Kassala, Sudan
Kassala, Sudan

Kassala University is a public university located in Kassala, Sudan.It was established in 1990 to replace the East University, and is an important institution for development in the east of Sudan. Wikipedia.

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Himeidan Y.E.,Kassala University | Kweka E.J.,Tropical Pesticides Research Institute
Frontiers in Physiology | Year: 2012

East African highlands are one of the most populated regions in Africa. The population densities in the highlands ranged between 158 persons/km 2 in Ethiopia and 410 persons/km 2 in Rwanda. According to the United Nations Population Fund, the region has the world's highest population growth rate. These factors are likely behind the high rates of poverty among the populations. As there were no employment opportunities other than agricultural, this demographic pressure of poor populations have included in an extensive unprecedented land use and land cover changes such as modification of bushland, woodland, and grassland on hillsides to farmland and transformation of papyrus swamps in valley bottoms to dairy pastures and cropland and changing of fallows on hillsides from short or seasonal to longer or perennial. Areas harvested for food crops were therefore increased by more than 100% in most of the highlands. The lost of forest areas, mainly due to subsistence agriculture, between 1990 and 2010 ranged between 8000 ha in Rwanda and 2,838,000 ha in Ethiopia. These unmitigated environmental changes in the highlands led to rise temperature and optimizing the spread and survival of malaria vectors and development of malaria parasites. Malaria in highlands was initially governed by low ambient temperature, trend of malaria transmission was therefore increased and several epidemics were observed in late 1980s and early 2000s. Although, malaria is decreasing through intensified interventions since mid 2000s onwards, these environmental changes might expose population in the highlands of east Africa to an increase risk of malaria and its epidemic particularly if the current interventions are not sustained. © 2012 Himeidan and Kweka.

Gadalla N.B.,London School of Hygiene and Tropical Medicine | Gadalla N.B.,Institute of Tropical Medicine | Abdallah T.M.,Kassala University | Atwal S.,London School of Hygiene and Tropical Medicine | And 2 more authors.
Malaria Journal | Year: 2013

Background: Artesunate/sulphadoxine-pyrimethamine (AS/SP) has been the first-line treatment for falciparum malaria in Sudan since 2004. The impact of this combination on anti-malarial resistance-associated molecular markers has not been investigated. In this study, an evaluation of the efficacy and prevalence of drug resistance alleles (pfcrt, pfmdr1, pfdhfr and pfdhps) eight years after the adoption of AS/SP in eastern Sudan is reported. Methods. A 28-day follow-up efficacy trial of AS/SP was conducted in eastern Sudan during the 2012 transmission season. Blood smears were collected from patients on days 0, 1, 2, 3, 7, 14, 21 and 28. Blood spots on filter paper were obtained pre-treatment and on the day the patient was parasite positive by microscopy. Genotyping of alleles was performed by qPCR (pfcrt 72-76 and pfmdr1 copy number) and direct sequencing of pfmdr1, pfdhfr and pfdhps. Results: Sixty-three patients out of 68 (93%) completed the 28-day follow-up, adequate clinical, and parasitological response occurred in 90.5% and 85.3% of the patients in the per-protocol and intent-to-treat analyses, respectively. PCR corrected per-protocol efficacy was 93.7%. The enrolment prevalence of pfcrt-CVMNK was 30.2% and pfmdr1-N86 was 40.3%. The pfmdr1 haplotype NFD occurred in 32.8% of pre-treatment samples and was significantly higher than previous reports (Fisher's exact p = 0.0001). The pfdhfr-51I/108N combination occurred in all sequenced isolates and 59R was observed in a single individual. pfdhps substitutions 436A, 437G, 540E, 581G and 613S were observed at 7.8, 77.3, 76.9%, 33.8% and 0.0%, respectively. Treatment failures were associated with the pfdhps haplotype SGEGA at these five codons (OR 7.3; 95% CI 0.65 - 368; p = 0.048). Conclusion: The decrease of CQR associated genotypes reflects the formal policy of complete removal of CQ in Sudan. However, the frequency of markers associated with SP failure is increasing in this study area and may be contributing to the treatment efficacy falling below 90%. Further monitoring of AS/SP efficacy and of post-treatment selection of pfdhfr and pfdhps alleles in vivo is required to inform future treatment guidelines. © 2013 Gadalla et al.; licensee BioMed Central Ltd.

