title: Fetal malformation in maternal toxoplasma and rubella co-infection in Cameroon: a case report.
abstract: 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.
  
  
  METHODS
  A 25-year-old black Cameroonian woman of Bakossi origin, gravida3para1010, 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Tombel District Hospital, Ministry of Public Health, Tombel, Republic of Cameroon. njohandreas@yahoo.com.|General Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Republic of Cameroon. njohandreas@yahoo.com.
authors.forename: Andreas Ateke
authors.initials: AA
authors.lastname: Njoh
authors.affiliation: Educational Psychology/Special Education, Faculty of Education, University of Buea, Buea, Republic of Cameroon.
authors.forename: Sarah Namondo
authors.initials: SN
authors.lastname: Njoh
authors.affiliation: General Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Republic of Cameroon.
authors.forename: Messang Blandine
authors.initials: MB
authors.lastname: Abizou
mesh_terms: D000328:Adult; D000757:Anencephaly / Q000469:parasitology* / Q000821:virology*; D002163:Cameroon; D060085:Coinfection; D037001:Directive Counseling; D005260:Female; D005315:Fetal Diseases / Q000469:parasitology* / Q000821:virology*; D006801:Humans; D010290:Parents / Q000523:psychology; D066087:Perinatal Death; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000469:parasitology / Q000821:virology; D012409:Rubella / Q000150:complications; D014123:Toxoplasmosis / Q000150:complications
keywords: Anencephaly; Case report; Resource-limited settings; Toxoplasma and rubella co-infection