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<i>Leishmania donovani</i>-Induced Immune Dysregulation among Sudanese Patients with Visceral and Post Kala-Azar Dermal Leishmaniases: Possible Roles in Pathogenesis

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Advances in Infectious Diseases 2020年第4期10卷 235-242页

作者： Elsamani Elmotwafig Mohamed Elsammani Brima Younis Musa Mona Elfaki eltahir Elfaki ahmed Mudawi Mudawi eltahir Awad Gasim Khalil Institute of Endemic Diseases University of Khartoum Khartoum Sudan Department of Microbiology and Clinical Parasitology College of Medicine King Khalid University Abha KSA

L. donovani infections (visceral and post kala-azar dermal leishmaniases) are characterized by infection-induced reversible immune suppression. Autoimmunity is a well-documented phenomenon among patients with primary immune deficiencies. This study aimed to study auto-immune phenomena accompanying L. donovani infections. In a prospective case-controlled study and following informed consent, 155 individuals with visceral leishmaniasis (VL;n = 62), post kala-azar dermal leishmaniasis (PKDL;n = 31) and apparently healthy volunteers (n = 62) were recruited. Sera antinuclear (ANA), anti-dsDNA, anti-thyroid peroxidase (TPO), anti-smooth muscles (ASMA) and F-actin auto-antibodies were measured using ELISA and indirect immune-fluorescence assay. The mean ages of VL, PDKL patients and apparently healthy volunteers were: 17.5 ± 12.5, 15.0 ± 7.0 and 17.5 ± 9.5 years with Male:Female ratios of 2:0, 1:2 and 1:5 respectively. Significantly high frequencies of F-actin (74.2%;46/62) and ASMA (50%;31/62) auto-antibodies were seen among VL patients (p = 0.003, p = 0.001) compared to apparently healthy volunteers. Likewise, significantly high frequencies of F-actin (64.5%;20/31;p = 0.001), ASMA (42%;13/31;p = 0.003), ANA (36%;11/31;p = 0.001) and anti-dsDNA (16%;5/31;p = 0.01) auto-antibodies were seen among PKDL patients. Development of tissue-based autoantibodies in L. donovani infections probably indicates loss of peripheral tolerance with activation of circulating auto-reactive T and B cells probably contributing to disease pathogenesis (increased bilirubin/liver enzymes, prolonged QT interval/arrythmias and blood cytopenias). In conclusion, L. donovani infection-induced immune suppression with development of tissue-based auto-antibodies is prevalen

关键词： L. donovani-Induced Immune Suppression Tissue-Based Autoimmunity Pathogenesis

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First-Line Drug Resistance Patterns of Mycobacterium tuberculosis Complex Isolates from Re-Treatment Patients from Sudan

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Journal of Tuberculosis Research 2016年第3期4卷 98-104页

作者： Muatsim ahmed Mohammed Adam Hamdan Mustafa Hamdan Ali eltahir Awad Gasim Khalil National Tuberculosis Reference Laboratory National Public Health Laboratory Federal Ministry of Health Khartoum Sudan National Tuberculosis Control Program Federal Ministry of Health Khartoum Sudan Tuberculosis Research Group/Institute of Endemic Diseases University of Khartoum Khartoum Sudan

Drug susceptibility testing (DST) plays a pivotal role in TB patients’ management leading to the selection of most effective drugs. This study aimed to determine resistance patterns to first line anti-TB drugs in Mycobacterium tuberculosis isolates from re-treated patients from Sudan. A total of 239 sputum specimens were collected from smear positive re-treatment TB patients during the period from July 2009 to July 2010. Specimens were pre-treated according to Petroff method. The recovered isolates were tested for sensitivity to first line anti-TB drugs by the 1% proportion method. One hundred and forty three (143/239, 59.8%) mycobacterial isolates were successfully recovered. The majority (98.6%, 141/143) of the isolates were Mycobacterium tuberculosis complex strains. Two strains (2/143, 1.4%) were identified as RIF/INH-resistant MOTT, while fifty four isolates (38.3%, 54/141) were MDR. Multi- drug resistant Mycobacterium tuberculosis complex (MDR-TB) among re-treatment patients from national referral centers for tuberculosis diagnosis and management was considerably high in the study isolates.

