: 10.5492/wjccm.v12.i5.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/19/2023] [Accepted: 11/08/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) is a major public health concern, particularly in Africa where HIV rates remain substantial. Pregnant women are at an increased risk of acquiring HIV, which has a significant impact on both maternal and child health. AIM To review summarizes HIV seroprevalence among pregnant women in Africa. It also identifies regional and clinical characteristics that contribute to study-specific estimates variation. METHODS The study included pregnant women from any African country or region, irrespective of their symptoms, and any study design conducted in any setting. Using electronic literature searches, articles published until February 2023 were reviewed. The quality of the included studies was evaluated. The DerSimonian and Laird random-effects model was applied to determine HIV pooled seroprevalence among pregnant women in Africa. Subgroup and sensitivity analyses were conducted to identify potential sources of heterogeneity. Heterogeneity was assessed with Cochran's Q test and I2 statistics, and publication bias was assessed with Egger's test. RESULTS A total of 248 studies conducted between 1984 and 2020 were included in the quantitative synthesis (meta-analysis). Out of the total studies, 146 (58.9%) had a low risk of bias and 102 (41.1%) had a moderate risk of bias. No HIV-positive pregnant women died in the included studies. The overall HIV seroprevalence in pregnant women was estimated to be 9.3% [95% confidence interval (CI): 8.3-10.3]. The subgroup analysis showed statistically significant heterogeneity across subgroups (P < 0.001), with the highest seroprevalence observed in Southern Africa (29.4%, 95%CI: 26.5-32.4) and the lowest seroprevalence observed in Northern Africa (0.7%, 95%CI: 0.3-1.3). CONCLUSION The review found that HIV seroprevalence among pregnant women in African countries remains significant, particularly in Southern African countries. This review can inform the development of targeted public health interventions to address high HIV seroprevalence in pregnant women in African countries.
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Affiliation(s)
- Jean Thierry Ebogo-Belobo
- Center for Research in Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
| | | | | | | | - Guy Roussel Takuissu
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | | | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon
| | - Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaounde 00237, Cameroon
| | - Cyprien Kengne-Ndé
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala 00237, Cameroon
| | - Donatien Serge Mbaga
- Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon
| | | | - Ginette Irma Kame-Ngasse
- Center for Research in Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde 00237, Cameroon
| | | | | | - Seraphine Nkie Esemu
- Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
| | | | - Lucy Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon
| | - Richard Njouom
- Department of Virology, Centre Pasteur du Cameroun, Yaounde 00237, Cameroon
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Badawi MM, Atif MS, Mustafa YY. Systematic review and meta-analysis of HIV, HBV and HCV infection prevalence in Sudan. Virol J 2018; 15:148. [PMID: 30253805 PMCID: PMC6157049 DOI: 10.1186/s12985-018-1060-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 09/19/2018] [Indexed: 02/07/2023] Open
Abstract
Viral hepatitis constitutes a global health problem; previous studies have affirmed a considerable morbidity and mortality from both acute infections and chronic complications. On the other hand, Human Immunodeficiency Virus (HIV) infection is also of known burden. Determining prevalence measures of these viruses is crucial for establishing appropriate country specific strategies regarding prevention, diagnosis, and containment. This systematic review was aimed to provide pooled seroprevalence estimates of the three viruses in Sudan. Structured review of the literature was conducted to obtain relevant studies published in both national and international databases. After assessment of quality and bias in all proposed studies, 57 prevalence studies were included. Meta-analysis was conducted for all studies and subgroup analysis was also approached. The total sample size of participants in included studies providing HIV antibodies prevalence was 15,479. Based on information retrieved from these studies, HIV prevalence ranged from 0 to 18.3% among different study populations. However, pooled prevalence estimate for HIV antibodies was 1%. Kassala, Eastern Sudan was the most endemic State (4.18%). The HBV reported seroprevalence rates ranged from 5.1 up to 26.81% among different populations and the overall pooled prevalence was 12.07%. For HCV antibodies; 2.74% was determined to be the pooled prevalence. Khartoum State was the most endemic State of both HBV and HCV with seroprevalence of 12.69% and 6.78%, respectively.Based on data reviewed and synthesized; there is no evidence for an HIV endemic in the general population of Sudan. However, both HBV and HCV seroprevalence rates are indicating otherwise. Reducing the overall burden of HIV, HBV and HCV infections will require new measures and national strategies and the recognition of the infections as one of the country's priority issues.
