Most of the adverse effects of malaria in pregnancy on the fetus are usually as a consequence of placental malaria (PM). This study was conducted with the objective of determining the prevalence, risk factors and pregnancy outcome of PM. A cross-sectional study of 437 pregnant women who delivered at the UMTH, Maiduguri was conducted between 24 July 2007 and 12 January 2008. Placental histology was done for the malaria parasite. Maternal packed cell volume was done and thick blood films were studied for the malaria parasite in maternal peripheral blood and the cord blood/heel prick of their babies. The prevalence of PM was 33.9% (148/437). It is associated with non-usage of intermittent preventive treatment of malaria in pregnancy (IPT) and maternal HIV infection. PM in turn predisposes to low birth weight and cord parasitaemia. Only 2.8% of the women were sleeping under insecticide-treated nets (ITNs). The high prevalence of PM calls for renewed efforts for preventive measures, particularly the routine use of IPT and ITN during the antenatal period.
Female patients who present with adnexial mass and weight loss should not be presumed to have ovarian carcinoma until after extensive investigation. This is to avoid the mistake of radical surgery with its attendant morbidity and mortality. An important disease to consider in our environment is ovarian TB that respond well to medication. A 35 year old HIV-1 positive house wife presented with fever, persistent vomiting, progressive weight loss, vague abdominal pain and swelling. Patient occasionally ingest unpasteurized milk since childhood but had no sustained contact with adult with chronic cough. She had no menstrual abnormality. Imaging studies revealed right ovarian mass measuring 11.8cmx10cm. Right ovarian malignancy was highly suspected, for which she underwent exploratory laporotomy. Histopathology result was consistent with tuberculous granuloma. Chest radiograph was normal. Her CD4 count was 541cells/ul. Patient was commenced on anti tuberculotic therapy based on the Nigerian National TB control and she responded well. Tuberculosis of the ovary can masquerade as ovarian cancer, especially among HIV patients in regions where TB-HIV co infections is endemic, it should be ruled out before performing extended surgery.
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