Early onset myasthenia gravis in a Malawian woman: Challenges in managing myasthenia gravis in a low-resource setting.

Myasthenia gravis is a rare autoimmune disease, which presents with ocular or generalised symptoms. Few publications describe its prevalence in African populations. We describe a young woman who was diagnosed with myasthenia gravis in a Malawian public hospital and outline the challenges encountered in managing this condition in a low-resource setting.

Prevalence of vitamin D deficiency in adult tuberculosis patients at a central hospital in Malawi.

Vitamin D deficiency (VDD) is associated with impaired mycobacterial immunity and susceptibility to tuberculosis (TB). We measured 25 hydroxy vitamin D levels in 161 adult TB patients at a central hospital in Malawi, of whom 120 (74.5%) had ≤75 nmol/l (hypovitaminosis D), 68 (42%) had ≤50 nmol/l (VDD) and 13.6% of in-patients and 6.8% of out-patients had ≤25 nmol/l (severe VDD). In-patients had lower body mass index (BMI; 19.0 vs. 20.5, P < 0.004), and vitamin D levels were lower in those with BMI < 20. However, on multiple regression analysis in-patient status and BMI were not associated with vitamin D level. We conclude that VDD is common in adult TB patients in Malawi. In this small sample, it was not possible to identify any independent associations of VDD.