Fetal malformation in maternal toxoplasma and rubella co-infection in Cameroon: a case report.

BACKGROUND: There has been a recent increase in the number of newborns with brain malformations due to congenital infections, but the impact of these diseases remains largely under ascertained in middle-income and low-income countries. This case report presents a fetal anencephaly following maternal toxoplasma and rubella co-infection in a resource-limited setting and the challenges faced by the patient and the health care provider in the management of the condition. CASE PRESENTATION: A 25-year-old black Cameroonian woman of Bakossi origin, gravida3 para1010, presented with a positive rubella and toxoplasma immunoglobulin G serologic test at 21 weeks of pregnancy; she could not benefit from a fetal morphologic ultrasound partly because there was none at the site of her antenatal clinic and because there were accessibility constraints getting to the nearest referral hospital approximately 100 km away. She returned to the hospital in labor pains 14 weeks later and, upon examination, she was observed to be at almost full cervical dilatation and had a stillbirth a few minutes later; a baby boy weighing 1600 g with anencephaly. The devastated parents of the baby were counseled and given psychological support. She was discharged from hospital 3 days later and now benefits from continual follow up as out-patient. She was advised to consult a gynecologist-obstetrician before her next pregnancy. CONCLUSION: Much attention still has to be paid to ameliorate the health care in resource-limited settings where pregnant women generally obtain less than adequate care.

[Diagnosis of toxoplasmosis by polymerase chain reaction].

Based on the partial sequences of the specific DNA cloned fragment from T. gondii (ZS2 strain) a specific primer of the oligonucleotide for the Toxoplasma gondii DNA sequence has been designed and synthesized in our laboratory. The method of the DNA diagnosis for toxoplasmosis by polymerase chain reaction (PCR) has been established. A specific amplified band was shown in the PCR products from DNAs of T. gondii and seven manifold terata. The DNAs from the peripheral blood leukocytes of fifty normal individuals and seventy-five patients as infants with hepatitis syndrome and pregnant women with previous abnormal birth histories were diagnosed by PCR. Among the seventy-five diagnosed cases, ten were positive. The normal individuals all were negative. Using 32P-cloned T. gondii specific DNA fragment as probe and Southern blot assay, the results showed that the probe only hybridized to the specific amplified DNA bands, but did not hybridize to the amplified DNA products of negative cases. Our PCR method is a rapid, highly specific and sensitive one for detecting toxoplasmosis as compared with DNA probing, immunoassay and animal inoculation.