Acute myelopathy is increasingly being recognized as a common neurological complication of schist... more Acute myelopathy is increasingly being recognized as a common neurological complication of schistosomiasis. Schistosome eggs reach the spinal cord either as egg emboli or as eggs produced by ectopic worms. This leads to inflammatory reaction and granuloma formation around the eggs. Patients with spinal schistosomiasis may not have clinical evidence of schistosomiasis. The typical clinical picture is that of lumbar pain preceded by other symptoms by hours or up to 3 weeks. Patients may present with paraparesis, urinary retention or paraplegia. Definitive diagnosis of spinal cord schistosomiasis is by detection of the eggs in a spinal cord biopsy or at autopsy. However, most cases are diagnosed based on a presumptive diagnosis that depends on a suggestive clinical picture, history or evidence of active schistosomiasis and exclusion of other conditions. Investigations include stools and urine examination for schistosome eggs, blood tests, magnetic resonance imaging (MRI) and examination of the cerebrospinal fluid. Treatment of cases is mainly by praziquantel, corticosteroids, surgical intervention and rehabilitation.
Seroprevalence studies on human toxocariasis help to assess the burden and the morbidity associat... more Seroprevalence studies on human toxocariasis help to assess the burden and the morbidity associated with this zoonosis. This review searched the seroprevalence studies and case reports in six North African countries: Algeria, Egypt, Libya, Morocco, Sudan and Tunisia, since 1990. The search also included studies on the environmental factors related to the risk of transmission. Most of the published epidemiological studies were done in Egypt. Cross-sectional and case-control studies in Egypt demonstrated that toxocariasis is a significant zoonosis that could be associated with conditions like bronchial asthma allergies and certain neuropsychiatric disorders. The population at risk of this infection includes all ages, both genders, in contact with dogs, resident in rural areas with poor housing conditions. The publications from Tunisia, Morocco and Algeria are limited to case reports and retrospective analyses of cases, but the disease is probably under-diagnosed in these three countries. There are no published reports on human toxocariasis in Libya and Sudan during the period covered by the review. Animal studies confirm high infection rates of dogs with Toxocara canis in North Africa. There is also evidence of wide-spread contamination of soil and water with Toxocara spp. eggs. Moreover, the use of untreated wastewater for irrigation in parts of North Africa could be a source of contamination of agricultural products with eggs of Toxocara spp. Population-based studies on human toxocariasis are recommended, using standardized diagnostic tests. These surveys should also assess risk factors to guide preventive measures.
appointments in Britain, he joined the R.A.M.C. in 1906 winning the prize in pathology at the Arm... more appointments in Britain, he joined the R.A.M.C. in 1906 winning the prize in pathology at the Army Medical College at Milbank in that year. He worked for one year in Colonel (later Sir) William Leishman’s laboratory under his personal supervision. In 1907 he joined the Sleeping Sickness Commission in Uganda headed by Colonel (later Sir) David Bruce. After spending an eventful period in Uganda, he was transferred to Sudan in 1908 as regimental medical officer and at the same time he held the post of Assistant Bacteriologist and Pathologist in
The designations employed and the presentation of the material in this publication do not imply t... more The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers ’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. The named authors alone a...
This study was done to investigate malaria case management at the community level in Gezira, Suda... more This study was done to investigate malaria case management at the community level in Gezira, Sudan, which is an area of unstable malaria predominantly due to Plasmodium falciparum. Questionnaire surveys were conducted at four consecutive weekly intervals in October 1995. A sample of 400 households (3062 persons) including 200 rural and 200 urban households was studied. Use of antimalarials was assessed in terms of diagnosis, types of antimalarial used, self-medication and compliance. During the four weeks of observation, 25.1% of the rural population and 35.6% of the urban population received at least one course of antimalarial drugs. Diagnosis was confirmed microscopically in 81.7% of treated persons in the urban community and in only 34.3% those treated in the rural community. Chloroquine is the most frequently used antimalarial in both communities with notable overuse of injections in rural patients and in patients treated by paramedical health workers. Self-medication was common...