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Affiliation(s)
- M. M. Badawi
- Medical Microbiology department, Faculty of Medical Laboratory Sciences, Elrazi University, Khartoum, Sudan
| | - M. S. Atif
- Medical Microbiology department, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
| | - Y. Y. Mustafa
- Medical Microbiology department, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
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3
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Mustafa A, Bilal NE, Abass AE, Elhassan EM, Adam I. The association between Helicobacter pylori
seropositivity and low birthweight in a Sudanese maternity hospital. Int J Gynaecol Obstet 2018; 143:191-194. [PMID: 30092620 DOI: 10.1002/ijgo.12641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/05/2018] [Accepted: 08/06/2018] [Indexed: 01/18/2023]
Affiliation(s)
- Ahmed Mustafa
- Faculty of Medicine; University of Khartoum; Khartoum Sudan
| | - Naser E. Bilal
- Faculty of Medical Laboratory Sciences; University of Khartoum; Khartoum Sudan
| | - Awad-Elkareem Abass
- Faculty of Medical Laboratory Sciences; University of Khartoum; Khartoum Sudan
| | | | - Ishag Adam
- Faculty of Medicine; University of Khartoum; Khartoum Sudan
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Elkheir SM, Babiker ZO, Elamin SK, Yassin MI, Awadalla KE, Bealy MA, Agab Eldour AA, Alloba FE, Atabani SF, Osman HK, Babiker AG, Herieka EA. Seroprevalence of maternal HIV, hepatitis B, and syphilis in a major maternity hospital in North Kordofan, Sudan. Int J STD AIDS 2018; 29:1330-1336. [PMID: 30049254 DOI: 10.1177/0956462418784687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Routine infectious diseases screening of Sudanese pregnant women has been patchy due to scarcity of healthcare resources and social stigma. We sought to determine the seroprevalence of HIV, hepatitis B, and syphilis among pregnant women attending antenatal care (ANC) at El Obeid Maternity Hospital in western Sudan. We also explored the association between these infections and a set of socio-demographic and maternal variables. Unlinked anonymous testing for HIV-1/2 antibodies, hepatitis B surface antigen, and Treponema pallidum antibodies was performed on residual blood samples collected during routine ANC (August 2016-March 2017). Seroprevalence of HIV was 1.13% (5/444; 95% CI 0.37-2.61%), hepatitis B 2.93% (13/444; 95% CI 1.57-4.95%), and syphilis 7.43% (33/444; 95% CI 5.17-10.28%). On bivariate analysis, there were no statistically significant associations between hepatitis B, syphilis, or a composite outcome including any of the three infections and age, stage of pregnancy, gravidity, parity, previous mode of delivery, history of blood transfusion, or husband polygamy. Urgent action is needed to scale up routine maternal screening for HIV, hepatitis B, and syphilis on an opt-out basis. Further research into the socio-demographic and behavioural determinants of these infections as well as their clinical outcomes is needed.
