Papers by Ishraga Eltayeb A-Elbasit
Relation between morphological features & bio-ecological factors of date palm trees cultivars from sub-saharan region
International Journal of Botany Studies, 2020
Cerebral malaria is frequently associated with latent parasitemia among the semi-immune population of eastern Sudan
Microbes and Infection, 2005
The accurate diagnosis of malaria starts with clinical suspicion, confirmed by reliable laborator... more The accurate diagnosis of malaria starts with clinical suspicion, confirmed by reliable laboratory results. A hospital-based study, described here, was carried out in a malaria mesoendemic area in eastern Sudan, where the inhabitants are semi-immune to malaria, and the fever threshold of parasitemia is not above the detection level of microscopy. Thus, we hypothesized that patients with symptoms highly suggestive of cerebral malaria (CM), but aparasitemic by microscopy, may have submicroscopic parasitemia. Patients in our malaria clinic were screened by microscopy, and 120 individuals were selected for the study, including febrile patients with and without microscopically detectable parasitemia, and apparently healthy individuals. In the two former groups there were patients with severe anemia and deep coma. Polymerase chain reaction (PCR) for parasite detection and ELISA tests for measuring serum antibody levels were carried out on all blood samples. A majority of the febrile patients who were parasite negative by microscopy showed the presence of a Plasmodium falciparum infection by PCR. The occurrence of P. falciparum infection with parasitemia below the detection level of microscopy was recognized more often in patients with CM symptoms than in those with severe malarial anemia (SMA), and in older rather than younger patients. Patients clinically suspected (CS) of having CM ((CS)CM) mostly were infected with a single clone, and a large proportion of them acquired antibodies (Abs) against merozoite surface protein (MSP) antigens (Ags). The therapeutic response to quinine treatment was comparable between patients with (CS)CM and CM. In conclusion, uniquely in this setting, CM can be associated with sub-patent parasitemia; thus, a diagnostic tool more sensitive than microscopy is needed.
Acta Tropica, 2006
The pathogenesis of severe Plasmodium falciparum malaria is still obscure, but is believed to be ... more The pathogenesis of severe Plasmodium falciparum malaria is still obscure, but is believed to be multi-factorial, and among the important factors are intrinsic parasite-properties. Here we investigated the association between clinical manifestation of P. falciparum malaria (an indicator of virulence) and two parasite properties-drug resistance and gametocyte production. Among 996 P. falciparum infections detected in the outpatient clinic of Gedarif Hospital in eastern Sudan, there was no significant association between the incidence of severe versus mild disease and the presence of resistant alleles at the chloroquine-resistance transporter locus (pfcrt-T76) and the multi-drug-resistance locus (pfmdr1-Y86). However, among severe cases, there was a significantly lower prevalence of parasites carrying resistant alleles among patients that died versus survived. There was a trend towards a higher gametocyte rate among severe malaria patients compared with uncomplicated malaria cases. These results are discussed in relation to the fitness of drug resistant parasites.
The inappropriate drug use during the pregnancy may cause serious complications. However, the con... more The inappropriate drug use during the pregnancy may cause serious complications. However, the consumption of drugs during the pregnancy cannot be totally avoided because of the existing chronic illness that may require continuous treatment or the development of new medical conditions during pregnancy that require therapeutic intervention. The main objective of this study was to evaluate the awareness about the drug safety and medication use among the pregnant women of the Northern Border Region of the Kingdom of Saudi Arabia. This cross-sectional study was carried out using a pretested and structured questionnaire among the pregnant women (N = 50) of the rural area, near Arar City and Rafha City, of the Northern Border Region of the Kingdom of Saudi Arabia. The data obtained was analyzed using the Statistical Package for Social Sciences (SPSS) version 19. It was surprising to note that neither doctors nor the pharmacists provided full information about the medicine to more than 3/4 th of the patients. This type of practice by the doctors and pharmacist may pose pregnancy related problems to the expecting mothers and may lead to serious consequences. There is an urgent need to take remedial actions regarding this issue by the concerned authorities of the Northen Border Region of the Kingdom of Saudi Arabia.
