HIV-1 and pregnant women: associated factors; prevalence; estimate of incidence and role in fetal wastage in central Africa

The major goals of this study were to measure the current prevalence and estimate the annual incidence of HIV-1 infection in young pregnant women from urban Malawi; to identify factors that were associated with HIV-1 infection; and to examine adverse pregnancy outcomes. Four hundred and sixty-one consecutive pregnant women were studied when they presented for prenatal care. The overall seroprevalence for HIV-1 infection in these urban populations was 17.6 percent (81 out of 461) during early 1989. Based on previous seroprevalence in similar unselected pregnant women; the estimated annual incidence of HIV-1 seroconversion in urban pregnant women ranged from 3 to 4 percent per annum between 1985 and 1987 and from 7 to 13 percent between 1987 and 1989. HIV-1 infection was significantly associated with reactive syphilis serology. Reported history of sexually transmitted disease was also correlated with HIV-1 infection but was not statistically significant. Other variables; such as history of transfusion; history of tuberculosis; parity or occupation were not associated with HIV-1 infection. History of spontaneous abortion was significantly associated with reactive syphilis serology; HIV-1 infection and history of sexually transmitted disease. In logistic regression analysis; HIV-1 infection remained the only significant variable that was correlated with spontaneous abortion. This study suggests that HIV-1 infection may play a role in fetal wastage

The child spacing programme in Malawi

A brief summary of the child spacing programme during the first two years of its official existence

Review of the activities of the child-spacing clinic (Q.E.C.H.) for 1984

The statistics from the Queen Elizabeth Central Hospital child spacing clinic were the first ever collected in Malawi

Medico-legal consideration in child spacing

Many countries introducing child spacing programmes have discovered existing law do not give guidance regarding the proper conduct of the activities and Malawi is no exception. Malawi uses the common law principle that states if an activity is not prohibited by law that it is legal; this is strengthened when government pronouncements state a particular activity is acceptible to the government. In the absence of specific laws in Malawi; the author raises points in order to guide providers of child spacing services and provide a basis for further discussion

Maternal mortality in the Thyolo District of southern Malawi

The study used the Sisterhood Method to estimate maternal mortality which uses community surveys to includes deaths which occured at home as well as health facilities. The results show an estimated MMR of 450-500 per 100;000 live births; higher than the WHO estimate for Malawi (250/100;000) and a previous study by Bullough; 1981; based on a survey of fixed health facilites which gave an estimated MMR of 263/100;000