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Affiliation(s)
- Sirelkhatim M Elkheir
- 1 Department of Obstetrics and Gynaecology, El Obeid Maternity Hospital, El Obeid, Sudan
| | - Zahir Oe Babiker
- 2 Sudan HIV/AIDS Working Group (SHAWG), Glasgow, UK.,3 Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Sabah K Elamin
- 1 Department of Obstetrics and Gynaecology, El Obeid Maternity Hospital, El Obeid, Sudan
| | - Mohammed Ia Yassin
- 1 Department of Obstetrics and Gynaecology, El Obeid Maternity Hospital, El Obeid, Sudan.,4 Department of Obstetrics and Gynaecology, Faculty of Medicine & Health Sciences, University of Kordofan, El Obeid, Sudan
| | - Khidir E Awadalla
- 1 Department of Obstetrics and Gynaecology, El Obeid Maternity Hospital, El Obeid, Sudan.,4 Department of Obstetrics and Gynaecology, Faculty of Medicine & Health Sciences, University of Kordofan, El Obeid, Sudan
| | - Mohamed A Bealy
- 5 Diagnostic Centre, Faculty of Medicine & Health Sciences, University of Kordofan, El Obeid, Sudan
| | - Ahmed A Agab Eldour
- 6 Department of Pathology, Faculty of Medicine & Health Sciences, University of Kordofan, El Obeid, Sudan
| | - Fath E Alloba
- 2 Sudan HIV/AIDS Working Group (SHAWG), Glasgow, UK.,7 The Liverpool Centre for Sexual Health, Royal Liverpool University Hospital, Liverpool, UK
| | - Sowsan F Atabani
- 2 Sudan HIV/AIDS Working Group (SHAWG), Glasgow, UK.,8 Public Health Laboratory Birmingham, National Infection Service, Heart of England Foundation NHS Trust, Birmingham, UK
| | - Husam Ke Osman
- 2 Sudan HIV/AIDS Working Group (SHAWG), Glasgow, UK.,8 Public Health Laboratory Birmingham, National Infection Service, Heart of England Foundation NHS Trust, Birmingham, UK
| | - Abdel G Babiker
- 2 Sudan HIV/AIDS Working Group (SHAWG), Glasgow, UK.,9 MRC Clinical Trials Unit at University College London, London, UK
| | - Elbushra Am Herieka
- 2 Sudan HIV/AIDS Working Group (SHAWG), Glasgow, UK.,10 Department of Genitourinary Medicine, Royal Bournemouth Hospital, Bournemouth, UK
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5
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Ahmed MA, Sharif ME, Rayis DA, Nasr AM, Adam I. Hepatitis B infection and preeclampsia among pregnant Sudanese women. Virol J 2018; 15:20. [PMID: 29357885 PMCID: PMC5778691 DOI: 10.1186/s12985-018-0927-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/09/2018] [Indexed: 12/16/2022] Open
Abstract
Background Previous published studies have reported conflicting results of association between hepatitis B virus (HBV) infection and preeclampsia. There was no published data on HBV and preeclampsia in Africa including Sudan. The aim of the present study was to investigate the association between HBsAg seropositivity and preeclampsia. Methods A case –controls study (200 women in each arm) was conducted at Saad Abualila Maternity Hospital, Khartoum, Sudan. The cases were women with preeclampsia and the controls were healthy pregnant women. Socio-demographic characteristics were gathered using questionnaire and HBsAg was investigated using an ELISA. Results There was no significant difference between the cases and the controls in their age, parity, residence, education and blood groups. The majority of the cases were mild preeclampsia (159; 79.5%). In comparison with the controls, a significantly higher number of the cases were HBsAg seropositive [30 (15.0%) vs.12 (6.0%), P = 0.005]. In binary regression women with HBsAg seropositive were at higher risk of preeclampsia than women who were HBsAg seronegative (OR = 2.86, 95%, CI = 1.41–5.79, P = 0.003). Conclusion In the current study HBsAg seropositivity is associated with preeclampsia. Preventive measure should be implemented.
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Affiliation(s)
- Mohamed A Ahmed
- Faculty of Medicine, University of Khartoum, P. O. Box 102, Khartoum, Sudan
| | - Manal E Sharif
- Faculty of Medicine Al-Neelain University, Khartoum, Sudan
| | - Duria A Rayis
- Faculty of Medicine, University of Khartoum, P. O. Box 102, Khartoum, Sudan
| | - Abubakr M Nasr
- Faculty of Medicine, University of Khartoum, P. O. Box 102, Khartoum, Sudan
| | - Ishag Adam
- Faculty of Medicine, University of Khartoum, P. O. Box 102, Khartoum, Sudan.
