Emmanuel Edwar Siddig

BACKGROUND: Fresh vegetables are considered as vital nutrients of a healthy diet as they supply the body with essential supplements. The consumption of raw vegetables is the main way for transmission of intestinal parasitic organisms. This study was aimed at detecting the parasitic contamination in fresh vegetables sold in two central open-aired markets in Khartoum state, Sudan. METHODS: In this prospective cross-sectional study, a total of 260 fresh vegetable samples and 50 water samples used to sprinkle vegetable(s) were collected from two central open-aired markets (namely; Elshaabi and Central markets) during November 2011 to May 2012. The samples were microscopically examined for detection of parasitic life forms using standardized parasitological techniques for protozoans and helminthes worms. RESULTS: Of the 260 fresh vegetable samples, 35 (13.5 %) were microscopically positive for intestinal parasites whereas 7/50 (14 %) of water samples used to sprinkle vegetable(s) were found positives. Remarkably, high level of contamination in fresh vegetable samples was recorded in lettuce (Lactuca sativa) 36.4 % (4/11) while cayenne pepper (Capsicum annuum) and cucumber (Cucumis sativus) were not contaminated. The identified protozoans and helminthes were Entamoeba histolytica/dispar, Entamoeba coli, Giardia lamblia, Ascaris lumbricoides, Strongyloides stercoralis, T. trichiura and hookworms. The most predominant parasite encountered was E. histolytica/dispar (42.9 %) whereas both T. trichiura and A. lumbricoides (2.9 %) were the least detected parasites. None of the fresh vegetables had single parasitic contamination. The highest percentages found in water samples used to sprinkle vegetable(s) was for Strongyloides larvae 60 % (3/5). It is worth-mentioned that the rate of contamination in Elshaabi market was higher compared with Central market. However, there was no significant correlation between the type of vegetables and existence of parasites in both markets and a high significant relationship was observed between the type of parasite and total prevalence in fresh vegetables (p = 0.000). CONCLUSION: The study has identified a moderate rate of fresh vegetables contaminated with protozoan and helminthes. Contaminated fresh vegetables in central markets of Khartoum state may play a significant role in transmission of intestinal parasitic infections to humans, and the water used by greengrocers to sprinkle vegetable(s) can be implicated in vegetable contamination.

Global challenges and opportunities for malaria control were perfectly outlined in The Lancet Microbe's Editorial,1 emphasising the effects of the COVID-19 pandemic; growing political instability and violence; and socioeconomic, demographic, and geographical inequalities on malaria burden. Another serious threat to the global health effort in Africa is rapidly developing: the emergence and spread of the invasive malaria vector, Anopheles stephensi (An stephensi).2 An stephensi is a competent vector of Plasmodium vivax and Plasmodium falciparum and a probable vector of zoonotic malaria parasites (appendix p 1).

INTRODUCTION: Malaria remains one of the most common public health problems worldwide, especially in Sudan. With this short communication we aimed at reporting on the latest malaria epidemic that had occurred in the humanitarian settings in South Kordofan state, south-western Sudan, during 2018 and 2019. METHODOLOGY: This is a cross-sectional study analyzing malaria surveillance reports between February 2018 to September 2019. Malaria was reported from febrile patients with confirmed malaria diagnosis using Giemsa stain. According to age, patients were distributed across three categories: less than 5 years, 5 to 15 years, and more than 15 years. RESULTS: In 2019 and 2018, 63,214 and 63,224 cases of malaria were reported, respectively, constituting around 5.5% of the state population (1,152,900). In 2018, 3,571 malaria cases were reported in February, then they decreased in August followed by increase in September-October. In 2019, 15,610 malaria cases were reported in September. Malaria cases aged less than 5 years were 21,848 and 23,561 cases in 2018 and 2019, respectively. CONCLUSIONS: The reported sudden epidemic of malaria is alarming. Therefore, identifying the risk factors associated with this epidemic is crucial to malaria prevention and control, and hence successful achievement of malaria elimination.

OBJECTIVES: Malaria infection is still known to be a worldwide public health problem, especially in tropical and sub-tropical African countries like Sudan. A pilot study conducted to describe the trend of P. falciparum drug resistance markers in 2017-2018 in comparison to CQ and AS/SP eras in Sudan. The Pfcrt, Pfmdr-1, Pfdhfr, and Pfdhps genes were investigated. Data deposited by the worldwide antimalarial resistance network was consulted, and the molecular markers previously reported from Sudan were analyzed. RESULTS: Drug molecular markers analysis was successfully done on 20 P. falciparum isolates. The Pfcrt K76 showed high frequency; 16 (80%). For the Pfmdr-1, 9 (45%) isolates were carrying the N86 allele, and 11 (55%) were 86Y allele. While the Y184F of the Pfmdr-1 showed a higher frequency of 184F compared to Y184; 16 (80%) and 4 (20%), respectively. In the Pfdhfr, 51I allele showed higher frequency compared to N51; 18 (90%) and 2 (10%), respectively. For S108N, 18 (90%) were 108 N and 2 (10%) were S108. In the Pfdhps, all isolates were carrying the mutant alleles; 437G and 540E. The frequency distribution of the Pfcrt, Pfmdr-1, Pfdhfr, Pfdhps was significantly different across the whole years in Sudan.

Climate change is impacting the life, health, and security of people worldwide with poor communities and displaced populations at particular risk due to lack of awareness and mitigation plans. The Tigray war in Ethiopia has forced thousands of refugees to flee and seek safety and shelter in Sudan. We investigated the impacts of climate change on this displaced population with a focus on the conditions experienced by Ethiopian humanitarian refugees who fled from the Tigray war in Ethiopia and settled in the Gedaref state, East Sudan. We analyzed data regarding the displaced population and climate-related weather effects in Sudan. Sudan is currently hosting over 63 thousand Ethiopian refugees who arrived between November 2020 and April 2021. These refugees were exposed to severe weather conditions including heavy rains, strong storms, severe floods, and heat waves which resulted in over 50% loss of their shelters and belongings, and around two thousand latrines were destroyed. Furthermore, an outbreak of Hepatitis E virus is ongoing among refugees with nearly one thousand cases reported. Massive and routine vaccination campaigns were launched to avoid the spread of locally transmitted diseases among the refugees including COVID-19, polio, cholera, and measles. The living conditions and lack of reliability of essential services among the displaced populations are increasing their vulnerability to the negative impacts of climate change on their life, health, and security. We recommend incorporating a mitigation and adaptation plan to climate change into humanitarian response plan and strategies, including raising awareness and training, in order to prepare a well-developed contingency plan that takes these factors into account.