On Their International Day: Children with Down Syndrome — Complementary Medicine and Family Guidance to Support the Chil| Sudanow Magazine

Khartoum (Sudanow)

March 21 marks World Down Syndrome Day. This occasion comes at a time when the number of children born with Down syndrome is increasing. With advances in science, children with Down syndrome can live relatively normal lives and actively participate in society. Sudan has made significant progress in how it deals with these children and integrates them into the community.

Dr. Mohammed Osman Maysara, a consultant in community medicine and public health, an expert in complementary medicine and therapeutic nutrition, member of the Permanent Committee for Medicinal and Aromatic Plants, and head of the founding committee for complementary and integrative medicine schools at the Ministry of Health in Khartoum State, is one of the contributors to building rehabilitation frameworks for children with Down syndrome. Speaking to Sudanow on the occasion of World Down Syndrome Day, March 21, he said:

The day aims to support mothers’ communities, promote rights, and raise awareness and acceptance—especially as it coincides with Mother’s Day. It also seeks to improve their quality of life by providing comprehensive healthcare.

Down syndrome is defined as a group of symptoms and characteristics that often appear together, causing developmental changes and distinct physical features due to the presence of an extra full or partial copy of chromosome 21 in the cell. It is a genetic disorder resulting from a chromosomal abnormality before birth. Normally, human cells contain 46 chromosomes (23 from the mother and 23 from the father), but in this condition, the number increases to 47.

The syndrome is named after the British physician John Down, who first described and classified it in 1866. It was previously referred to as “Mongolism” due to certain facial similarities, a term that is now outdated and inappropriate. Down syndrome is not a disease; rather, it results from an extra chromosome during cell division, leading to functional differences that vary from one child to another. These differences may include intellectual disability, physical traits, learning difficulties, and developmental delay—though not necessarily severe cognitive impairment compared to typical children.

The extra chromosome may originate from either parent, and the exact cause is unknown. However, observations indicate that the likelihood increases with maternal age, though this is a probability, not a rule. According to World Health Organization estimates, it occurs in approximately 1 in every 1,000 live births.

There are three types of Down syndrome:

Trisomy 21 (95%): The most common type, where there are three copies of chromosome 21 in every cell. It is often associated with health complications such as congenital heart defects (around 40%), digestive system issues (like intestinal blockage or anal atresia), weakened immunity, thyroid dysfunction, hearing and vision problems, reduced cognitive ability, muscle hypotonia, and spinal issues.

Mosaic (1%): The mildest form, where only some cells carry the extra chromosome, resulting in milder symptoms.

Translocation (4%): A moderate form involving rearrangement of genetic material.

Children with Down syndrome often exhibit four main characteristics from birth:

1. Distinct facial features

2. Low muscle tone and joint laxity

3. Short neck

4. A single transverse palmar crease instead of two

Other features may include a small head, developmental delays in sitting, walking, and movement, limited attention span, lower-than-average IQ, small oral cavity leading to tongue protrusion, behavioral challenges, and hyperactivity. They are also more prone to epilepsy.

Breastfeeding is important to strengthen immunity. Proper hygiene, including bathing, is essential as rough skin may encourage fungal growth. Exposure to sunlight, eye care, muscle stimulation, and providing an active and supportive environment are also important. Reducing excessive antibiotic use is crucial, as it disrupts beneficial gut bacteria and promotes harmful ones.

Therefore, therapeutic nutrition and complementary medicine play a significant role in preventing and managing respiratory and digestive infections, obesity, hormonal imbalances, constipation, and oral or gastrointestinal ulcers. Undescended testicles are also common among boys with Down syndrome due to delayed growth or hormonal factors, requiring careful monitoring to prevent future fertility issues.

Diagnosis must be confirmed through laboratory tests detecting the extra chromosome. Although prevention is not currently possible, early screening can estimate the likelihood of occurrence. Individuals with Down syndrome can live beyond 65 years. Marriage is religiously permissible, and its success depends on awareness and the individual’s level of independence, along with social support. It may be more difficult in cases of severe intellectual disability. Fertility in females may reach up to 50%, while it is lower—but not impossible—in males. Assisted reproduction is recommended when both The couple have Down syndrome. Despite this, more than 96% of cases are not hereditary, and the chance of recurrence in future pregnancies is less than 1%.

Dr. Maysara noted that cosmetic surgery only alters appearance and does not provide a cure. However, early intervention through rehabilitation centers is critical. Children’s abilities vary individually, but with specialized educational interventions and stimulating environments, remarkable progress can be achieved. Early years are especially important, with services such as speech therapy, occupational therapy, educational rehabilitation, and academic support, alongside family counseling to build confidence and improve adaptation.

Such interventions reduce health and cognitive challenges and enhance quality of life, helping children showcase their unique talents. Therefore, early intervention programs and rehabilitation centers are not a luxury but a fundamental right, enabling greater independence and social integration.

Sudan has made notable progress in this field by establishing specialized centers for speech and learning difficulties, as well as vocational training centers. Girls have shown remarkable excellence in cooking and home management skills. Additionally, sports centers for basketball, tennis, taekwondo, and weightlifting have enabled them to achieve advanced rankings and discover talents in fields such as metalwork, painting, and gardening.

In academic education, students with Down syndrome have achieved advanced results in intermediate and secondary school exams, qualifying them for integration into mainstream education and continuing alongside other students.

Dr. Maysara added that these centers were established through private efforts, with more than thirty rehabilitation centers in Khartoum State alone, in addition to others across Sudan. Significant improvements have also been achieved in managing obesity, reducing digestive and respiratory infections, and controlling hyperactivity through collaboration with therapeutic nutrition specialists. Under professional supervision, natural medical nutritional treatments administered over three to nine months have yielded impressive results.

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