African Journals Online
The Central African Journal of Medicine

ABSTRACTS (Vol. 46. No.1)

The Central African Journal of Medicine, Vol. 46. No. 1, 2000 pp. 1-4

ORIGINAL ARTICLES

Seroprevalence of hepatitis C virus infection among indigent urban pregnant women in Zimbabwe

S MADZIME, M A WILLIAM, K MOHAMED, T OCTOBER, M ADEM, S MUDZAMIRI, G B WOELK

Abstract

Objective: To estimate the seroprevalance of hepatitis C virus (HCV) infection among indigent pregnant women.

Design: A serological survey study of indigent pregnant women admitted for labour and delivery.

Setting: Harare Maternity Hospital, Harare, Zimbabwe

Subjects: A random sample of 1 607 women, delivering at the hospital during the study period agreed to participate in the research. Serum samples were available for 1 591 women.

Main Outcome Measures: Serum samples were tested for the presence of antibodies to HCV using a second generation agglutination assay and a third generation enzyme immuno-assay (EIA).

Results: Of the 1 591 women tested 25 (1.6%) were anti-HCV positive (95% confidence interval 1.0% to 2.2%). The frequency of anti-HCV positives was associated with maternal age (p=0.0202) and maternal syphilis status (p=0.020). Gravidas aged 25 to 29 years had the highest anti-HCV seroprevalence (3.4%) as compared with gravidas of other age categories (1.0% to 1.5%). Women with serologic evidence of syphilis infection during the index pregnancy has an increased prevalence of anti-HCV as compared with those women without evidence of syphilis infection (7.9%) versus 1.4%, p = 0.020). There was some evidence (p=0.094) that a positive prior history of delivering a stillborn infant was also associated with an increased prevalence of anti-HCV (4.1% vs 1.4%). Other maternal characteristics, including hepatitis B virus carriage status, parity, and whether she had received prenatal care during the index pregnancy were not determinants of maternal anti-HCV status.

Conclusions: Overall, hepatitis C antibody was detected in 1.6% of indigent women delivering at Harare Maternity Hospital. This proportion of anti-HCV positive pregnant women is similar to estimates published for North American and European women. Factors positively associated with maternal seropositivity in our population included maternal age (between 25 to 29 years), prior history of delivering a stillborn infant, and seropositivity for syphilis during the index pregnancy. Given the relatively low seroprevalence of HCV and the fact that risk factors for HCV infection remain largely unknown, more studies are needed to identify high risk populations likely to benefit from HCV screening and treatment programmes.

The Central African Journal of Medicine, Vol. 46. No. 1, 2000 pp. 5-9

Association of HIV infection with the development of severe and complicated malaria cases at a rural hospital in Zimbabwe

J CHIRENDA, S SIZIYA, M TSHIMANGA

Abstract

Objective: To determine the association between HIV infection and progression of Plasmodium falciparum malaria illnes in Hurungwe district, Zimbabwe.

Design: Prospective cohort.

Setting: Hurungwe Rural Hospital in Mashonaland West Province, Zimbabwe.

Subjects: Blood slide positive P. falciparum malaria patients.

Main Outcome Measures: Development of severe and complicated malaria.

Results: A total of 659 clinical malaria cases were investigated and 237 (36.0%) confirmed cases entered the study. The total HIV positive malaria patients were 82 (34.6%) of confirmed cases of 12.4% of the total clinical cases. The case fatality rate was 5.9% (14 deaths) in the confirmed cases and 11 of these deaths were HIV positive. The commonly reported complications were high parasite count of 2% or more (38.5%), anaemia (29.0%), cerebral malaria (23.1%), low blood pressure (8.3%) and renal failure (1.2%). The HIV positive cases which developed severe and complicated malaria were 72, 30.4% of the sample studied or 55.8% of the total severe and complicated cases. The mode of transport to the nearest health centre was the only confounding factor identified during the analysis. After adjusting for this confounding factor, the risk of developing severe complicated malaria was 2.35 (95%CI 1.85 to 2.98) times more in the HIV positive malaria patients than in HIV negative patients.

Conclusion: We conclude that HIV infection is significantly associated with the development of severe and complicated malaria. There is need for future studies to determine whether HIV positive malaria patients require different management protocol from HIV negative malaria patients.