Abdallah T.M.,Kassala University | Abdeen M.T.,University of Khartoum | Ahmed I.S.,Kassala University | Hamdan H.Z.,Neelain University | And 2 more authors.
Malaria Journal | Year: 2013

Background: There have been few published reports on severe Plasmodium falciparum and Plasmodium vivax malaria among adults in Africa. Methods. Clinical pattern/manifestations of severe P. falciparum and P. vivax (according to World Health Organization 2000 criteria) were described in adult patients admitted to Kassala Hospital, eastern Sudan. Results: A total of 139 adult patients (80 males, 57.6%) with a mean (SD) age of 37.2 (1.5) years presented with severe P. falciparum (113, 81.3%) or P. vivax (26, 18.7%) malaria. Manifestations among the 139 patients included hypotension (38, 27.3%), cerebral malaria (23, 16.5%), repeated convulsions (18, 13.0%), hypoglycaemia (15, 10.8%), hyperparasitaemia (14, 10.1%), jaundice (14, 10.1%), severe anaemia (10, 7.2%), bleeding (six, 4.3%), renal impairment (one, 0.7%) and more than one criteria (27, 19.4%). While the geometric mean of the parasite count was significantly higher in patients with severe P. vivax than with severe P. falciparum malaria (5,934.2 vs 13,906.6 asexual stage parasitaemia per μL, p = 0.013), the different disease manifestations were not significantly different between patients with P. falciparum or P. vivax malaria. Three patients (2.2%) died due to severe P. falciparum malaria. One had cerebral malaria, the second had renal impairment, jaundice and hypoglycaemia, and the third had repeated convulsions and hypotension. Conclusions: Severe malaria due to P. falciparum and P. vivax malaria is an existing entity among adults in eastern Sudan. Patients with severe P. falciparum and P. vivax develop similar disease manifestations. © 2013 Abdallah et al.; licensee BioMed Central Ltd.

Ali A.A.,Kassala University | Abdallah T.M.,Kassala University
International Journal of Gynecology and Obstetrics | Year: 2012

Objective: To describe the epidemiology and clinical presentation of female genital tuberculosis (FGTB) among women in eastern Sudan. Methods: A cross-sectional survey was conducted at Kassala Maternity Hospital, Sudan, from January 1 to December 31, 2010. Results: Of the 2778 women presenting with various gynecologic symptoms, 44 suspected cases of FGTB were identified. Granulomatous tissue reactions were observed in 25 of the suspected FGTB cases, yielding an incidence of 0.9%. The majority (20/25; 80%) of these patients presented with chronic pelvic and lower abdominal pain; however, 68.0% (17/25) presented with pelvic mass, cyst and/or abscess; 48.0% (12/25) had dyspareunia; 40.0% (10/25) were infertile; 28% (7/25) had menstrual dysfunction; 20.0% (5/25) had dysmenorrhea; and 4.0% (1/25) experienced postmenopausal bleeding. Body mass index, residence, and educational level were significantly different between women diagnosed with FGTB and those where FGTB was excluded (P values = 0.02, 0.03, and 0.01, respectively). However, no significant differences were found in age and Bacillus Calmette-Guérin vaccination status. Conclusion: Clinical suspicion may facilitate and improve the detection of FGTB, with chronic pelvic pain identified as the predominant clinical presentation among women in eastern Sudan. © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Abdallah T.M.,Kassala University | Ali A.A.A.,Kassala University
Asian Pacific Journal of Tropical Biomedicine | Year: 2012

Objective: To investigate the epidemiological factors of tuberculosis (TB) in eastern Sudan. Methods: The socio-demographic and clinical data was retrieved from the database at Kassala hospital during the year of 2011. The medical file of consequent patients who was discharged from the same ward in the hospital was reviewed to act as control for the TB patients. Results: A total of 670 patients were registered at Kassala hospital with clinical, laboratory and radiological evidence proven TB. Pulmonary TB accounted for 73.4% while extra-pulmonary TB was reported in 26.6% of all TB patients. The mean age (SD) was not significantly different between the cases and controls (670 in each arm). TB patients were those who had less education, and the infection more likely common among male patients. Conclusions: Intervention from outside the health field in particular awareness of associated risk factors and improvement of the educational level potentially will strengthen TB control. © 2012 Asian Pacific Tropical Biomedical Magazine.

Ali A.A.A.,Kassala University
Reproductive Health | Year: 2012

Background: Female Genital Mutilation (FGM) or cutting caries legal and bioethical debates and it is practiced in many developing countries. Methods. Random selection of 154 midwives was used for the study during June 2012 and through July 2012 aiming to assess knowledge and attitudes of the midwives towards FGM in Eastern Sudan. Results: A total of 157 midwives enrolled in this study. They had been practicing for 3 - 44 years (mean SD 19.2±10.3). More than two third of them experienced practicing FGM sometime in their life (127/157, 80.9%). There was low level of awareness of types of FGM practice since only 7% (11/157) identified the four types correctly. 53.5% (84/157) identified type 1 correctly while 18.5% (29/157), 17.8% (28/157) and 15.9% (25/157) identified type 2, 3 and 4 as correct respectively. While 30 (19.1%) of the midwives claimed that all types of FGM are harmful, 76.4% (120/157) were of the opinion that some forms are not harmful and 7 (4.5%) reported that all types of FGM are not harmful. Likewise while 74.5% (117/157) of the interviewed midwives mentioned that the FGM is a legal practice only 25.5% (40/117) were of the opinion that FGM is illegal practice. The vast majority of the respondents (64.3%, 101/157) have an opinion that FGM decreases the sexual pleasure. More than half (53.5%, 84/157) of the participants affirmed that FGM does not increase the risk of HIV transmission. High proportion of the respondents (71.3%, 112/157) did not know whether or not infertility could complicate FGM. Conclusions: Thus a substantial effort should be made to discourage the continuation of FGM practice among midwives in Sudan. This might be achieved by improving knowledge and awareness among the midwives and the community. © 2012 Ali; licensee BioMed Central Ltd.

