It is still debatable whether congenital Plasmodium falciparum malaria is a rarity or a frequent occurrence in sub-Saharan Africa. The objective of this report is to review scientific information and findings from investigations conducted in sub-Saharan Africa on the occurrence of congenital malaria to highlight the need for development of appropriate public health policy on prevention, care, treatment, and support activities. Studies conducted in sub-Saharan Africa within the last two decades (1986 to 2006) that investigated congenital or transplacental malaria were identified using the Medline-Entrez Pubmed search and systematically reviewed. References from selected publications obtained from a Google search were also used to identify additional relevant literature for the review. Five of the studies reviewed indicated that congenital malaria is a rare event in sub-Saharan Africa with prevalence ranging from 0% to 0.7% although maternal malaria parasitemia rates of between 24.8 and 54.4% were obtained. Nine other studies noted that congenital malaria was not uncommon, with prevalence reaching up to 37%. These studies also noted high frequency of neonatal peripheral parasitemia ranging from 4.0 to 46.7%. Congenital malaria should be suspected and investigated in babies whose mothers are parasitemic, particularly if the babies are febrile.
The prevalence of HIV infection among individuals referred from faith-based organizations (FBOs) in south-eastern Nigeria for mandatory pre-marital HIV screening was determined. Of the total of 319 individuals (148 males, 171 females) screened, 25 (7.8%, 95%CI: 4.9-10.7%) were confirmed HIV-positive, comprising 13 (8.8%, 95%CI: 4.2-13.4%) males and 12 (7%, 95%CI: 3.2-10.8%) females. No significant difference was observed in the association between HIV infection and gender (chi2=0.58, df = 1, P < 0.05). The highest prevalence of HIV infection (8.9%) was recorded among individuals in the 21-30 years age category, while the least HIV infection prevalence (5.3%) was observed among persons above 40 years old. There was no significant difference in the association between HIV infection and age (chi2=0.68, df = 3, P < 0.05). Mandatory pre-marital HIV screening could generate social stigmatization and infringement of the fundamental human rights of infected individuals. Voluntary counselling and confidential HIV testing and especially pre- and post-test counselling as the basis of pre-marital HIV testing are more desirable. Guidelines for the management of test-positive individuals and non-concordant couples and the safeguarding of confidentiality should be developed. Training and capacity building for religious leaders, to appropriately manage social issues associated with HIV/AIDS as it affects their organizations, are recommended.
Soil transmitted helminth infections (STH) and schistosomiasis constitute major public health challenges among school-age children in sub-Saharan Africa. This review assessed the efficacy of chemotherapeutic intervention in line with the World Health Assembly (WHA) resolution since the passage in 2001. Using the Medline Entrez-Pubmed search, relevant publications were identified via combinations of key words such as helminth infection, school children, chemotherapy, Africa. Albendazole, mebendazole, and praziquantel were the antihelminthic drugs most commonly evaluated. Cure rates >80% and egg reduction rates >90% were recorded in most cases of schistosomiasis using praziquantel. Albendazole was very effective against A. lumbricoides and hookworm infections with majority of the studies recording cure rates >75%, but the efficacy of the drug was poor against T. trichiura. To ensure the realization of the WHA resolution, there is need for regular treatment of school children, development of alternative antihelminthic drugs and vaccines, environmental control measures and health education.
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