The Central African Journal of Medicine, Vol. 46. No. 1, 2000 pp. 9-13

Pharmacological actions of Heteromorpha trifoliates (“dombwe”) on rat isolated muscle preparations

D KATERERE, O PARRY

Abstract

Objective: To investigate the effects of Heteromorpha trifoliata on rat uterine and skeletal muscle.

Design: Laboratory based study using experimental animals. Investigating the effects of the plant extract and agonists on isolated muscle preparations.

Subjects: 28 Sprague-Dawley rats.

Main Outcome Measures: Amplitude of contraction of uterine smooth muscle and skeletal muscle.

Results: Experiments were performed on the isolated rat uterus preparation in which strips of myometrium were placed in tissue baths filled with Kreb's solution. The aqueous extract of the root bark of Heteromorpha trifoliata (“dombwe”) contracted the rat uterus. The contractions were not antagonised by atropine but were blocked by both cyproheptadine and verapamil. In additon, “dombwe” induced a contracture of the rat diaphragm muscle on the presence of alcuronium.

Conclusions: The contractile effects on the uterus appear to involve stimulation of 5-HT receptors leading to an increase in calcium influx into the smooth muscle cell. Promotion of calcium influx could also explain the effects observed on the skeletal muscle preparation since the contracture induced by “dombwe” occurred in the presence of the nicotinic antagonist, alcuronium. In view of the effects of “dombwe” on other smooth muscle preparations (from previous work) it appears that the pharmacological profile of the crude aqueous extract of the root bark Heteromorpha trifoliata is complex and suggestive of the presence of more than one active ingredient.

The Central African Journal of Medicine, Vol. 46. No. 1, 2000 pp. 13-6

Pathological study of retinoblastoma in Mbarara, Uganda

A U MUKHTAR, K KAGAME

Abstract

Objective: Histological study of retinoblastoma: cellular differentiation, optic nerve and choroidal involvement.

Design: Series of specimens examined in the Pathology laboratory.

Subjects: 32 eye specimens.

Results: 31 specimens consisted of poorly differentiated tumours and one specimen had a well differentiated retinoblastoma showing Flexner-Wintersteiner rosettes. Fifteen out of 25 specimens with optic nerves showed both choroid and optic nerve invasion. In 10 eye specimens, the optic nerves and choroid were free of tumour. In the remaining seven specimens, the optic nerves were not submitted with the enucleated specimens and there was no choroidal involvement on histology.

Conclusion: This review supports findings from previous studies done in Africa which indicated that poorly differentiated retinoblastoma is more common among African children than well differentiated retinoblastoma.

The Central African Journal of Medicine, Vol. 46. No. 1, 2000 pp. 16-8

CASE REPORT

Abnormal rotation of the right kidney

S C CHAUDHARY, P V V PRASADA RAO

An unusual case of abnormal rotation of the right kidney with extra renal calyces and pelvis is reported in a Caucasian female. The hilum of this kidney is directed posteriorly. The condition did not appear to be associated with any pathology. This case is discussed in the light of its embryological development.

The Central African Journal of Medicine, Vol. 46. No. 1, 2000 pp. 18-22

REVIEW ARTICLE

Former migrant mineworkers with respiratory disease: the South African compensation system, and implications for neighbouring countries

T W STEEN, N MABONGO, T MOETI, B MONARE, A S M TRAPIDO

In the region of Southern Africa, substantial numbers of people, primarily males, have been employed in the South African mining industry. Migrant workers from neighbouring countries have constituted a large part of the work force. Until recently, there has been little or no attention directed toward the state of health of these individuals, despite the fact that their work involves a high health risk, especially in regard to mine-related lung diseases. In addition, the South African workers' compensation programme has seldom been utilised by the migrant worker who is victim of occupational disease.

However, recent experiences from Botswana show that compensation claims can be successfully made from the neighbouring countries where the migrant workers originate. Efforts are being made to address the problem systematically, and the government of Botswana is actively involved.

The major occupational lung disorders are described briefly, and differential diagnostic problems with pulmonary TB are discussed.

Furthermore, a survey of the compensation system in South Africa is presented, and practical steps for medical examinations involving compensation claims are described.