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Adam I, Ehassan EM, Mohmmed AA, Salih MM, Elbashir MI. Decreased susceptibility to placental malaria in anaemic women in an area with unstable malaria transmission in central Sudan. Pathog Glob Health 2013; 106:118-21. [PMID: 22943548 DOI: 10.1179/2047773212y.0000000011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
The interaction between iron level, iron supplementation, and susceptibility to infection, including malaria, remains a concern. A cross-sectional study was conducted at Medani hospital in central Sudan to investigate the relationship between anaemia and placental malaria. Obstetrical history was obtained; haemoglobin levels were determined. Placental tissue was obtained and malaria histology classified as active, chronic, past or no malaria infection. Among 324 women investigated, 7 (2·2%), 4 (1·2%), and 44 (13·6%) of the placentae showed active, chronic and past infection on histology examination respectively, while 269 (83·0%) of them showed no infection. Anaemia (haemoglobin <11 g/dl) was less frequent in women with placental Plasmodium falciparum infection, 27/55 (49·1%) vs 174/269 (64·7%), P=0·02. Anaemia was associated with a decreased risk for placental malaria, and the odds ratio for placental malaria (in both primiparae and multiparae group) was 0·2, 95% CI: 0·1-0·6, P=0·002 and it was 0·2, 95% CI: 0·03-0·7; P=0·02 for primiparae group. Thus, there is a strong relationship between anaemia and the absence of placental malaria.
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Affiliation(s)
- Ishag Adam
- University of Khartoum, Khartoum, Sudan.
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7
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Schistosoma mansoni infection among prenatal attendees at a secondary-care hospital in central Sudan. Int J Gynaecol Obstet 2011; 116:10-2. [PMID: 22036060 DOI: 10.1016/j.ijgo.2011.08.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 08/28/2011] [Accepted: 10/03/2011] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the epidemiology of Schistosoma mansoni infection among pregnant women in a secondary-care hospital in Geizera state, Sudan. METHOD Between August and September 2010, a cross-sectional study was conducted and questionnaires were administered to obtain basic sociodemographic and obstetric characteristics of pregnant women attending prenatal care at Araba Waeshreen Hospital. Stool samples were investigated for helminth infection via formol-ether concentration and Kato-Katz techniques. RESULTS Of 292 pregnant women, 38 (13.0%) had S. mansoni infections. Hymenolepis nana and hookworm infections were present in 5 (1.7%) and 1 (0.3%) women, respectively. The intensity of the S. mansoni infection was light, moderate, and high in 13 (34.2%), 21 (55.3%), and 4 (10.5%) women, respectively. In multivariate analyses, parity, gestational age, and occupation were not associated with S. mansoni infection, unlike maternal age less than 20 years (odds ratio [OR] 9.8; 95% confidence interval [CI], 1.5-16.3; P=0.01) and no education (OR 6.2; 95% CI, 2.8-12.9; P<0.001). CONCLUSION There was a high level of S. mansoni infection among pregnant women in the present setting, especially among younger women and those with no education. Control and preventive measures should be used in the area.
