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      Sudden emergence and spread of cutaneous larva migrans in Sudan: A case series calls for urgent actions

      case-report

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          Abstract

          Cutaneous larva migrans (CLM) is a self-limiting dermatosis parasitic disease that is caused by zoonotic hookworm mainly infects cats, dogs, and accidentally humans. The disease affects hosts through the invasion and the migration of the hookworm larva into top layers of the skin. The disease occurs in tropical and subtropical regions; where people commonly are infected when sitting or barefoot walking on places contaminated with feces of infected cats or dogs. Due to self-limiting nature of the disease, the exact burden and prevalence are commonly underestimated. In this communication, we investigated all cases presented to the skin-diseases outpatient clinic’ at the reference hospital of Tropical Diseases Medicine in Khartoum state between January 2019 and January 2021. This is the first-ever a case series report of cutaneous larva migrans in Sudan. We identified 15 cases of CLM presented with rash (100 %), redness of skin (67 %), and only adults were presented with larva crawling under their skins (27 %). Infection sites were (53 %) leg, (40 %) foot, only 7 % showed abdominal infection. The majority of patients were children or young adults, 47 % of them are ≤5 year-old, male to female ratio is 2.75:1. Duration of infection was one to three weeks and all patients fully recovered after treatment with albendazole. This urges for One Health interventions including deworming cats and dogs, improving water, sanitation, and hygiene, community-engagement and raising awareness in area with risk of infection.

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          Most cited references18

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          Epidemiological and clinical characteristics of hookworm-related cutaneous larva migrans.

          Hookworm-related cutaneous larva migrans is caused by the migration of animal hookworm larvae in the human skin. The disease mainly occurs in resource-poor communities in the developing world, but it is also reported sporadically in high-income countries and in tourists who have visited the tropics. Diagnosis is made clinically in the presence of a linear serpiginous track moving forward in the skin, associated with itching and a history of exposure. Itching is typically very intense and can prevent patients from sleeping. Bacterial superinfection occurs as a result of scratching. Treatment is based on oral drugs (albendazole or ivermectin) or the topical application of tiabendazole. To control hookworm-related cutaneous larva migrans at the community level, regular treatment of dogs and cats with anthelmintic drugs is necessary, but this is seldom feasible in resource-poor settings. Animals should be banned from beaches and playgrounds. For protection at the individual level, unprotected skin should not come into contact with possibly contaminated soil.
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            Unique Outbreak of Rift Valley Fever in Sudan, 2019

            We report a unique outbreak of Rift Valley fever in the Eldamar area, Sudan, May–July 2019, that resulted in 1,129 case-patients and 19 (1.7%) deaths. Patients exhibited clinical signs including fever (100%), headache (79%), and bleeding (4%). Most (98%) patients also reported death and abortions among their livestock.
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              Urgent call for a global enforcement of the public sharing of health emergencies data: lesson learned from serious arboviral disease epidemics in Sudan

              Abstract One crucial element of the timely detection and identification of the causative agent(s) of a health emergency is access to live and historical data about the health risks in the area of concern. Therefore, sharing data on health emergencies is essential to the early investigation and detection teams. Although, theoretically, there is a global agreement on sharing data rapidly, in practice this is not always the case, particularly in developing countries such as Sudan, where there is continuous failure in making epidemics-related data publicly available. An alternative model for information and data sharing is suggested.
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                Author and article information

                Contributors
                Journal
                IDCases
                IDCases
                IDCases
                Elsevier
                2214-2509
                05 May 2023
                2023
                05 May 2023
                : 32
                : e01789
                Affiliations
                [a ]Institute of endemic diseases, University of Khartoum, Khartoum, Sudan
                [b ]Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
                [c ]University of Basel, Petersplatz 1, Basel, Switzerland
                [d ]Unit of Applied Medical Sciences, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
                [e ]General Director, Tropical Medicine Hospital, Omdurman, Khartoum State, Sudan
                [f ]The Mycetoma Research Center, University of Khartoum, Khartoum, Sudan
                [g ]ErasmusMC, University Medical Center Rotterdam, Department of Medical Microbiology and Infectious Diseases, Rotterdam, the Netherlands
                Author notes
                [* ]Corresponding author at: Unit of Applied Medical Sciences, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan. emanwell-eds3@ 123456hotmail.com
                Article
                S2214-2509(23)00113-0 e01789
                10.1016/j.idcr.2023.e01789
                10189479
                37207175
                c4295824-70ff-4b85-ab11-b56a667bb490
                © 2023 The Authors. Published by Elsevier Ltd.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 20 February 2023
                : 27 April 2023
                : 2 May 2023
                Categories
                Case Report

                cutaneous larva migrans,skin diseases zoonoses,integrated surveillance and response system,one health,sudan

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