A longitudinal pharmacoepidemiological study on prescribing patterns of antimalarials was conduct... more A longitudinal pharmacoepidemiological study on prescribing patterns of antimalarials was conducted in Gezira State, Sudan. Different core drug prescribing indicators were identified, measured and correlated. Chloroquine and quinine were the most frequently prescribed antimalaria drugs but in 44.7% of cases, the dosage was inappropriate and did not conform to standard regimens. Due to variable and unmonitored patterns of drug resistance, most medical practitioners in Sudan tend to follow their own protocols to treat severe cases of malaria rather than conforming to standard regimens. We attribute the emergence of a high rate of resistance to malaria chemotherapy to such practices. We recommend interventions to ensure rational prescribing, and call for the formulation of a national antimalarial drugs policy.
This article explores the origins of an old brass monocular microscope in the Central Laboratory ... more This article explores the origins of an old brass monocular microscope in the Central Laboratory in Khartoum, which used to be the Wellcome Tropical Research Laboratory in Khartoum (1903-1934). Examination of the microscope and review of published literature gave clues to the historical background of this microscope. Identical microscopes were first manufactured by R and J Beck in 1898, and continued to be advertised in 1899. The microscope was probably among the instruments provided by Wellcome for the initial establishment of the laboratories in 1902-1903. The article includes a brief review of the development of light microscopy. The need for preservation and proper restoration of old relics of the Wellcome laboratories in Khartoum is emphasized.
This is a case report of acute organophosphate poisoning in a child treated with topical applicat... more This is a case report of acute organophosphate poisoning in a child treated with topical application of Diazinon-60 (WHO Class II toxicity) for head lice (pediculosis capitis). The patient presented with neurological symptoms and signs. After emergency respiratory and circulatory resuscitation the patient underwent dermal decontamination and was treated with atropine, high flow oxygen and pralidoxime. Scanning electron micrographs of scalp hair specimens revealed both viable and empty head lice nits (lice eggs that attach to the hair shaft). The patient was hospitalized for seven days and discharged after full recovery. The case highlights the importance of raising the awareness of health workers and the community about the danger of misusing pesticides for the treatment of head lice.
Resistance of falciparum malaria to chloroquine (CQ) has gradually emerged in the late 1970s, rea... more Resistance of falciparum malaria to chloroquine (CQ) has gradually emerged in the late 1970s, reaching unacceptably high proportions over the following three decades of use as frst line treatment in Sudan. By 2004-2006 CQ was replaced by artemisinin-based combination treatment (ACTs), with combination of sulfadoxine-pyrimethamine (SP) and artesunate (AS) deployed as frst-line drug against falciparum malaria. The present review follows the evolution of CQ resistance in Sudan and the available evidence on the response to the present frst-line drugs. The fndings in Sudan are analyzed in view of developments in other African countries and at the global level, with the hope of elucidating possible scenarios for the course of events in the Sudan. Northern Sudan has been one of the areas where signals indicating the emergence of drug resistant malaria parasites have frst originated in Africa. The pattern of low endemicity and low population immunity to malaria, together with massive deploy...
Henry Solomon Wellcome, the famous drug manufacturer had a fascinating association with the Sudan... more Henry Solomon Wellcome, the famous drug manufacturer had a fascinating association with the Sudan. Besides supporting tropical medicine research in this country, he established an extensive project in the Sudan that aimed at combining archeological excavations, philanthropy and social reform. This article is an archives-based account on this side of Wellcome's association with the Sudan. The article starts with Wellcome's early years in the American Midwest and the evolution of his career and his rise as a world-renowned drug manufacturer. After the battle of Omdurman, Wellcome visited Sudan in 1900 - 1901 where he offered to support the establishment of the research laboratories which later came to be known as the Wellcome Tropical Research Laboratories in Khartoum. He then became directly involved in the planning and running of extensive archeological excavations in the central Sudan. This project served as a field in which Wellcome found an outlet for his philanthropy. Mo...