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8
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Mohamed AA, Ali AAA, Ali NI, Abusalama EH, Elbashir MI, Adam I. Zinc, parity, infection, and severe anemia among pregnant women in Kassla, eastern Sudan. Biol Trace Elem Res 2011; 140:284-90. [PMID: 20428963 DOI: 10.1007/s12011-010-8704-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Accepted: 04/16/2010] [Indexed: 11/27/2022]
Abstract
The study was conducted to investigate determinants (clinical, nutritional, and nonnutritional factors) of anemia among pregnant women in Kassala, eastern Sudan. Sociodemographic characteristics were gathered; serum ferritin, zinc, albumin, and C-reactive protein were measured using different laboratory methods in a cross-sectional study of 250 pregnant women. Of the 250 women, 58.4% had anemia (hemoglobin (HB) <11 g/dl), 6.8% had severe anemia (HB < 7 g/dl), 19.6% had iron deficiency (S-ferritin <15 µg/l), 14.8% had iron deficiency anemia (<11 g/dl and S-ferritin <15 µg/l), and 38% had zinc deficiency (<80 µg/ml). S-albumin, zinc, and ferritin were significantly lower in patients with severe anemia. While age, gestational age, ferritin, and C-reactive protein were not predictors for anemia, primigravidae (OR = 2.7, 95% CI = 1.1-6.7, P = 0.02), low S-albumin (OR = 5.9, 95% CI = 1.4-25.2, P = 0.01), and low S-zinc (OR = 2.6, 95% CI = 1.0-6.6, P = 0.03) were the predictors for anemia. While there was no significant correlation between hemoglobin, S-zinc, and S-ferritin, there was a significant positive correlation between hemoglobin and S-albumin (r = 0.308, P = 0.001) and significant inverse correlation between hemoglobin and C-reactive protein (r = 0.169, P = 0.007). Thus, the role of chronic inflammation and zinc as possible contributing factors to anemia in pregnancy has important implications for the clinical evaluation and treatment of these women.
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Affiliation(s)
- Ayoub A Mohamed
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
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Hamdan HZ, Abdelbagi IE, Nasser NM, Adam I. Seroprevalence of cytomegalovirus and rubella among pregnant women in western Sudan. Virol J 2011; 8:217. [PMID: 21569321 PMCID: PMC3112446 DOI: 10.1186/1743-422x-8-217] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 05/11/2011] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Maternal cytomegalovirus (CMV) and rubella infections have adverse neonatal outcomes. Basic epidemiological data concerning CMV and rubella is necessary for health planners and care providers. METHODS A cross sectional study was conducted at El-Rahad hospital, Sudan to investigate seroprevalence of CMV and rubella infections and associated possible risk factors among pregnant women. Structured questionnaires were used to gather socio-demographic data and ELISA was used to detect CMV and rubella infections using IgG and IgM. RESULTS Out of 231 pregnant women, 167 (72.2%) and 151 (65.3%) were CMV-IgG and rubella-IgG positive, respectively. Only 6 (2.5%) and 8 women (3.4%) were CMV-IgM and rubella-IgM positive, respectively. While, high parity (OR = 14.7, 95%CI = 1.7 - 123.6; P = 0.01] and illiteracy (OR = 3.0, CI = 1.4 - 6.5; P = 0.004) were significantly associated with seropostive CMV-IgG in multivariate analysis, none of the other obstetrical and medical characteristics were significantly associated with CMV or rubella infections. CONCLUSION CMV prevalence was 72.2% and rubella susceptibility among pregnant women was 34.6%. Rubella vaccine and routine screening for rubella and CMV should be introduced for pregnant women in this setting. Further research is needed.
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Affiliation(s)
- Hamdan Z Hamdan
- Department of Biochemistry, Faculty of Medicine, Al-Neelain University, Khartoum, Sudan
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10
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Ali AAA, Rayis DA, Mamoun M, Adam I. Use of family planning methods in Kassala, Eastern Sudan. BMC Res Notes 2011; 4:43. [PMID: 21356106 PMCID: PMC3056802 DOI: 10.1186/1756-0500-4-43] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Accepted: 02/28/2011] [Indexed: 11/15/2022] Open
Abstract
Background Investigating use and determinants of family planning methods may be instructive in the design of interventions to improve reproductive health services. Findings 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. Conclusion Education, encouragement of health education programs and involvement of the religious persons might promote family planning in eastern Sudan.
