Co-Infection with Chikungunya and Malaria: A Case ReportEmmanuel Edwar Siddig 1, Alaa Tajeldeen Habeeb Abdallah2, Yousif Ali3, Claude Mambo Muvunyi 4, Nouh Mohamed 5, Ayman Ahmed 4,5,61 Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan.2 Rufa’a Teaching Hospital3 Sudan Field Epidemiology Training Program, Health Emergencies and Epidemics Control General Directorate, Sudan Federal Ministry of Health, Khartoum 11111, Sudan4 Rwanda Biomedical Center (RBC), Kigali P.O. Box 7162, Rwanda5 Pan-Africa One Health Institute (PAOHI), Kigali 11KG ST203, Rwanda6 Institute of Endemic Diseases, University of Khartoum, Khartoum 11111, Sudan.Correspondence: Ayman Ahmed; Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan.Tel: +249123997091Email: [email protected]: 0000-0002-9516-9508.

Background Yellow fever (YF) is a zoonotic arboviral disease that is mainly transmitted by Aedes aegypti and Ae. albopictus mosquitoes. It mainly infect both, human and non-human primates including the endangered mountain gorillas. Despite that Yellow fever is a vaccine preventable disease, according to the World Health Organization, it is still endemic in 47 countries; 72% of those countries are in Africa and 28% in Central and South America. Methodology We deployed several transdisciplinary research methods for the implementation of this risk assessment and situation analysis as well as developing national preparedness, prevention, and response strategy for YF in Rwanda. These methods included epidemiological and entomological surveys, health system analysis, and stakeholders and expert consultations. This was supported with in-depth desk and literature review analysis. Results We have identified high risk of Yellow fever emergence and outbreaks in Rwanda. The main underpinning sources of this risk are including the confirmed presence of the main vector of the disease; Aedes aegypti. More importantly, the lack of vector surveillance for Aedes mosquitoes, surveillance for the disease among human or animals at risk in the country despite the ongoing transmission in the region including countries with open-borders and free movements with Rwanda. Additional important sources of risk include limited vaccination coverage and requirement for travelers to and from endemic countries. Accordingly, we have developed a preparedness, prevention, and response (PPR) framework for Yellow fever in Rwanda. Conclusion In addition to strengthen the implementation of the developed preparedness, prevention, and control measures, the One Health authority should invest in the establishment and operation of integrated surveillance and response system that comprehensively monitors the indicators of humans, animals, and environmental health. Additional support should be given to operational research to generate evidence that informs policymaking, and guide the strategic planning and implementation of cost-effective interventions.

Brief report:

A case report of membranoproliferative glomerulonephritis (MPGN): infection-related or immune-related?Ayman Azhary *1, 2, \RLMohammed Taha3, Nooh Mohamed Hajhamed1, 2, Salahaldeen Ismail Mohammed1, Nouh Saad Mohamed2, Waleed Azhary Sir Alkhatim4 , Emmanuel Edwar Siddig5

not-yet-known not-yet-known not-yet-known unknown A Case of Pneumocystis Pneumonia in an HIV/AIDS Patient from Sudan Emmanuel Edwar Siddig1, Alaa Tajeldeen Habeeb2, Claude Mambo Muvunyi3 , Ayman Ahmed3,4,5 1 Faculty of Medical Laboratory sciences, University of Khartoum, Khartoum, Sudan 2 Rufa’a Teaching Hospital, Aljazeira state, Sudan 3 Rwanda Biomedical Centre, Kigali, Rwanda. 4 Institute of Endemic diseases, University of Khartoum, Khartoum, Sudan 5 Pan-Africa One Health Institute (PAOHI), Kigali 11KG ST203, Rwanda

A case report of venous ulcer mimicking cutaneous leishmaniasisAlaa Tajeldeen Habeeb Abdallah1, Emmanuel Edwar Siddig2*, Jean Claude Semuto Ngabonziza3,4, Claude Mambo Muvunyi5, Ayman Ahmed5,61 Rufa’a Teaching Hospital2 Faculty of Medical Laboratory sciences, University of Khartoum, Khartoum, Sudan3 Department of Clinical Biology, University of Rwanda, Kigali P.O. Box 3900, Rwanda4 Research, Innovation and Data Science Division, Rwanda Biomedical Centre, Kigali P.O. Box 7162, Rwanda5 Rwanda Biomedical Centre, Kigali P.O. Box 7162, Rwanda6 Institute of Endemic Diseases, University of Khartoum, Khartoum 11111, Sudan