Acute myelopathy is increasingly being recognized as a common neurological complication of schist... more Acute myelopathy is increasingly being recognized as a common neurological complication of schistosomiasis. Schistosome eggs reach the spinal cord either as egg emboli or as eggs produced by ectopic worms. This leads to inflammatory reaction and granuloma formation around the eggs. Patients with spinal schistosomiasis may not have clinical evidence of schistosomiasis. The typical clinical picture is that of lumbar pain preceded by other symptoms by hours or up to 3 weeks. Patients may present with paraparesis, urinary retention or paraplegia. Definitive diagnosis of spinal cord schistosomiasis is by detection of the eggs in a spinal cord biopsy or at autopsy. However, most cases are diagnosed based on a presumptive diagnosis that depends on a suggestive clinical picture, history or evidence of active schistosomiasis and exclusion of other conditions. Investigations include stools and urine examination for schistosome eggs, blood tests, magnetic resonance imaging (MRI) and examination of the cerebrospinal fluid. Treatment of cases is mainly by praziquantel, corticosteroids, surgical intervention and rehabilitation.
Seroprevalence studies on human toxocariasis help to assess the burden and the morbidity associat... more Seroprevalence studies on human toxocariasis help to assess the burden and the morbidity associated with this zoonosis. This review searched the seroprevalence studies and case reports in six North African countries: Algeria, Egypt, Libya, Morocco, Sudan and Tunisia, since 1990. The search also included studies on the environmental factors related to the risk of transmission. Most of the published epidemiological studies were done in Egypt. Cross-sectional and case-control studies in Egypt demonstrated that toxocariasis is a significant zoonosis that could be associated with conditions like bronchial asthma allergies and certain neuropsychiatric disorders. The population at risk of this infection includes all ages, both genders, in contact with dogs, resident in rural areas with poor housing conditions. The publications from Tunisia, Morocco and Algeria are limited to case reports and retrospective analyses of cases, but the disease is probably under-diagnosed in these three countries. There are no published reports on human toxocariasis in Libya and Sudan during the period covered by the review. Animal studies confirm high infection rates of dogs with Toxocara canis in North Africa. There is also evidence of wide-spread contamination of soil and water with Toxocara spp. eggs. Moreover, the use of untreated wastewater for irrigation in parts of North Africa could be a source of contamination of agricultural products with eggs of Toxocara spp. Population-based studies on human toxocariasis are recommended, using standardized diagnostic tests. These surveys should also assess risk factors to guide preventive measures.
appointments in Britain, he joined the R.A.M.C. in 1906 winning the prize in pathology at the Arm... more appointments in Britain, he joined the R.A.M.C. in 1906 winning the prize in pathology at the Army Medical College at Milbank in that year. He worked for one year in Colonel (later Sir) William Leishman’s laboratory under his personal supervision. In 1907 he joined the Sleeping Sickness Commission in Uganda headed by Colonel (later Sir) David Bruce. After spending an eventful period in Uganda, he was transferred to Sudan in 1908 as regimental medical officer and at the same time he held the post of Assistant Bacteriologist and Pathologist in
The designations employed and the presentation of the material in this publication do not imply t... more The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers ’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. The named authors alone a...
This study was done to investigate malaria case management at the community level in Gezira, Suda... more This study was done to investigate malaria case management at the community level in Gezira, Sudan, which is an area of unstable malaria predominantly due to Plasmodium falciparum. Questionnaire surveys were conducted at four consecutive weekly intervals in October 1995. A sample of 400 households (3062 persons) including 200 rural and 200 urban households was studied. Use of antimalarials was assessed in terms of diagnosis, types of antimalarial used, self-medication and compliance. During the four weeks of observation, 25.1% of the rural population and 35.6% of the urban population received at least one course of antimalarial drugs. Diagnosis was confirmed microscopically in 81.7% of treated persons in the urban community and in only 34.3% those treated in the rural community. Chloroquine is the most frequently used antimalarial in both communities with notable overuse of injections in rural patients and in patients treated by paramedical health workers. Self-medication was common...
