Magdi M.M. Ali

Ivermectin treatment in severe asymmetric reactive onchodermatitis (sowda) in Sudan

Ivermectin efficacy and post-treatment reactions in asymmetric severe reactive ochodermatitis (sowda) were studied in 8 patients with sowda syndrome and 6 with mild generalized onchodermatitis in Sudan. Initial skin snips from 12 patients contained microfilariae (1-9 per mg skin). Patients were treated in hospital with a single oral dose of c. 150 micrograms/kg ivermectin (103-200 micrograms/kg) and monitored for frequency and severity of post-treatment reactions for 4 weeks. Serial samples of heparinized blood were collected over the first 24 h after treatment for determination of ivermectin pharmacokinetics. Skin snips from all patients on days 3 and 28 revealed no microfilariae. Post-treatment reactions were more common and severe in individuals with sowda; they consisted mainly of musculoskeletal pain, local swellings with pitting oedema, and lymph gland tenderness and enlargement. No relation was established between these reactions, the microfilarial infection intensity, or the plasma pharmacokinetic profiles. A single oral dose of ivermectin cleared the skin of microfilariae and led to improvement of symptoms and dermatological signs of sowda, but resulted in more marked reactions than in cases of generalized onchodermatitis.

Evaluation of haematuria as an indirect screening test for schistosomiasis haematobium: a population-based study in the White Nile Province, Sudan

Haematuria elicited in the history, seen macroscopically or detected by reagent strips, was used as an indirect screening test for Schistosoma haematobium infection in Um-Hani Irrigation Scheme in the White Nile province, Sudan. These approaches were used separately or combined in different sequences. Reagent strips alone detected 81% of cases and 88% of those who excreted 50 egg/10 ml of urine or more. The sequence of observation of gross haematuria followed by screening with reagent strips and then taking history of haematuria had the highest sensitivity of all the orders, 0.87, and it saved 18% of reagent strips. If history and inspection were done first, followed by reagent strips, the sensitivity would be 0.86 and 47% of strips would be saved. The specificity of haematuria as a diagnostic index for schistosomiasis, however, was low.

Demonstration of Urinary Eosinophils in Schistosoma haematobium: a Comparative Study among Three Different Stains

Three stains, Hansels stain, alkaline erythrocin B (AEB) and naphthalene black (NB), were used to demonstrate eosinophils in the urine of patients infected with Schistosoma haematobium. Hansels stain was superior to the other two stains; it stained eosinophils bright red and their nuclei faint blue, and they were easily differentiated from neutrophils, lymphocytes, macrophages and epithelial cells. The method using AEB took longer than Hansels stain and 10% of the specimens were lost during staining with this method. Like eosinophils, the neutrophils took up NB stain and their nuclei stained poorly with the counterstain.