Congenital syphilis in an immunocompromised neonate: case report.

Syphilis is a notifiable and preventable disease, congenital syphilis more so. Consequently, attention has been recently focused on prenatal diagnosis of foetal syphilis by the use of ultrasonography apart from the conventional serologic screening. Congenital syphilis has not been reported from the Kingdom of Lesotho. We report the case of a 3.0 kg male neonate with florid joint and bone lesions of congenital syphilis associated with HIV infection seen at the Queen Elizabeth II Hospital, Maseru, Kingdom of Lesotho. Co-existing HIV infection influences the clinical manifestation of syphilis, the progression of neurosyphilis and the response to standard therapy. The baby had the recommended standard treatment with good response and he was followed-up for a period of twelve months with serologic screening and radiographic evaluation.

Prevalence of psychiatric morbidity among convicted inmates in a Nigerian prison community.

Studies of psychiatric morbidity in Nigerian prisons have not involved assessment for specific psychiatric disorders. The general aim of this study was to highlight the prevalence of psychiatric morbidity among convicted inmates at a medium security prison in Nigeria. In a one month period in 1996, 100 inmates (93% males, mean age, 31.4 years) of the prison in Benin City, were assessed, using the General Health Questionnaire (GHQ-30) and the Psychiatric Assessment Schedule (PAS). The 34 subjects who scored upto GHQ-30 cut-off, four, had specific axis I DSM III-R diagnoses, including, schizophrenia in two, major depression in two in recurrent mild depression in twenty one, generalised anxiety disorder in eight and somatisation disorder in one. On axis II, six subjects had antisocial personality disorder while another subject had probable mild mental retardation. On Axis III, 15 subjects had chronic physical illnesses, including one with epilepsy. Twenty five inmates had past histories of drug abuse prior to imprisonment, including cannabis (11%) and alcohol (13%). Total PAS scores were significantly predicted only by GHQ scores and length of stay in prison. There was no association between offence committed and psychiatric morbidity. Most subjects with psychiatric morbidity developed these illnesses while in prison. The findings differed from the situation in developed countries where personality disorders and substance use are much more prevalent. The fairly high level of psychiatric disorders underscores the need to improve medical services in the prison.