Objective. We have reviewed the scientific literature on ectopic pregnancy (EP) in African countries published over the past 20 years and available from several databases (MED-LINE, EMBASE, POPLINE, and Cochrane Fertility Regulation Group), with the aim of painting a complete picture of the situation (incidence, risk factors, diagnosis, treatment, and complications). Results. Although hospital-based African studies indicate EP incidence has probably increased in Africa in recent decades, major methodological limitations in the published literature make it impossible to draw formal conclusions concerning the incidence of EP in Africa in recent years. As in industrialized countries, pelvic inflammatory disease (PID) associated with sexually transmitted diseases (STDs) must be considered as the most important risk factor for EP in developing countries. In African developing countries, a majority of hospital-based studies have reported EP case fatality rates of around 1-3%, 10 times higher than that reported in industrialized countries. Late diagnosis, leading in almost all cases to major complications, and emergency surgical treatments are key elements accounting for such high fatality rates in women suffering from EP in Africa. Conclusion. EP should be considered a relevant public health indicator in developing countries, providing an overall picture of the capacity of a health system to deal with the diagnosis and treatment of emergency situations, especially in the field of obstetrics and gynecology.

Full-term newborns have antibody (Ab) repertoires and levels similar to their mothers to help protect them from environmental pathogens. Unfortunately, preterm babies, especially those born < 34 weeks, have reduced levels of protective antibodies. In Africa, antibodies to Plasmodium falciparum are important in protection from malaria. This study investigated the transfer of total IgG and antibodies to 9 P. falciparum antigens and tetanus toxoid between 24 weeks and term. Paired maternal and cord samples from 166 preterm (24–37 weeks) and 154 term deliveries were used. Transfer efficiency was expressed as the ratio of Ab levels in cord to maternal plasma (CMR). At 24–25 weeks, CMR ranged from 0.31 to 0.94 for the different antigens; the rate of transfer was similar for all antigens between 24 and 40 weeks; resulting in median CMR of 0.49–0.95 at term. Babies of mothers with hypergammaglobulinemia and normal IgG levels had similar amounts of IgG, supporting data that saturation of the neonatal Fc-receptor occurs at ~ 16 mg IgG/ml. Thus, babies born prior to 34–35 weeks in Africa are likely to have reduced Ab levels to some, but not all antigens. Since IgG transfer is Fc-mediated, why differences exist in CMR among the antigens warrants further investigation.

Full-term newborns have antibody (Ab) repertoires and levels similar to their mothers to help protect them from environmental pathogens. Unfortunately, preterm babies, especially those born < 34 weeks, have reduced levels of protective antibodies. In Africa, antibodies to Plasmodium falciparum are important in protection from malaria. This study investigated the transfer of total IgG and antibodies to 9 P. falciparum antigens and tetanus toxoid between 24 weeks and term. Paired maternal and cord samples from 166 preterm (24–37 weeks) and 154 term deliveries were used. Transfer efficiency was expressed as the ratio of Ab levels in cord to maternal plasma (CMR). At 24–25 weeks, CMR ranged from 0.31 to 0.94 for the different antigens; the rate of transfer was similar for all antigens between 24–40 weeks; resulting in median CMR of 0.49 to 0.95 at term. Babies of mothers with hypergammaglobulinemia and normal IgG levels had similar amounts of IgG, supporting data that saturation of the neonatal Fc-receptor occurs at ~ 16 mg IgG/ml. Thus, babies born prior to 34–35 weeks in Africa are likely to have reduced Ab levels to some, but not all antigens. Since IgG transfer is Fc-mediated, why differences exist in CMR among the antigens warrants further investigation.