Papers by elhassan elhassan
Annals of Tropical Medicine and Parasitology, 2002
Since its inauguration in 1995, the African Programme for Onchocerciasis Control (APOC) has made ... more Since its inauguration in 1995, the African Programme for Onchocerciasis Control (APOC) has made significant progress towards achieving its main objective: to establish sustainable community-directed treatment with ivermectin (CDTI) in onchocerciasis-endemic areas outside of the remit of the Onchocerciasis Control Programme in West Africa (OCP). In the year 2000, the programme, in partnership with governments, non-governmental organizations and the endemic communities themselves, succeeded in treating 20,298,138 individuals in 49,654 communities in 63 projects in 14 countries. Besides the distribution of ivermectin, the programme has strengthened primary healthcare (PHC) through capacity-building, mobilization of resources and empowerment of communities. The community-directed-treatment approach is a model that can be adopted in developing other community-based health programmes. The approach has also made it possible to bring to the poor some measure of intervention in some other healthcare programmes, such as those for malaria control, eye care, maternal and child health, nutrition and immunization. CDTI presents, at all stages of its implementation, a unique window of opportunity for promoting the functional integration of healthcare activities. For this to be done successfully and in a co-ordinated manner, adequate funding of CDTI within PHC is as important as an effective sensitization of the relevant policy-makers, healthworkers and communities on the value of integration (accompanied by appropriate training at all levels). Evaluation of the experiences in integration of health services, particularly at community level, is crucial to the success of the integration.
Parasites & Vectors, 2011
Background Pregnant women are more susceptible to severe Plasmodium falciparum malaria, which can... more Background Pregnant women are more susceptible to severe Plasmodium falciparum malaria, which can lead to poor maternal and fetal outcomes. Few data exist on the epidemiology of severe P. falciparum malaria in pregnant women. A hospital-based study was carried out to assess the pattern of severe P. falciparum malaria among pregnant women at the Kassala and Medani maternity hospitals, which are located in areas of unstable malaria transmission, in eastern and central Sudan, respectively. Pre-tested questionnaires were used to gather socio-demographic, clinical and obstetrical data. Suitable tests were performed for clinical and biochemical investigations. Results Among 222 pregnant women diagnosed with malaria at the two hospitals, 40 (18.0%) women at mean (SD) gestational age of 29.3 (6.7) weeks fulfilled one or more of the WHO criteria for severe P. falciparum malaria. These were hypoglycaemia (14; 35.5%), severe anaemia (12; 30%), hypotension (10; 25%), jaundice (9; 22.5%), cerebral malaria (6; 15%), repeated convulsions (4; 10%), hyperparasitaemia (4; 10.0%) and more than one manifestation (9; 22.5%). While the mean (SD) presenting temperature was significantly lower for women presenting with hypoglycaemia [38.2(0.6) versus 38.8(0.7) °C, P = 0.04], other clinical and biochemical characteristics were not significantly different among women with different manifestations of severe P. falciparum malaria. Conclusion Preventive measures for pregnant women such as insecticide-treated bednets and chemoprophylaxis may be beneficial in areas of unstable malaria transmission. Early detection and prompt treatment of severe malaria, especially in pregnant women with hypoglycaemia, are needed.
Tropical Doctor, 2009
The aim of this study was to investigate the incidence and causes of maternal deaths and stillbir... more The aim of this study was to investigate the incidence and causes of maternal deaths and stillbirths at the Hospital of Obstetrics and Gynecology at Wad Medani, Sudan, from 1 January 2003 through 31 December 2007. All maternal deaths and stillbirths during this period were reviewed and classified retrospectively. There were 146 maternal deaths and 33034 live births, giving a maternal mortality ratio of 442/100,000 live births. The age range was 18-42 years with a mean (standard deviation) of 30.57 (5.26) years. The most common cause of death was septicaemia following obstructed labour or abortion-related sepsis, followed by haemorrhage, pre-eclampsia/ecalampsia, viral hepatitis and malaria. The stillbirth rate was 29/1000 births; the majority of which (8/1000) were macerated stillbirths.
International Journal of Gynecology & Obstetrics, 2005
International Journal of Gynecology & Obstetrics, 2009
S95 by oral analgesia. Follow up revealed complete cure in 25 (75.5%) cases and improved in 8 (24... more S95 by oral analgesia. Follow up revealed complete cure in 25 (75.5%) cases and improved in 8 (24.5%) cases. 27 (81.8%) patients are satisfied. Conclusion: TVT-obturator procedure, for the treatment of female stress urinary incontinence, is effective safe and associated with fewer complications, both intra-operatively and postoperatively. The drawback of this procedure is the high cost.
Annals of Tropical Medicine and Parasitology, 2009
S95 by oral analgesia. Follow up revealed complete cure in 25 (75.5%) cases and improved in 8 (24... more S95 by oral analgesia. Follow up revealed complete cure in 25 (75.5%) cases and improved in 8 (24.5%) cases. 27 (81.8%) patients are satisfied. Conclusion: TVT-obturator procedure, for the treatment of female stress urinary incontinence, is effective safe and associated with fewer complications, both intra-operatively and postoperatively. The drawback of this procedure is the high cost.
