Efficacy of BCG vaccine against leprosy and tuberculosis in northern Malawi

Protection afforded BCG vaccines against tuberculosis and leprosy varies widely between different populations. In the only controlled trial which assessed protective efficacy of BCG (Danish and Pasteur strains) against both diseases; there was slightly more protection against leprosy than against tuberculosis. Protection was estimated at 50 percent or greater against leprosy; and there was no evidence for lower protection against multibacillary than against paucibacillary disease. There was no statistically significant protection by BCG against tuberculosis in this population

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

Rhinoscleroma in Malawi and Eastern Zaire

"The first ten cases of rhinoscleroma from Malawi and six from Eastern Zaire are reported. Most of the patients were aged between 20 and 40 years (age range 3-60) and presented with either a nasal ""tumour' or abnormalities of the nasal septum. Histological examination of biopsy material revealed features diagnostic of rhinoscleroma - a mixture of mature plasma cells and large foamy macrophages (Mikulicz cells) containing intra-cellular Gram negative bacilli. The organisms were best seen in sections stained by the Warthin-Starry technique. This study suggests that rhinoscleroma is perhaps more common in Malawi and Zaire than has been realised."