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Critical disparities threaten health care in developing countries and hinder progress towards global development commitments. Almost a billion people and thousands of public services are not yet connected to electricity – a majority in sub-Saharan Africa. In economically fragile settings, clinics and health services struggle to gain and maintain their access to the most basic energy infrastructure. Less than 30% of health facilities in LMICs report access to reliable energy sources, truncating health outcomes and endangering patients in critical conditions. While ‘universal health coverage’ and ‘sustainable energy for all’ are two distinct SDGs with their respective targets, this review challenges their disconnect and inspects their interdependence in LMICs. To evaluate the impact of electrification on healthcare facilities in LMICs, this systematic review analysed relevant publications up to March 2021, using MEDLINE, Embase, Scopus, CENTRAL, clinicaltrials.gov and CINAHL. Outcomes captured were in accordance with the WHO HHFA modules. A total of 5083 studies were identified, 12 fulfilled the inclusion criteria of this review – most were from Africa, with the exception of two studies from India and one from Fiji. Electrification was associated with improvements in the quality of antenatal care services, vaccination rates, emergency capabilities and primary health services; with many facilities reporting high-quality, reliable and continuous oxygen supplies, refrigeration and enhanced medical supply chains. Renewable energy sources were considered in six of the included studies, most highlighting their suitability for rural health facilities. Notably, solar-powered oxygen delivery systems reduced childhood mortality and length of hospital stay. Unavailable and unreliable electricity is a bottleneck to health service delivery in LMICs. Electrification was associated with increased service availability, readiness and quality of care – especially for women, children and those under critical care. This study indicates that stable and clean electrification allows new heights in achieving SDG 3 and SDG7 in LMICs.

Preconceptual folic acid use is known to have a protective effect against neural tube defects (NTDs). This study assessed knowledge and determinants of awareness on folic acid use among pregnant women at Omdurman Maternity Hospital, Sudan during 2014. The standardized, anonymous questionnaire was used to collect data. Almost 80% of respondents had heard of folic acid. College-educated women (92.2%) knew more about folic acid and used it more often in the pre-conceptual period (8.3%). Doctors were the commonest source of information on folic acid (62%). Fewer subjects (8.9%) knew that it prevented birth defects, and 33.8% of subjects knew that green leafy vegetables are a source of folic acid. Of all subjects, only 3.2% use it preconceptually. Supplementation of folic acid preconceptually needs to be addressed in order to reduce the rate of NTDs found in Sudan.معلومات ومحددات تناول حمض الفوليك بين النساء الحوامل في أم درمان، السودان.محمد الخاتم السمانى، عبد الإله كنه، الشيخ محمد آدم.من المعروف أن استخدام حمض الفوليك قبل الحمل له أثر وقائي ضد عيوب الأنبوب العصبي. وقد عمدت هذه الدراسة إلى تقييم معلومات ومحددات الوعي باستخدام حمض الفوليك في صفوف النساء الحوامل في مستشفى الولادة بأم درمان في السودان خال عام 2014. واستُخدم استبيان موحد مجهّل الأساء من أجل جمع البيانات. وتبن أن نحو 80 % من المستجيبات قد سمعن عن حمض الفوليك من قبل. وسجلت النساء الجامعيات (92.2 %) معرفة أعى بحمض الفوليك كا استخدمنه أكثر من غيرهن في مرحلة ما قبل الحمل (8.3 %). وشكل الأطباء أكثر المصادر شيوعا للمعلومات المتعلقة بحمض الفوليك (62 %). وتبن أن عدد أقل من أفراد الدراسة (8.9 %) كن عى معرفة بأن حمض الفوليك يحول دون حدوث عيوب ولادية، وأن 33.8 % المشاركات كن عى معرفة بأن الخروات الورقية تمثل مصدراً من مصادر حمض الفوليك. وأن 3.2 % فقط تستخدمنه في مرحلة ما قبل الحمل. وارتبط مستوى الوعي بالعيش في المناطق الحضرية، وارتفاع مستوى التعليم، والحصول عى رعاية ما قبل الولادة (0.05P). ويجب النظر في استخدام مكمات حمض الفوليك في مرحلة ما قبل الولادة من أجل خفض معدل الإصابة بعيوب الأنبوب العصبي في السودان.Facteurs associés aux connaissances et déterminants concernant l’apport en acide folique parmi les femmes en âge de procréer au Soudan.La consommation d’acide folique avant la conception est connue pour avoir un effet protecteur contre les anomalies du tube neural (ATD). La présente étude avait pour objectif d’évaluer les connaissances et déterminants de la sensibilisation à la consommation d’acide folique parmi les femmes enceintes à la maternité de l’hôpital d’Omdourman au Soudan en 2014. Un questionnaire, standardisé et anonyme, a été utilisé pour collecter des données. Près de 80 % des répondants avaient déjà entendu parler de l’acide folique. Les femmes ayant reçu une éducation universitaire (92,2 %) en savaient plus sur l’acide folique et en consommaient davantage souvent durant la période préconceptionnelle (8,3 %). Les médecins étaient la source d’information la plus courante sur l’acide folique (62 %). Un nombre inférieur de sujets (8,9 %) étaient conscients que l’acide folique permet de prévenir les malformations congénitales et 33,8 % des sujets savaient que les légumes vert à feuilles constituent une source d’acide folique. Parmi tous les sujets, seulement 3,2 % en consommaient avant la conception. La supplémentation préconceptionnelle en acide folique doit être prise en compte afin de réduire la forte incidence des ATD constatées au Soudan.

The hepatosplenic form of Schistosoma mansoni infection contributes considerably to morbidity and mortality in endemic areas. The present study investigated serum protein concentrations and serum enzyme activities of 58 Sudanese patients with hepatosplenic schistosomiasis. All of them had a history of infection with S. mansoni and one or several episodes of oesophageal bleeding due to portal hypertension. Diagnosis was based on clinical (n = 24), ultrasonographical (n = 18) and histological (n = 16) grounds. The control group consisted of 40 Sudanese healthy blood donors. Serum albumin was found to be significantly lower in patients with hepatosplenic schistosomiasis (median = 37 g/l) than in controls (median = 47 g/l). Serum enzyme analysis revealed only minimal alterations of cellular enzyme activities, but a marked decrease of cholinesterase activity. Serum albumin concentration correlated significantly with cholinesterase activity. We conclude that liver function in patients with schistosomiasis and portal hypertension is partially disturbed. Low serum albumin and low cholinesterase activity reflected an impaired protein synthesis of the liver. Destruction of parenchymal liver cells was mild or absent.

In order to compare clinical versus ultrasound based diagnosis of Schistosoma mansoni induced periportal fibrosis (pF) 536 infected Sudanese schoolchildren underwent clinical and sonographical examination. A liver exceeding 3 cm in sternal line and a palpable spleen were considered pathological. Ultrasound criteria for age dependent organometry of a Central European cohort were used as reference. Based on clinical criteria 190 children (35.4%) had hepatomegaly, whereas according to ultrasound results the rate was only 11.4%. Splenomegaly was detected in 77 cases (14.4%) by clinical means, but in 196 by ultrasound (36.6%). The sensitivity of clinical parameters as indication of pF was around 50%. Results for ultrasound detected organomegaly were only slightly better. It was concluded that assessment of liver and spleen sizes was of limited value as an indication for pF and that a considerable discrepancy existed between clinical and ultrasound based assessment of hepato- and splenomegaly.