Foreign-body aspiration is a common paediatric emergency requiring immediate recognition and management. We report a case of a four-year-old boy who presented to the Emergency Department at Al Sabah Children’s Hospital in Juba, South Sudan, with a two-month history of an inhaled foreign body (bead). He had previously attended several healthcare facilities with recurrent chest infections that led to acute respiratory distress. On admission, he was managed for respiratory failure, severe aspiration pneumonia, pleural empyema/lung abscess, and pneumothorax. Despite the prolonged aspiration and a prior unsuccessful bronchoscopic retrieval attempt, the foreign body was expelled after back blows. The child developed complications necessitating chest tube thoracostomy, prolonged intravenous antimicrobial therapy, oxygen supplementation, and anti-tuberculosis treatment. His clinical condition gradually improved. Prevention of foreign-body aspiration in children requires restricting access to high-risk choking objects and providing age-appropriate feeds.
Introduction: Maternal and perinatal mortality remain a major challenge in developing countries, including South Sudan, where rates are among the highest in the world. Providing adequate antenatal care is regarded as a cornerstone of maternal and perinatal health care and is expected to have a considerable impact on achieving the Sustainable Development Goals. The objective of this study was to assess the quality of health facilities providing antenatal care services in Bor, South Sudan. Method: Data were collected from six health facilities providing antenatal care in Bor town in June 2023. The availability of equipment for assessing pregnant women and foetuses at the facilities and the qualifications of the health care workers who provided care were assessed. Results: Not all equipment considered necessary for antenatal care was available in every facility. Three of the six facilities had all three: a blood pressure (BP) apparatus, an examination couch or bed, and a thermometer. While all facilities had a thermometer, one had a BP apparatus and a couch, and only three had an examination couch. For foetal assessment, only one facility had an obstetric calendar, one had a tape measure for fundal height measurement, and four had Pinard’s foetal stethoscope. For measuring nutritional status, only two facilities had adult mid-upper arm circumference (MUAC) tapes, weighing scales, and height measurements for calculating BMI. Of the 18 workers who provided antenatal care, 10 were not health professionals. Conclusion: Health facilities providing antenatal care in Bor should be equipped with all necessary tools and staffed with trained health workers to improve maternal health outcomes.
Introduction: Rural and semi-urban communities in Central Kalimantan face severe environmental health risks due to inadequate municipal solid waste management. With waste generation exceeding 1,200 tons daily, local infrastructure is overwhelmed. This study investigates the complex interplay among environmental degradation, occupational hazards, and community health in this region resulting from open dumping practices. Method: We used a cross-sectional observational study design with a mixed-methods approach across 14 regencies in Central Kalimantan. Data were collected through field observations of final disposal sites, qualitative focus group discussions with local stakeholders, and a review of the 2024 national waste registry. Thematic analysis was applied to identify sanitation deficits and health vulnerabilities. Results: The region’s waste stream is heavily organic (30%–57%). The study revealed that most disposal sites operate as unregulated open dumps lacking daily soil cover and functional leachate treatment plants, posing severe risks of groundwater contamination and vector-borne diseases. Furthermore, informal waste pickers were observed foraging for recyclables and livestock feed (e.g., for swine) without adequate personal protective equipment. This practice exposes them to acute physical and biological hazards, while the use of untreated refuse for animal feed introduces severe epidemiological risks, including zoonotic and parasitic pathogens (such as Taenia solium), into the human food chain. Conclusion: This research highlights the critical environmental and public health crises driven by open dumping. Urgent multisectoral interventions are required to upgrade sanitation infrastructure, enforce occupational safety standards for informal workers, and develop culturally sensitive policies to mitigate the epidemiological risks posed by unmanaged waste.
Introduction: Evidence-based Medicine (EBM) has become important for integrating critical appraisal of research evidence into routine clinical practice. Increasingly, acquiring knowledge and skills for this new concept is becoming a core competence for all doctors. This study aimed to assess knowledge and attitudes toward EBM among undergraduate medical students at the Faculty of Medicine, Gadarif University, Sudan. Method: This cross-sectional descriptive study was conducted during the 2019-2020 academic year, and 150 undergraduate students from Gadarif University’s Faculty of Medicine participated. Convenience sampling was employed to gather data. A self-administered questionnaire was used to assess students’ knowledge and attitudes towards EBM. SPSS version 23 was used to analyse the data. Results: Of the 150 students involved, 94 (62.7%) of them were not aware of EBM, and 96 (64%) did not understand the concept; 133 (88.7%) had poor knowledge of the basic components of EBM; 14 (9.3%) understood the term PICO (Problem, Information/Intervention, Comparison, Outcome) which is the standard method for searching evidence. Participants considered/mentioned the following methods for obtaining evidence: Google search 81 (54%), Cochrane Library 10 (6.7%), TRIP (Turning Research Into Practice) 3 (2%), others 42 (28%), and 14 (9.3%) did not respond. Students’ perceptions of the validity of EBM implementation across learning phases were as follows: 35 (23.3%) for basic science, 88 (58.7%) for clinical practice, and 27 (18%) considered it not useful. Conclusion: The study found that students had poor knowledge of EBM but positive attitudes towards it, supporting the recommendation to implement EBM in the curriculum.
In South Sudan, rabies is a serious public health burden with an estimated 204 deaths per year. According to the Global Alliance for Rabies Control 2024 report, this is exacerbated by limited dog vaccination coverage and high annual cost of rabies treatment and control, with approximately 9,290 people receiving post-exposure prophylaxis (PEP) annually. In Pariang and the surrounding area, dog bites are very common. In the last two years, four patients died in the hospital due to clinical rabies. Reported cases of clinical rabies in pregnancy with surviving infants are very rare. A 2019 non-systematic review reported only 16 cases worldwide, with four identified in Africa. There are few reported cases of rabies exposure among Human Immunodeficiency Virus (HIV) positive individuals, but none of them was in pregnancy. This is a case report of an HIV-positive pregnant mother who was referred to Pariang Civil Hospital at 37 weeks of gestation with a history of a dog bite six weeks previously, restlessness, inability to swallow, hydrophobia, vomiting, fear, hypersalivation, and fever. Diagnosis of clinical rabies in pregnancy was made, and an emergency Caesarean Section was done with a live baby girl. The mother died 49 hours after delivery. The baby received nevirapine syrup at birth and tested negative for HIV at six weeks and at nine months but does not seem to have received rabies vaccine. One year later, she has no symptoms of rabies. This case report highlights the unique co-occurrence of clinical rabies and HIV infection in a pregnant mother, with a good outcome for the newborn. Community awareness, ensuring the availability of rabies vaccines in all health facilities, plus mass vaccination of dogs and the elimination of street dogs may help reduce rabies cases in Greater Pariang and South Sudan at large.