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Mohammed AA, Babiker ZOE, Ali AKM, Adam AAAH, Hassan EA, Osman HKE, Herieka EAM. Seroprevalence of the human immunodeficiency virus (HIV) among pregnant women in eastern Sudan. J Infect Public Health 2011; 4:55-8. [PMID: 21338960 DOI: 10.1016/j.jiph.2010.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Revised: 10/28/2010] [Accepted: 12/06/2010] [Indexed: 11/28/2022] Open
Abstract
We conducted a cross-sectional survey to determine the prevalence of the human immunodeficiency virus (HIV) among pregnant women attending a major hospital in Kassala state, eastern Sudan. Unlinked anonymous testing of residual blood specimens, which were originally collected for other routine clinical purposes, was performed using rapid immunochromatographic assays. In total, 430 residual blood specimens were consecutively collected over a 6-week period (April-May 2010). Specimens from the antenatal clinic (ANC) constituted 50.7% (218/430) of the total whereas specimens from the labour ward accounted for the remaining 49.3% (212/430). The median age of pregnant women was 29 years (range 16-40). The prevalence of HIV-1 infection was 0.23% (1/430) [95% confidence interval=0.01-1.29%]. The only reactive specimen came from a 20-year-old ANC attendee. We report low HIV prevalence among pregnant women in eastern Sudan but further research is needed to confirm our findings. An integrated framework to diagnose and treat maternal HIV infection should be developed in order to prevent transmission to infants.
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Affiliation(s)
- Abdalla Ali Mohammed
- Department of Obstetrics and Gynaecology, Faculty of Medicine & Health Sciences, University of Kassala, Kassala, Sudan.
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12
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Salih MM, Safi ME, Hart K, Tobi K, Adam I. Genotypes of human papilloma virus in Sudanese women with cervical pathology. Infect Agent Cancer 2010; 5:26. [PMID: 21192803 PMCID: PMC3022610 DOI: 10.1186/1750-9378-5-26] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 12/30/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Knowledge of the distribution of human papillomavirus (HPV) genotypes among women with cervical lesion and in invasive cervical cancer is crucial to guide the introduction of prophylactic vaccines. There is no published data concerning HPV and cervical abnormalities in Sudan. This study aimed to define the prevalence of HPV and its subtypes in the cervical smears of women presenting with gynecological complains at Omdurman Military Hospital, Sudan.During the period between March 2003 and April 2004, 135 cervical smears collected from these women, were screened using cytological techniques, and analysed by PCR for (beta)-globin and HPV DNA using gel electrophoresis and ELISA. RESULTS Of these 135 smears, there were 94 (69.3%) negative, 22 (16.3%) positive for inflammation, 12(8.9) mild dyskaryosis, 5 (3.7) moderate dyskaryosis and 2 (1.8) severe dyskaryosis. There were 60.7% ß. globin positive samples for HPV indicating DNA integrity. HPV DNA was identified in three samples (2.2%) by gel electrophoresis and. was positive in four samples (2.9%) as single and multiple infections by PCR-ELISA. The high risk HPV types 16 and 58 were identified in one sample as a mixed infection. The low risk HPV types 40 and 42 were also found as a mixed infection in another patient. HPV types 58 and 42 were identified in the other two patients. CONCLUSION HPV type distribution in Sudan appears to differ from that in other countries. The HPV genotypes identified were not associated with cancer.
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Affiliation(s)
- Magdi M Salih
- Department of Histopathology and Cytology, Faculty of Medical Laboratory Sciences, University of Khartoum, Sudan
| | - Mohamed El Safi
- Department of Pathology, Al Ribat National University, Sudan
| | - Keith Hart
- Central Biotechnology Service, Henry Wellcome Building, School of Medicine, Cardiff University, Cardiff, UK
| | - Khater Tobi
- Department of Obstetrics and Gynecology, Omdurman Military Hospital, Sudan
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
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Rayis DA, Abbaker AO, Salih Y, Diab TE, Adam I. Epidemiology of underweight and overweight-obesity among term pregnant Sudanese women. BMC Res Notes 2010; 3:327. [PMID: 21134264 PMCID: PMC3004927 DOI: 10.1186/1756-0500-3-327] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Accepted: 12/06/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND 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). FINDINGS 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) CONCLUSION The high prevalence of obesity in these pregnant women represents a competing public health problem in Sudan. More research is needed.
