Prevalence of restless legs syndrome in patients with chronic pain in Maputo, Mozambique.

OBJECTIVES: Because there is only one study to our knowledge on the prevalence of restless legs syndrome (RLS) in sub-Saharan Africa and RLS is more common in patients with some pain syndromes, we aimed to determine the prevalence of RLS in a population with chronic pain in Maputo, Mozambique. METHODS: Our study was conducted in the Pain Unit of the Central Hospital of Maputo, Mozambique. Patients were individually interviewed by a neurologist, and only those fulfilling the criteria were included. After collection of demographic data and pain features, the patients answered the screening questions regarding RLS. RESULTS: A total of 123 patients with pain were interviewed. Five individuals were excluded. RLS was found in eight (6.77%) of 118 patients. The mean age of the eight patients with RLS was 54.6years. Five patients (62.5%) were women and six (75%) were black individuals. Seven (87.5%) patients were diagnosed with neuropathic pain; one of them had AIDS and another one (12.5%) had orthopedic pain. The presence of hypertension and neuropathies was more frequent in the RLS group. CONCLUSION: Despite the secondary causes involved, we believe that it is relevant to report the RLS prevalence detected in our study.

Materno-fetal transmission of pregnancy malaria: an immunoparasitological study on 202 parturients in Maputo.

A total of 202 delivering mothers and their newborns were studied with the intention to follow the materno-fetal transmission of malaria. Malaria infection was encountered in 35 cases (17.3%) in which Plasmodium falciparum predominated in peripheral blood while P. malariae predominated on the placental surface. In cord blood P. falciparum was encountered in 1.5% of the cases. There was slightly more maternal infection in rural (23%) than in suburban areas (19%). Less malaria infection was encountered in primiparas than in multiparas and there was similar antibody response in both mothers and their newborns. Anaemia was encountered in 70% of the mothers and in 93% of the newborns. There was no significant correlation between low birthweight of the newborn and malaria parasitaemia in the mother.

Evaluation of four therapeutic regimens for falciparum malaria in Mozambique, 1986.

A randomized study on the effect of the following four treatment regimens on Plasmodium falciparum parasitaemia was carried out on 200 asymptomatic schoolchildren in Maputo, Mozambique: chloroquine (25 mg/kg body weight), amodiaquine (25 mg/kg), sulfadoxine-pyrimethamine (25 mg/kg and 1.25 mg/kg), or amodiaquine (25 mg/kg) + sulfadoxine-pyrimethamine (25 mg/kg and 1.25 mg/kg) administered on the third day of the study. The results of in vivo tests indicated that 94% of the infections were resistant to chloroquine, 76% to amodiaquine, and 16% to sulfadoxine-pyrimethamine. The cure rate with amodiaquine + sulfadoxine-pyrimethamine was 100%, which was not significantly different from that with sulfadoxine-pyrimethamine alone; the latter regimen was the most rapidly acting of the treatments studied. It is concluded that amodiaquine is not an appropriate substitute for chloroquine, but that the effect of the combination amodiaquine + sulfadoxine-pyrimethamine may be superior to that of sulfadoxine-pyrimethamine alone, although this requires further study.

The Plasmodium falciparum chloroquine in vivo test: extended follow-up is more important than parasite counting.

349 in vivo tests of the susceptibility of Plasmodium falciparum to chloroquine, 25 mg/kg, were analysed. In some surveys, standard in vitro tests were also carried out. The proportions of sensitive and resistant infections in different areas found by the 2 methods were similar, but, within a given area, correlation between the two methods was often poor. Two RI cases and one RII/RIII case were sensitive in vitro, and it is suggested that the extended in vivo test may sometimes be more sensitive than the in vitro test, and that even in endemic areas, where reinfection is possible, patency on day 14 will nearly always be due to resistance. Parasite density data were analysed by calculating the geometric mean of each day's parasite density as a percentage of the day 0 parasite density + 0.1. Most resistant and sensitive infections attained minimal values on day 4, and it is proposed that assessment of sensitivity based on parasite densities should use day 4 values. Contrasts between materials were more clearly defined statistically when comparisons were based on ranking in vivo test classifications, than when based on day 4 parasitaemia. It is therefore suggested that, for epidemiological purposes, extension of tests to at least 14 d is more important than parasite counting. Parasitaemia above 20-25% of the day 0 value on day 2 in a severely ill patient, or persistent patency on day 4 in a symptomatic patient, are both indications for a change of treatment.

Plasmodium falciparum in vitro schizont maturation tests in Mozambique are not improved by removing immune parasite carriers' plasma.

To study the effect of immune parasite carriers' plasma on Plasmodium falciparum schizont maturation, peripheral blood stages were incubated for 24-40 h in RPMI medium with either 5% carrier's plasma + 5% non-immune AB serum or 10% non-immune serum. The number of schizonts per 200 asexual P. falciparum was lower in non-immune serum than in the presence of carrier's plasma in 19 of 26 cases, due to increased frequency of schizont rupture when carrier's plasma was absent. It is concluded that, under these test conditions, the replacement of immune plasma by non-immune serum makes schizont maturation tests, which are based on the proportion of schizonts among asexual P. falciparum as a measure of growth, more difficult to interpret.