A longitudinal pharmacoepidemiological study on prescribing patterns of antimalarials was conduct... more A longitudinal pharmacoepidemiological study on prescribing patterns of antimalarials was conducted in Gezira State, Sudan. Different core drug prescribing indicators were identified, measured and correlated. Chloroquine and quinine were the most frequently prescribed antimalaria drugs but in 44.7% of cases, the dosage was inappropriate and did not conform to standard regimens. Due to variable and unmonitored patterns of drug resistance, most medical practitioners in Sudan tend to follow their own protocols to treat severe cases of malaria rather than conforming to standard regimens. We attribute the emergence of a high rate of resistance to malaria chemotherapy to such practices. We recommend interventions to ensure rational prescribing, and call for the formulation of a national antimalarial drugs policy.
This article explores the origins of an old brass monocular microscope in the Central Laboratory ... more This article explores the origins of an old brass monocular microscope in the Central Laboratory in Khartoum, which used to be the Wellcome Tropical Research Laboratory in Khartoum (1903-1934). Examination of the microscope and review of published literature gave clues to the historical background of this microscope. Identical microscopes were first manufactured by R and J Beck in 1898, and continued to be advertised in 1899. The microscope was probably among the instruments provided by Wellcome for the initial establishment of the laboratories in 1902-1903. The article includes a brief review of the development of light microscopy. The need for preservation and proper restoration of old relics of the Wellcome laboratories in Khartoum is emphasized.
This is a case report of acute organophosphate poisoning in a child treated with topical applicat... more This is a case report of acute organophosphate poisoning in a child treated with topical application of Diazinon-60 (WHO Class II toxicity) for head lice (pediculosis capitis). The patient presented with neurological symptoms and signs. After emergency respiratory and circulatory resuscitation the patient underwent dermal decontamination and was treated with atropine, high flow oxygen and pralidoxime. Scanning electron micrographs of scalp hair specimens revealed both viable and empty head lice nits (lice eggs that attach to the hair shaft). The patient was hospitalized for seven days and discharged after full recovery. The case highlights the importance of raising the awareness of health workers and the community about the danger of misusing pesticides for the treatment of head lice.
Resistance of falciparum malaria to chloroquine (CQ) has gradually emerged in the late 1970s, rea... more Resistance of falciparum malaria to chloroquine (CQ) has gradually emerged in the late 1970s, reaching unacceptably high proportions over the following three decades of use as frst line treatment in Sudan. By 2004-2006 CQ was replaced by artemisinin-based combination treatment (ACTs), with combination of sulfadoxine-pyrimethamine (SP) and artesunate (AS) deployed as frst-line drug against falciparum malaria. The present review follows the evolution of CQ resistance in Sudan and the available evidence on the response to the present frst-line drugs. The fndings in Sudan are analyzed in view of developments in other African countries and at the global level, with the hope of elucidating possible scenarios for the course of events in the Sudan. Northern Sudan has been one of the areas where signals indicating the emergence of drug resistant malaria parasites have frst originated in Africa. The pattern of low endemicity and low population immunity to malaria, together with massive deploy...
Henry Solomon Wellcome, the famous drug manufacturer had a fascinating association with the Sudan... more Henry Solomon Wellcome, the famous drug manufacturer had a fascinating association with the Sudan. Besides supporting tropical medicine research in this country, he established an extensive project in the Sudan that aimed at combining archeological excavations, philanthropy and social reform. This article is an archives-based account on this side of Wellcome's association with the Sudan. The article starts with Wellcome's early years in the American Midwest and the evolution of his career and his rise as a world-renowned drug manufacturer. After the battle of Omdurman, Wellcome visited Sudan in 1900 - 1901 where he offered to support the establishment of the research laboratories which later came to be known as the Wellcome Tropical Research Laboratories in Khartoum. He then became directly involved in the planning and running of extensive archeological excavations in the central Sudan. This project served as a field in which Wellcome found an outlet for his philanthropy. Mo...
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