International Journal of Gynecology & Obstetrics, 2008
International Journal of Gynecology & Obstetrics, 2005
BMC Research Notes, 2010
Background Reducing the incidence of Low birth weight (LBW) neonates by at least one third betwee... more Background Reducing the incidence of Low birth weight (LBW) neonates by at least one third between 2000 and 2010 is one of the major goals of the United Nations resolution "A World Fit for Children". This was a case-control study conducted between August-October 2009 in Medani Hospital, Sudan to investigate the risk factors for LBW. Cases were mothers who delivered singleton baby < 2500 gm. Controls were mothers delivered singleton baby of ≥ 2500 gm. Findings Out of 1224 deliveries, 97 (12.6%) of the neonates were LBW deliveries. While maternal socio-demographic characteristics (age, parity and mother education) and anthropometrics measurements were not associated with LBW, lack of antenatal care (OR = 5.9, 95% CI = 1.4-24.4; P = 0.01) and maternal anaemia (OR = 9.0, 95% CI = 3.4-23.8; P < 0.001) were the main risk factor for LBW. Conclusion Thus, more care on antenatal care and nutrition may prevent LBW.
International Journal of Gynecology & Obstetrics, 2009
Biological Trace Element Research, 2010
International Journal of Gynecology & Obstetrics, 2005
International Journal of Gynecology & Obstetrics, 2009
Asian Pacific Journal of Tropical Medicine, 2010
International Journal of Gynecology & Obstetrics, 2007
Annals of Tropical Medicine and Parasitology, 2009
Between June 2006 and October 2008, the safety of artemisinins during early human pregnancy was a... more Between June 2006 and October 2008, the safety of artemisinins during early human pregnancy was assessed in central-eastern Sudan. Pregnant women in the first or second trimester who were attending antenatal-care clinics at the Wad Medani, Gadarif and New Halfa hospitals were interviewed. Each was asked if they had had malaria in the first trimester of the index pregnancy and, if so, what treatment they had received. The women who had received artemisinins were then followed-up until delivery and their babies were followed-up until they were 1-year-olds. Overall, 62 of the pregnant women reported receiving artemisinins - artemether injections (48), artesunate plus sulfadoxine-pyrimethamine (11) or artemether plus lumefantrine (three) - during the first trimester. Medical records were available for 51 (82%) of these 62 women, and, in each case, these records showed the reported treatment and that malaria had been confirmed. Only nine (15%) of the 62 women given artemisinins had not known that they were pregnant when treated. Two of the treated women (both given artemether injections in the first trimester) had miscarriages, one at 20 weeks of gestation and the other at 22 weeks, each while receiving quinine infusions for a second attack of malaria. The other 60 women who had received artemisinins delivered apparently healthy babies at full term. No congenital malformations were detected, there was no preterm labour, no maternal deaths were recorded during the follow-up, and none of the babies died during their first year of life. It therefore appears that artemisinins may be safe to use during early pregnancy, although further study is clearly needed.
Biological Trace Element Research, 2010
Anaemia is a widespread problem in many parts of the world especially in tropic areas. Among preg... more Anaemia is a widespread problem in many parts of the world especially in tropic areas. Among pregnant women, it has negative consequences on maternal and perinatal outcomes. A cross-sectional study was conducted to investigate the prevalence of anaemia, iron, zinc and copper deficiencies among pregnant women in Wad Medani hospital, central Sudan and to examine the relationship of these micronutrients with haemoglobin (Hb) levels. One hundred four (52.5%) out of 200 pregnant women had anaemia (Hb < 11 gm/dl) and 3 (1.5) % had severe anaemia (Hb < 7 gm/dl). Iron deficiency (S-ferritin < 15 µg/l), iron deficiency anaemia (<11 gm/dl and S-ferritin < 15 µg/l) were prevalent in 25 (12.5%) and 13 (6.5%) of these women, respectively. Ninety (45.0%) and eight (4.0%) of these women had zinc (<80 µg/ml) and copper (<80 µg/ml) deficiency, respectively. In 24 (12.0%) of these women, there were ≥2 deficiencies of these elements. S-copper was significantly lower in patients with anaemia. While age, parity, gestational age, ferritin, zinc and copper were not predictors for anaemia, women who practiced pica were at higher risk for anaemia (OR = 3.4, 95% CI = 1.4–7.9, P = 0.004). Gestational age was significantly inversely correlated with haemoglobin (r = 0.161, P = 0.03), S-ferritin (r = 0.285, P = 0.001) and S-zinc (r = 0.166, P = 0.02). Thus, dietary and supplement interventions are required to prevent and control anaemia in this setting. Further research is needed.
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Papers by elhassan elhassan