COVID-19 Related Pneumonia with Concurrent Dengue Fever in a Middle-Aged Patient a case reportEmmanuel Edwar Siddig1, Jean Claude Semuto Ngabonziza2,3, Claude Mambo Muvunyi4, Ayman Ahmed 4,51 Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan.2 Department of Clinical Biology, University of Rwanda, Kigali P.O. Box 3900, Rwanda3 Research, Innovation and Data Science Division, Rwanda Biomedical Centre, Kigali P.O. Box 7162, Rwanda4 Rwanda Biomedical Centre, Kigali, Rwanda.5 Institute of Endemic Diseases, University of Khartoum, Khartoum 11111, Sudan.Correspondence: Ayman Ahmed, Institute of Endemic Diseases, University of Khartoum, Khartoum 11111, SudanEmail: [email protected]

1 Introduction:Intestinal parasites are causing a significant global health concern, with over 3.5 billion people affected worldwide [1,2,3]. The infestation rates vary depending on the country of residence and individual demographics related to populations’ exposure. Common intestinal parasites include soil-transmitted helminths such asAscaris lumbricoides , Trichuris trichiura , hookworm, and protozoa like Giardia intestinalis and Entamoeba spp [4, 5]. Least developed countries in particular, face higher prevalence and burden rates of these infections due to factors related to poverty and underdevelopment including limited access to clean water, poor hygiene and sanitation practices, malnutrition, and hot and humid climates [6,7]. This combination of conditions and practices create an ideal environment for the transmission, spread, and local establishment of intestinal parasites [8,9,10]. Sudan and South Sudan are predominantly endemic with soil-transmitted helminthes and other parasitic diseases [10 - 23].Additionally, infection with intestinal parasites poses a serious health, socio-cultural, and economic burdens in endemic countries, while in industrialized nations, mainly immigrants, seasonal workers, and nomadic populations are the primary groups at risk [24, 25]. Transmission of parasites can occur through direct person-to-person contact or contact with contaminated sources like food, water, or soil [26]. In high burden areas, coinfections with multiple parasites are increasingly occurring due to the poor living conditions, malnutrition, and weakened immuno-system [27,28, 29]. It lead to high morbidity, mortality, disability, and enhance the susceptibility to other infections [27 - 29]. Children, teens and adult, are at higher risk of adverse health outcomes with multiple parasitic infections compared to single infestations [30]. Here, we report case to highlight how poor socio-economic conditions and disadvantaged living situations of immigrants can profoundly affect health outcomes even in developed countries.

Brief report:

Brief report:

Severe Subconjunctival Hemorrhage: An Uncommon Ocular Manifestation of Malaria Induced by Antimalarial Drug - A Case ReportNouh Saad Mohamed1,2*, Abdallah E. Ahmed1, Rihab Ramadan3, Hamza Sami4, Ahmed Mudawi Musa5, Emmanuel E. Siddig6, Ayman Ahmed5,7,81 Molecular Biology Unit, Sirius Training and Research Centre, Khartoum, Sudan.2 Sennar Malaria Research and Training Centre, Sennar, Sudan.3 Khartoum Ophthalmic Hospital, Khartoum, Sudan.4 Directorate of the Integrated Vector Management, Federal Ministry of Health, Khartoum, Sudan5 Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan.6 University of Khartoum, Faculty of Medical Laboratory Sciences, Khartoum, Sudan.7 Swiss Tropical and Public Health Institute (Swiss TPH), CH-4123 Allschwil, Switzerland.8 Faculty of Science, University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland.*Corresponding author: Nouh Saad Mohamed, Molecular Biology Unit, Sirius Training and Research Centre, Khartoum, Sudan. Email: [email protected].

Delayed cerebellar ataxia induced by Plasmodium falciparum malaria: A rare complicationEmmanuel Edwar Siddig1,2,*, Sarah Misbah EL-Sadig3, Hala Fathi Eltigani1, Ahmed Mudawi Musa4, Nouh Saad Mohamed5, Ayman Ahmed4,6,71 Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan2 Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan.3 Faculty of Medicine, University of Khartoum, Khartoum, Sudan4 Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan5 Molecular Biology Unit, Sirius Training and Research Centre, Khartoum, Sudan6 Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil 4123, Switzerland7 University of Basel, Petersplatz 1, Basel 4001, Switzerland* Correspondance: Emmanuel Edwar Siddig; University of Khartoum, Khartoum, Sudan.Email: [email protected]: 0000-0001-6314-7374