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Affiliation(s)
- Duria A Rayis
- Faculty of Medicine University of Khartoum, Khartoum, Sudan.
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Abstract
OBJECTIVE The Middle East and North Africa (MENA) region continues to be perceived as a region with very limited HIV epidemiological data, raising many controversies about the status of the epidemic in this part of the world. The objective of this review and synthesis was to address the dearth of strategic interpretable data on HIV in MENA by delineating a data-driven overview of HIV epidemiology in this region. METHODS A comprehensive systematic review of HIV, sexually transmitted infections (STIs) and risk behavior studies in MENA, irrespective of design, was undertaken. Sources of data included Medline for peer-reviewed publications, Google Scholar for other scientific literature published in nonindexed local and regional journals, international organizations reports and databases, country-level reports and database including governmental and nongovernmental organizations publications, as well as various other institutional documents. RESULTS Over 5000 sources of data related to HIV and STIs were identified and reviewed. The quality of data and nature of study designs varied substantially. There was no evidence for a sustainable HIV epidemic in the general population in any of the MENA countries, except possibly for southern Sudan. The general pattern in different countries in MENA points towards emerging epidemics in high-risk populations including injecting drug users, men who have sex with men (MSM) and to a lesser extent female sex workers, with heterogeneity between countries on the relative role of each of these high-risk groups. Exogenous HIV exposures among nationals linked to travel abroad appeared to be the dominant HIV transmission pattern in a few MENA countries with no evidence for much epidemic or endemic transmission. The role of bridging populations in bridging the HIV infection to the general population was found to be very limited. CONCLUSION Although they do not provide complete protection against HIV spread, near universal male circumcision and possibly the prevailing sexually conservative cultural norms seemed to have played so far a protective role in slowing and limiting HIV transmission in MENA relative to other regions. If the existing social and epidemiological context remains largely the same, HIV epidemic transmission is likely to remain confined to high-risk populations and their sexual partners, in addition to exogenous exposures. HIV prevention efforts in this region, which continue to be stymied by stigma associated with HIV/AIDS and related risk behaviors, need to be aggressively expanded with a focus on controlling HIV spread along the contours of risk and vulnerability. There is still a window of opportunity to control further HIV transmission among high-risk groups in MENA that, if missed, may entail a health and socioeconomic burden that the region, in large part, is unprepared for.
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Abbas AA, Gabo NEAAA, Babiker ZOE, Herieka EAM. Paediatric HIV in central Sudan: high sero-prevalence and poor performance of clinical case definitions. J Clin Virol 2009; 47:82-4. [PMID: 19857992 DOI: 10.1016/j.jcv.2009.09.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Revised: 08/06/2009] [Accepted: 09/25/2009] [Indexed: 11/28/2022]
Abstract
BACKGROUND Paediatric clinical case definitions (CCDs) for the human immunodeficiency virus (HIV) have been proposed as screening tools in resource-limited countries. OBJECTIVES We assessed the performance of the World Health Organisation CCD (WHO-CCD), the Bloemfontein CCD (B-CCD) and a locally modified version of the Bloemfontein CCD (MB-CCD) in comparison with HIV serology in acutely hospitalised children aged 1.5-14 years. We also determined the HIV sero-prevalence among this group of children. STUDY DESIGN A cohort of 106 consecutive acute paediatric admissions to a major teaching hospital in central Sudan was recruited over a 3-month period. RESULTS The WHO-CCD, B-CCD, and MB-CCD were relatively specific with estimates of 96.0% (95% confidence interval [CI] 90.1-98.9), 88.0% (95% CI 80.0-93.6), and 74.0% (95% CI 64.3-82.3), respectively. However, corresponding sensitivities were poor with estimates of 16.7% (95% CI 0.4-64.1), 33.3% (95% CI 4.3-77.7), and 66.7% (95% CI 22.3-95.7), respectively. The HIV sero-prevalence was high at 5.7% (95% CI 2.1-11.9). CONCLUSIONS CCDs performed poorly against HIV serology in acutely hospitalised children aged 1.5-14 years in central Sudan and, therefore, we advocate improving access to serological diagnostic tools. The high HIV sero-prevalence rate among this group of children poses serious challenges to policy makers and warrants further research.
