Background: This study was carried out to determine causative agents of acute respiratory illness of patients in
Khartoum State, Sudan.
Methods: Four hundred patients experiencing respiratory infections within January-March 2010 and January-March
2011 were admitted at Khartoum Hospital and had their throat swab samples subjected to multiplex real-time
RT-PCR to detect influenza viruses (including subtypes) and other viral agents. Isolation, nucleotide sequence and
phylogenetic analysis on some influenza viruses based on the HA gene were done.
Results: Out of 400 patients, 66 were found to have influenza viruses (35, 27, 2, and 2 with types A, B, C, and A and
B co-infections, respectively). Influenza viruses were detected in 28, 33 and 5 patients in the age groups <1, 1–10,
and 11–30 years old, respectively but none in the 31–50 years old group. Out of 334 patients negative for influenza
viruses, 27, 14, and 2 were positive for human respiratory syncytial virus, rhinovirus and adenovirus, respectively.
Phylogenetic tree on influenza A (H1N1) pdm09 subtype shows that Sudan strains belong to the same clade and
are related to those strains from several countries such as USA, Japan, Italy, United Kingdom, Germany, Russia,
Greece, Denmark, Taiwan, Turkey and Kenya. Seasonal A H3 subtypes have close similarity to strains from Singapore,
Brazil, Canada, Denmark, USA and Nicaragua. For influenza B, Sudan strains belong to two different clades, and just
like influenza A (H1N1) pdm09 and A H3 subtypes, seem to be part of worldwide endemic population (Kenya, USA,
Brazil, Russia, Taiwan and Singapore).
Conclusions: In Sudan, the existence of respiratory viruses in patients with acute respiratory infection was
confirmed and characterized for the first time by using molecular techniques.