Journal of Pharmaceutical Research International
Background: Anemia is a global health problem especially affecting pregnant and non-pregnant wome... more Background: Anemia is a global health problem especially affecting pregnant and non-pregnant women. Among many different causes of anemia, iron deficiency anemia is the most common cause. Hemoglobin concentration measurement is among the most commonly performed blood tests, usually as part of a complete blood count. Methods: A cross sectional study was conducted in Rafha Central Hospital and three associated health centers. Pregnant and none pregnant women (400) were included in the study. The data were collected by using questionnaire prepared by the investigator in Arabic language. Informed consents were taken prior to taking data from each participant. Results: Out of the 400 women enrolled in this study, 235 were pregnant. Majority of the participants were married (86%), and 45% were university graduates. Most of the participants (77.25%) were in the anemic range. The prevalence of anemia was almost equally distributed among pregnant (75.31%) and non-pregnant (80%) women. The pr...
Journal of Pharmaceutical Research, 2021
Background: The quality of medicinal/food products is directly related to the consumer’s safety. ... more Background: The quality of medicinal/food products is directly related to the consumer’s safety. Virgin Olive Oil (VOO) is a widely used oil in Saudi Arabia for cooking, frying, and salad dressing. It is also an ingredient of many pharmaceutical products. Therefore, its regular quality assessment is essential for the consumer’s safety. Objective: To assess standard quality parameters of the marketed VOO brands in the Rafha City of Saudi Arabia and to perform their antioxidant activity evaluation. Methodology: The different brands of VOO sold in the Rafha City of Saudi Arabia were collected from two supermarkets and one local shop. The quality of the different brands of the VOO was assessed for their physical appearance, solubility, relative density, refractive index, absorbance, acid value, and peroxide value. The standard procedures provided in the British Pharmacopeia Original Research Article A-Elbasit et al.; JPRI, 33(10): 20-28, 2021; Article no.JPRI.66024 21 (BP) were used to ...
Biochemical Investigation and Development of HPLC Method for Tacrolimus
The objective of this work was to develop a method for the quantification of tacrolimus in rabbit... more The objective of this work was to develop a method for the quantification of tacrolimus in rabbit aqueous humor by UHPLC. UHPLC analysis was performed on a Waters Acquity UHPLC system (Milford, MA, USA). A 50 μL aliquot of rabbit aqueous humor was pipetted into a 2.0 ml Eppendorf tube and 100 μL of acetonitrile was added to precipitate the protein. The samples were vortex mixed for 2 min followed by filtration through 0.22 μm nylon filter. To this filtrate, 0.4 ml of 0.01M iodine was added and volume up to 1.0 ml was made with acetonitrile. Five microliter of this solution was injected into the UHPLC system. All the rabbit aqueous humor samples were stored at −20°C and were allowed to thaw at room temperature prior to sample preparation. Linearity was investigated by the assay in parallel of triplicate rabbit’s aqueous humor samples spiked with TAC to concentrations of 10, 20, 50, 100, 200, 400, 600 and 800 ng/ml. Stability assessments under different conditions: bench-top, short-te...
Bioscience Biotechnology Research Communications
The present study investigates the comparative levels of some bioactive constituents of the impor... more The present study investigates the comparative levels of some bioactive constituents of the important plant Allium sativum (garlic). Comparisons have been made on the levels within three garlic types, one type from Asia (Chinese garlic), and two African garlic types from Sudan. Results showed that the garlic from Southwestern Sudan (Zalenge region) had higher levels concerning most of the constituents, particularly it contains 38.17±1.26 g/100g of carbohydrate, 2.53±0.45 g/100g fat, 110.00±2.45 mg/100g phosphorus, and 185.22 ±2.47 mg/100g calcium as compared to 29.00±1.00 g/100g, 1.23±0.25 g/100g, 90.22±1.66 mg/100g, and 176.60±1.20 mg/100g, respectively of the Northern Sudan garlic, and 23.97±1.06 g/100g, 0.57±0.21 g/100g, 99.11±3.72 mg/100g, and 148.21±3.28 mg/100g, respectively of the Chinese garlic. The variations were almost due to the enriched soil of that region of Sudan which is known as a source of many plant products, either cultivated or naturally grown. The justifi cation for the uncertainty of results of allicin levels in garlic samples had been discussed.
Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ṣiḥḥīyah li-sharq al-mutawassiṭ
A prospective clinical trial was carried out to determine in vivo efficacy of sulfadoxine/pyrimet... more A prospective clinical trial was carried out to determine in vivo efficacy of sulfadoxine/pyrimethamine for the treatment of uncomplicated Plasmodium falciparum malaria in children in New Halfa (eastern Sudan). Forty patients were enrolled; 31 completed the 28-day follow-up. Six (19.4%) patients showed recurrence of parasitaemia during follow-up, while the rest (80.6%) cleared the parasites and responded fully to treatment. All the failures were late treatment failures. Parasite genotyping by polymerase chain reaction showed that 1 (16.7%) of the 6 cases of late parasitaemia was due to reinfection while the rest (83.4%) were due to true recrudescence. During the follow-up period 22.6% of patients showed gametocytaemia. The high level of treatment failure as well as gametocytaemia necessitates the introduction of artesunate in this area in combination therapy. Efficacité de la sulfadoxine-pyriméthamine pour le paludisme à Plasmodium falciparum sans complications dans un petit échantillon d'enfants soudanais RESUME Un essai clinique prospectif a été effectué afin de déterminer l'efficacité in vivo de l'association sulfadoxine-pyriméthamine dans le traitement de l'accès palustre simple à Plasmodium falciparum chez des enfants à New Halfa (Soudan oriental). Quarante patients ont été recrutés ; 31 ont terminé la période de suivi de 28 jours. Six patients (19,4 %) ont présenté une parasitémie récurrente pendant le suivi, tandis que le reste des patients (80,6 %) ont éliminé les parasites et ont répondu au traitement complètement. Tous les échecs étaient des échecs thérapeutiques tardifs. Le génotypage du parasite par PCR (amplification en chaîne par polymérase) a montré qu'un cas sur 6 (16,7 %) des parasitémies tardives était dû à une réinfestation alors que le reste (83,4 %) était dû à une recrudescence. Pendant la période de suivi, 22,6 % des patients ont présenté une gamétocytémie. Le niveau élevé d'échec thérapeutique ainsi que la gamétocytémie nécessitent l'introduction de l'artésunate dans cette région en traitement associé.
Allelic polymorphism of MSP2 gene in severe P. falciparum malaria, in an area of a short transmission season and limited inoculation rate in Sudan Ishraga E. A-Elbasit1, Gehad A. Ghazali1, Amel A. Hamad2, Thoraya M. E. A-Elgadir, Mustafa I. Elbashir1 , Hayder A. Giha1
Acta biochimica Polonica, 2010
To study the glycaemic profile of patients with severe malaria (SM). For this purpose, 110 SM pat... more To study the glycaemic profile of patients with severe malaria (SM). For this purpose, 110 SM patients were recruited. Pre-treatment random blood glucose and plasma insulin were measured in a subset of donors. An ex-vivo experiment was developed for estimation of glucose consumption by parasitized erythrocytes. Hyperglycaemia was frequent in SM but more commonly associated with cerebral malaria (CM), while hyperinsulinaemia was recognized in severe-malarial-hypotension (median, 25 %-75 %, 188.2, 93.8-336.8 pmol/L). The plasma insulin level was positively correlated with age (CC = 0.457, p < 0.001) and negatively with parasitaemia (CC = -0.368, p = 0.045). Importantly, fatal-CM was associated with hyperglycaemia (12.22, 6.5-14.6 mmol/L), hyperinsulinaemia (141.0, 54.0-186.8 pmol/L) and elevated homeostasis model assessment (HOMA) values. However, there was a trend of higher glucose consumption by parasites in CM compared with that in uncomplicated malaria (UM). Hyperglycaemia, hyp...
Antigenic variation in severe Plasmodium falciparum malaria: A comparison between severe malarial anemia and cerebral malaria [MIM-TA-7406]
The efficacy of sulfadoxine-pyrimethamine alone and in combination with chloroquine for malaria treatment in rural Eastern Sudan: the interrelation between resistance, age and gametocytogenesis
Tropical Medicine and International Health, 2006
To compare the efficacy of sulfadoxine-pyremethamine (SP)+chloroquine (CQ) combination treatment ... more To compare the efficacy of sulfadoxine-pyremethamine (SP)+chloroquine (CQ) combination treatment against falciparum malaria with SP treatment alone. In-vivo study of 254 patients with uncomplicated Plasmodium falciparum malaria in rural eastern Sudan, where the population is semi-immune. Sulfadoxine-pyremethamine treatment alone cured 68.3% (41/60) and SP+CQ cured 63.4% (123/194). Early and late treatment failures occurred in both treatment groups. Host age (as a marker for immunity) and parasite gametocytogenesis (as a marker for transmissibility) were significantly associated with SP resistance. Patients who were cured were significantly older (median age 21 years) than patients whose treatment failed (median age 12 years). Gametocyte production was significantly higher in patients with treatment failure (0.72 vs 0.45) and associated with younger age. Gametocyte counts were comparable between both groups until day 7 of follow up; thereafter, they were significantly higher in patients with treatment failure. However, the longevity of gametocytes was comparable in both treatment groups. Chloroquine did not improve the parasite response to SP. Age was strongly associated with clearance of SP-resistant parasites. The fast rise of SP resistance may partially be due to selection of SP resistant parasites and expansion of the resistant population through the gametocytogenic effect of SP.