Ali A.A.A.,Kassala University | Adam I.,University of Khartoum
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2011

The aim of this study was to investigate the incidence and causes of maternal deaths at Kassala maternity hospital, eastern Sudan during 2005-2009. All maternal deaths during this period were reviewed and classified retrospectively. The medical file of consequent women who were discharged from the same ward in the hospital was reviewed to act as control for the maternal death. There were 132 maternal deaths and 20,485 (644/100,000) live births. Septicemia, preeclampsia/eclampsia, hemorrhage, anemia, viral hepatitis, and malaria were the causes for maternal mortality. Primipare (OR = 3.3, CI = 1.66.9, p = 0.001), lack of antenatal care (OR = 3.9, CI = 1.69.5, p = 0.002), illiteracy (OR = 2.6, CI = 1.44.8, p = 0.002), and rural residence (OR = 2.2, CI = 1.24.1; p = 0.008) were the predictors for maternal death. The levels of maternal education and antenatal attendance should be raised to reduce the high maternal mortality. © 2011 Informa UK, Ltd.

Ali A.A.A.,Kassala University | Adam I.,Kassala University | Adam I.,University of Khartoum
Journal of Tropical Pediatrics | Year: 2011

Background: Globally, the reduction of stillbirths is a high priority, especially in view of the targets set by the Millennium Development Goals. It is crucial that health policy-makers and programme managers are aware of the epidemiology of stillbirths. Objectives: This was a case-control study conducted in Kassala hospital in Eastern Sudan to investigate the prevalence and risk factors for stillbirth. Cases were women who delivered stillbirths; two consecutive women who delivered a live-born neonate per case were used as controls. Results: Among 1342 singleton deliveries, there were 44 stillbirths (33 per 1000 deliveries). Over half (54.5%) of these stillbirths were macerated stillbirths. While maternal sociodemographic characteristics were not associated with stillbirth, maternal anaemia was the main risk factor for stillbirth (Odds ratio=8.4, 95% CI=2.5-29.4; P=0.001). Conclusion: Thus, greater focus on maternal nutrition and prevention of anaemia may prevent stillbirth in this setting. © The Author [2010]. Published by Oxford University Press. All rights reserved.

Ali A.A.,Kassala University
BMC public health | Year: 2013

In the developing countries millions of women in the reproductive age who don't use contraceptives prefer to postpone or limit their birth. This indicates their failure to take necessary decision to prevent and avoid unwanted pregnancy. A community-based cross sectional household survey was conducted to investigate unmet need for family planning and associated factors and total demand for family planning in Kassala, Eastern Sudan between 1st May and 31st July 2012. A total of 812 married women were enrolled in this study. Their mean age and parity was 31.8 (7.3) and 3.4 (1.8) respectively. Ever use of contraception was 25.4% (206/812) and 26.2% (213/812) were currently using contraception. Unmet need for spacing was 15.1% while unmet need for limiting was 0.7%. The pregnant and amenorrheic women whose the pregnancy or birth was unwanted and mistimed were 105 (13%) and 130 (16%) respectively. Using Westoff model the total unmet need was estimated as 44.8%. The total demand for family planning was 71%.In logistic regression model, while age, age at marriage, parity, residence and experience of child death were not associated with total unmet need for family planning, women education < secondary level (OR=7.8; CI=5.6-10.9; P=0.00), husband education < secondary level (OR=1.9; CI=1.3-2.6, P = 0.00) and woman's occupation; housewife (OR=4.3; CI=2.5-7.2; P=0.00) were associated with the total unmet need. Unmet need for family planning in Eastern Sudan was significantly higher among women with less than secondary education. Also; it is influenced by couple's educational status and woman's occupation. The results of this study necessitate the need for the programme managers to take into account the concept of reproductive health education.

Ali A.A.,Kassala University
African journal of reproductive health | Year: 2011

This was a cross sectional prospective study carried out in Kassala Maternity Hospital, Eastern Sudan (2008-2011) to investigate the incidence rate and factors associated with delayed presentation in ruptured ectopic pregnancy. The total number of deliveries during the study period was 9578. The total number of ectopic pregnancy was 199 yielding an incidence rate of (1 in 48 deliveries or 20.7 per 1000 deliveries). One hundred eighty six (93.5%) out of these were ruptured ectopic reflecting very low rate of diagnosis (6.5%) before rupture occurred. Maternal educations secondary, parity and history of subfertilty were associated with ruptured ectopic pregnancy (P=0.00, 0.003 and 0.00 respectively). The causes of delay reported by the patients include: 64.5 not aware of the pregnancy, 28% have been seen by health provider but reassure and 7.5% regarded the symptoms not serious enough to ask for care.

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