Malaria is disease caused by the parasite Plasmodium. It is transmitted by the bite of a female Anopheles mosquito. Pregnancy is a time in which one or more fetus (baby) develops in a woman. Women are more susceptible to parasites and infections during the pregnancy period as their immunity drops.
Malaria is among the 5 leading causes of death in pregnant women worldwide. Sub-Saharan Africa has the largest burden of malaria disease, with over 90% of the world’s malaria-related deaths occurring in this region. Twenty-five million pregnant women are currently at risk of malaria. According to the World Health Organization (WHO), malaria accounts for over 10,000 maternal and 200,000 neonatal deaths per year. Malaria reamins rampant in Africa and some parts of Asia.
Malaria in pregnancy is a major public health concern as it leads to complications that affect the mother, the fetus or newborn. Complications that can result include; severe anaemia, maternal death, higher rate of miscarriage, low birth weight, premature delivery, intrauterine death and neonatal death.
The symptoms and complications of malaria in pregnancy vary according to malaria transmission intensity in the given geographical area, and the individual’s level of acquired immunity. In areas where malaria is endemic, the pregnant woman might be asymptomatic but the parasites can still lead to anaemia and low birth weight. In areas where the parasite is not endemic and the patient has low immunity to malaria the infection is more severe and can lead to spontaneous abortion, stillbirth, prematurity and maternal anaemia.
Prevention of Malaria in Pregnant Women
Pregnant women are 3 times more likely to suffer from severe diseases as a result of malaria when you compare them with their non-pregnant counterparts. They also have approximately 50% mortality rate from severe diseases. Prevention is very important in the management of this public health menace. Ways of preventing malaria in pregnant women include;
- Use of long-lasting insecticidal nets (LLINs); These are bed nets treated with mosquito repellants such as permethrin or deltamethrin. It is important pregnant women and children sleep under mosquito treated nets. This helps to prevent mosquito bites most especially at night when they are sleeping.
- Clearing of bushes around the house and prevention of stagnant water in the surrounding is important so as to prevent breeding sites for the mosquitoes.
- In all areas with moderate to high malaria transmission in Africa, intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is a part of antenatal care services. IPTp is also given in two doses after 20 weeks of gestation, four weeks apart. IPTp helps to reduce maternal malaria episodes and it also reduces placental parasite count thus reducing the rate of maternal anaemia, low birth weight and neonatal mortality.
- Prompt diagnosis and effective treatment of malaria infections are also very important in curtailing the morbidity and mortality by malaria in pregnancy.
- Spraying indoors with mosquito repellant sprays especially sleeping areas.
Also Read: 10 Common Causes of Miscarriage
Treatment of Malaria in Pregnant Women
- Doctors prescribe the use of artemisinin based therapy in the management of uncomplicated malaria. It is relatively safe in all trimesters. However, there are only a few trials to support its use especially in first trimester. Examples of artemisinin-based therapy drugs include; artesunate/lumefantrine, artesunate/amodiaquine, artesunate/mefloquine and dihydroartemisinin-piperaquine.
- Patients may use Camoquine in the first trimester for the treatment of uncomplicated malaria.
- Patients can use I.V quinine in the first trimester and I.V. artesunate in any of the three trimesters. When the patient is stable, you can give them the complete dose of the artemisinin-based drugs.
- Malaria has become one of the most challenging infectious diseases to eradicate in Africa. It prevents pregnant mothers from effectively caring for their families and it decreases the likelihood of a healthy pregnancy outcome. It is therefore important to prevent the spread of the disease.