Clinical pattern of severe Plasmodium falciparum malaria in Sudan in an area characterized by seasonal and unstable malaria transmission
Transactions of the Royal Society of Tropical Medicine and Hygiene, 2005
A hospital-based study was carried out in Gedarif town, eastern Sudan, an area of markedly unstab... more A hospital-based study was carried out in Gedarif town, eastern Sudan, an area of markedly unstable malaria transmission. Among the 2488 diagnosed malaria patients, 4.4% fulfilled the WHO criteria for severe malaria, and seven died of cerebral malaria. The predominant complication was severe malarial anemia (45.4%), followed by convulsions (21%), cerebral malaria (16. 4%) and hypotension (11.8%). Severe malaria was recognized in all age groups, but 44.5% of patients were aged 2 to 4 years. The mean ages of patients with severe anemia (5.6 years) and convulsions (5.9 years) were significantly lower than the mean ages of patients with cerebral malaria (14.1 years) or hypotension (35.2 years). Patients with convulsions and cerebral malaria had significantly higher mean parasite count (69972 and 56110 parasites/microL, respectively) than patients with severe anemia (24637 parasites/microL) or hypotension (13667 parasites/microL). The mean blood glucose level was higher in patients with cerebral malaria than in patients with anemia, and higher in patients who died than in patients who survived. In this setting, the clinico-epidemiological pattern of severe malaria varies considerably from that of hyperendemic regions in sub-Saharan Africa, and there is considerable variation between the individual complications of severe malaria.
Determinants of Variant Surface Antigen Antibody Response in Severe Plasmodium falciparum Malaria in an Area of Low and Unstable Malaria Transmission
Scandinavian Journal of Immunology, 2006
The variant surface antigens (VSA) of infected erythrocytes are important pathogenic markers, a s... more The variant surface antigens (VSA) of infected erythrocytes are important pathogenic markers, a set of variants (VSA(SM)), were assumed to be associated with severe malaria (SM), while SM constitutes clinically diverse forms, such as, severe malarial anemia (SMA) and cerebral malaria (CM). This study was conducted in Eastern Sudan, an area of seasonal and unstable malaria transmission. Parasites and plasma were obtained from patients with different clinical grades of malaria, and flow cytometry was used for analysis of VSA antibody (Ab) response. We found that individuals recognized a broader range of isolates had a higher level of VSA Ab against the recognized isolates (correlation coefficient, 0.727, P&lt;0.001). Unexpectedly, at the time of malaria diagnosis, plasma from patients with CM recognized a significantly larger number of isolates than did the plasma from patients with SMA (P&lt;0.001). Parasites obtained from patients with SMA or from children were better recognized than isolates obtained from patients with uncomplicated malaria or from adults, P&lt;0.001, P=0.021, respectively. Taken together, the above findings suggest that the limitations in the VSA immunoglobulin G repertoire were most probably contributing to the pathogenesis of SMA but not to that of CM.
PLoS Medicine, 2009
Background: Although the molecular basis of resistance to a number of common antimalarial drugs i... more Background: Although the molecular basis of resistance to a number of common antimalarial drugs is well known, a geographic description of the emergence and dispersal of resistance mutations across Africa has not been attempted. To that end we have characterised the evolutionary origins of antifolate resistance mutations in the dihydropteroate synthase (dhps) gene and mapped their contemporary distribution. Methods and Findings: We used microsatellite polymorphism flanking the dhps gene to determine which resistance alleles shared common ancestry and found five major lineages each of which had a unique geographical distribution. The extent to which allelic lineages were shared among 20 African Plasmodium falciparum populations revealed five major geographical groupings. Resistance lineages were common to all sites within these regions. The most marked differentiation was between east and west African P. falciparum, in which resistance alleles were not only of different ancestry but also carried different resistance mutations. Conclusions: Resistant dhps has emerged independently in multiple sites in Africa during the past 10-20 years. Our data show the molecular basis of resistance differs between east and west Africa, which is likely to translate into differing antifolate sensitivity. We have also demonstrated that the dispersal patterns of resistance lineages give unique insights into recent parasite migration patterns.
