In Vienna (BMJ2004;329:371–4, see also commentary; ibid:374OpenUrlAbstract/FREE Full Text) simple vaginal smear screening for abnormal vaginal flora early in the second trimester of pregnancy, and subsequent treatment, reduced the preterm birth rate from 5.3% to 3.0%. The proportion of babies born both preterm and of low birthweight was reduced from 3.5% to 1.7%. An unexpected finding was that the improvements were associated with treatment of vaginal candidiasis rather than of bacterial vaginosis. Vaginal colonisation with candida has not been thought to increase the risk of preterm birth.

Mothers in a village in Gabon, Central Africa (Journal of Epidemiology and Community Health2004;58:826–30OpenUrlAbstract/FREE Full Text) considered “fever” and “malaria” to be synonyms. They believed that fever was of two types, natural and supernatural. Natural fever responded to conventional treatment but supernatural fever was a result of witchcraft and needed to be treated by a traditional healer (Nganga), who is both a herbalist and a witch doctor. Worryingly, it is believed that one way of distinguishing supernatural fever is that the child is sicker. Another distinguishing feature is failure to respond to medical treatment. Mothers might stop the treatment and consult a Nganga. The two types of fever could occur in the same child simultaneously.

Methods for …