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Affiliation(s)
- Ahmed Abdalla Abbas
- Faculty of Medicine, University of Medical Sciences and Technology, PO Box 12810, Khartoum, Sudan.
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Hepatitis B virus and hepatitis C virus in pregnant Sudanese women. Virol J 2007; 4:104. [PMID: 17958904 PMCID: PMC2116999 DOI: 10.1186/1743-422x-4-104] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2007] [Accepted: 10/24/2007] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The epidemiology of viral hepatitis during pregnancy is essential for health planners and programme managers. While much data exist concerning viral hepatitis during pregnancy in many African countries, no proper published data are available in Sudan. AIM The study aimed to investigate the sero-prevalence and the possible risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) among antenatal care attendants in central Sudan. METHODS During 3 months from March-June 2006, sera were collected from pregnant women at Umdurman Maternity Hospital in Sudan, and they were tested for markers of hepatitis B virus (HBVsAg) and HCV. RESULTS HBVsAg was detected in 41 (5.6%) out 728 women, Anti-HCV was detected in 3 (0.6%) out of 423 women, all of them were not aware of their condition. Age, parity, gestational age, residence, history of blood transfusion, dental manipulations, tattooing and circumcision did not contribute significantly to increased HBVsAg sero-positivity. CONCLUSION Thus 5.6% of pregnant women were positive for HBVsAg irrespective of their age, parity and socio-demographic characteristics. There was low prevalence of Anti-HCV.
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Mahmoud MM, Nasr AM, Gassmelseed DEA, Abdalelhafiz MA, Elsheikh MA, Adam I. Knowledge and attitude toward HIV voluntary counseling and testing services among pregnant women attending an antenatal clinic in Sudan. J Med Virol 2007; 79:469-73. [PMID: 17385672 DOI: 10.1002/jmv.20850] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Human immunodeficiency virus (HIV) infection and the development of the acquired immunodeficiency syndrome (AIDS) are increasing at an alarming rate especially in the sub-Saharan region. Pregnant women susceptible to HIV and its transmission to the fetus provide a unique opportunity for implementing preventive strategy against HIV infection of newborn babies. During the period of August-December 2005 a cross-sectional study was conducted at the Fath-Elrahman Elbashir antenatal clinic, Khartoum Teaching Hospital, to investigate pregnant women's basic knowledge and attitude toward HIV and mother to child transmission as well as voluntary counseling and testing. Pre-tested structured questionnaires were given to antenatal attendants by professional counselors. Their basic socio-demographic and obstetric characteristics were obtained. Respondents' knowledge about HIV and mother to child transmission were tested. In addition, their willingness toward HIV testing was also reported. Out of the 1,005 women investigated, 79% had basic knowledge about HIV. Those who were resident in Khartoum and whose age was > or =26.1 years and their education level was secondary and above were found to be more knowledgeable about HIV. More than half of respondents were aware of mother to child transmission. Older (> or =26.1 years), educated, and working mothers were found to be more knowledgeable about mother to child transmission. Willingness to undergo the test was demonstrated in 72.8% of respondents. However, only 30.3% had the test done. Older women, primigravidae, and Muslims have higher acceptance of voluntary counseling and testing. There is a need to extend the voluntary counseling and testing program in all antenatal clinics. In addition, there is a need to increase the level of education and raise health awareness about HIV and mother to child transmission.
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