Parasitology Research, 2008
The parasite dynamics in severe malaria (SM) varies with malaria endemicity. This study was condu... more The parasite dynamics in severe malaria (SM) varies with malaria endemicity. This study was conducted in eastern Sudan, an area of seasonal and unstable malaria transmission. From the beginning of October to the end of December (malaria season) in the years 2000, 2001, and 2003, 99 patients with severe malarial anemia (SMA) and 54 patients with cerebral malaria (CM) were identified. There was marked variation in the incidence of SMA and CM (up to six folds) and in the CM/SMA incidence ratio, over 3 years. In the heavy season of 2003, CM peaked at the beginning of the season and declined within a month at a time that the SMA reached the peak. At diagnosis, the rate of gametocytemia had inclined from ∼10% to 100% from the beginning to the end of the season. During follow-up, gametocytemia was more associated with SMA than with CM. Paradoxically, the late occurring SMA was associated with early gametocytemia (day 7) and the opposite was true in CM. In conclusion, within the season the transmission of CM and SMA was bimodal, the prevalence of the asexual and sexual parasitemia was reciprocal, and the peaks of transmission and gametocytemia were paradoxical.
Parasitology Research, 2007
The severe malaria (SM) and uncomplicated malaria (UM) infections are expected to have different ... more The severe malaria (SM) and uncomplicated malaria (UM) infections are expected to have different genetic makeup. In this study, blood samples were obtained from 325 donors with SM and UM and malaria-free donors (including asymptomatic submicroscopic malaria-ASUM), from Eastern Sudan. The SM group included patients with cerebral malaria (CM), severe malarial anemia (SMA), and other complications. The MSP2 locus was exploited for parasite genotyping. We found that the genetic diversity of the parasite population was marked (51 genotypes). The overall multiplicity of infection (MOI) was 1.5, and it was comparable between SM and UM. However, the MOI in ASUM (1.0) and fatal CM (1.14) was comparable and significantly lower than in UM (1.53), SMA (1.52), and nonfatal CM (1.7). The ratio of the IC1 to FC27 allele families was comparable between SM and UM, and the distribution of the allele sizes was correlated (correlation coefficient=0.59 and 0.718; P<0.001). It is interesting to note that the FC27 genotype was overrepresented in ASUM (68.2%) and was not recognized in fatal CM, while in mixed-clone infections, the clearance of IC1 after quinine treatment was faster than FC27 clearance. Finally, the composition of the multiclone infections (IC1 and FC27) was suggesting a stronger cross-immunity within rather than between MSP2 gene families.
Parasitology Research, 2008
In this study, antibodies (Ab) directed against three MSP antigens; MSP1 19 , MSP2 A , and MSP2 B... more In this study, antibodies (Ab) directed against three MSP antigens; MSP1 19 , MSP2 A , and MSP2 B were analyzed in blood samples obtained from 223 Sudanese patients who presented with either severe malaria (SM) or uncomplicated malaria (UM) and from 117 malaria-free donors (MF). The results showed that the prevalence of MSP Abs was associated with the clinical outcome of malaria infection, and the Ab prevalence was age-dependent (P< 0.0005). More importantly, the prevalence of MSP Abs against the test antigens was lower in SM compared to UM (P=0.001 to 0.020), suggesting a protective role for these Abs against SM. Furthermore, the Ab responses between individual complications of SM were significantly different.
Malaria Journal, 2007
Background The Plasmodium falciparum dihydrofolate reductase (DHFR) and dihydropteroate synthetas... more Background The Plasmodium falciparum dihydrofolate reductase (DHFR) and dihydropteroate synthetase (DHPS) are enzymes of central importance in parasite metabolism. The dhfr and dhps gene mutations are known to be associated with sulphadoxine/pyrimethamine (SP) resistance. Objective To investigate the effects of dhfr/dhps mutations on parasite characteristics other than SP resistance. Method Parasite infections obtained from 153 Sudanese patients with uncomplicated falciparum malaria treated with SP or SP + chloroquine, were successfully genotyped at nine codons in the dhfr/dhps genes by PCR-ELISA. Results & conclusion Mutations were detected in dhfr at N51I, S108N and C59R, and in at dhps at A/S436F, A437G, K540E and A581G, the maximum number of mutations per infection were five. Based on number of mutant codons per infection (multiplicity of mutation, MOM), the infections were organized into six grades: wild-types (grade 0; frequency, 0.03) and infections with MOM grades of 1 to 5,...
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Papers by Ishraga Eltayeb A-Elbasit