关键词： MDR Sudan TB Re-Treatment DST

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Prevalence of Latent Tuberculosis Infection (LTBI) among House Hold Contacts of Sudanese Patients with Pulmonary Tuberculosis in Eastern Sudan: Revisiting the Tuberculin Skin Test

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Journal of Tuberculosis Research 2017年第1期5卷 69-76页

作者： Saima Abdalrhman Osman Walla Saeed eltahir Saeed ahmed Mudawi Musa Brima Musa Younis Abd Elgadir Ali Bashir Fath Elrahman Mohamed Idris Ala Eddin Hassan ahmed eltahir Awad Gasim Khalil Department of Clinical Pathology & Immunology Institute of Endemic Diseases University of Khartoum Khartoum Sudan Sudanese Medical Specialization Board Khartoum Sudan Chest Diseases Department Khartoum North Teaching Hospital Khartoum Sudan Department of Medicine Faculty of Medicine University of Khartoum Khartoum Sudan

A third of the world’s population is latently infected with TB with an increased risk of developing active TB. Household contacts (HHCs) of pulmonary TB cases are at a greater risk of developing disease. Early identification and treatment of latent TB infected individuals may reduce progression to active TB. This study aimed to determine latent TB infections (LTBI) point prevalence among HHCs and community contacts (CCs) using Tuberculin Skin Test (TST) and whole blood IFN-γ release assay in an area of high TB prevalence. In a prospective, longitudinal and community-based study and following informed consent, 768 volunteers (HHCs n = 245;CCs n = 523) were enrolled. Tuberculin Skin Test (TST), whole blood stimulation with PPD and IFN-γ levels determination using ELISA were performed. Mean ages of HHCs and the CCs were not significantly different (HHCs 35.6 ± 15.7 and CCs 30.6 ± 11.7 years;p = 0.99), with a Male:Female ratio of 1:2. Mean recruitment TST indurations were 4.6 ± 5.5 mm and 2.8 ± 3 mm for HHCs and CCs respectively (p = 0.000). Follow-up (Day 614) mean TST indurations increased significantly to 9.1 ± 7.2 mm and 4.4 ± 3.2 mm for HHCs and CCs respectively (p = 0.001). Using TST indurations ≥ 10 mm, LTBI point prevalence for HHCs and CCs was significantly different (HHCs 461/1000 and 367/1000 individuals, p = 0.03). The mean IFN-γ levels for HHCs and CCs at recruitment day (Day 0) were 0.66 ± 0.17 IU/ml and 0.06 ± 0.04 respectively. The mean of IFN-γ production levels dropped significantly at Day 614 for HHCs and CCs to 0.66 ± 0.15 IU/ml and 0.02 ± 0.02 respectively (p = 0.03) (p = 0.00001). Recruitment LTBI point prevalence using IFN-γ level ≥ 0.35 IU/ml for HHCs and CCs was 440/1000 and 203/1000 respectively (p = 0.000000001). No correlations between TST indurations and IFN-γ levels were detected among HHCs or CCs (p > 0.05). TST is a simple, efficient and cheap technique for LTBI diagnosis and triaging individuals for treatment.

关键词： Latent TB Infections Household Contacts Community Contacts TST

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Nutritional Status of Mothers and Its Determinants in Alemtidad Area, Khartoum

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Food and Nutrition Sciences 2014年第22期5卷 2203-2208页

作者： Waled Amen Mohammed ahmed Eiman Abdalla ahmed Khalid Ahmad Omar Arafa Ehab Ibrahim Salih El-Amin Ziad M. Alostaz Khalid eltahir Khalid Nursing Department Faculty of Applied Medical Sciences Albaha University Al Bahah Saudi Arabia Altaiseer Medical Complex Khartoum Sudan Faculty of Applied Medical Sciences Albaha University Al Bahah Saudi Arabia Basic Sciences Department Faculty of Applied Medical Sciences Albaha University Al Bahah Saudi Arabia Faculty of Applied Medical Sciences Albaha University Al Bahah Saudi Arabia

Background: Nutritional status of mothers is considered one of the major problems facing mothers in the world. The nutrition plays a major role in mothers and child health. Objective: This study aims to assess mothers’ nutritional status and its determinants in Alemtidad area, Khartoum. Methods: A descriptive community based survey was conducted in the Alemtidad area of Khartoum between November 2012 and December 2012. One hundred and eighty mothers were selected by simple randomization. Data were collected by using structured designed questionnaire which was then analyzed by (SPSS) program version 20. Results: The study conducted among mothers in Alemtidad area;their age ranged between 19 and 86 years with the mean age 38 ± 12 years. From those mothers about half were unemployed, and having mainly primary and secondary educational level. 81.1% of mothers were not able to select the proper food according to age and nutrients and about 71.1% of mothers took two meals per day and 23.3% one meals per day, and only 5.6 take three meals per day. The Body Mass Index (BMI) was calculated to measure the nutrition status of mothers;this study shows that mothers in Alemtidad are mainly overweight and obese, 45.6% and 18% respectively and only 35% within normal range of Body Mass Index (BMI). Conclusion: The study concludes that mothers are either overweight or obese (45.6%, 17.7% respectively). Compared to national and international statistics the findings of this study reflect high Body Mass Index (BMI) of mothers in Alemtidad.

关键词： Nutritional Status Determinant of Nutritional Status Food Consumption Mothers

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