Malaria in pregnancy can threaten the lives of the mum and the baby when i got sick from malaria, i often cried from the bonerattling chills, the pounding headaches, the body pains and the stomach aches, says nnenna okaro md, a gyneacologist at the. The remaining 3% of the population live in the malaria free highlands. In line with who guidelines, pmi supports a threepronged approach to reducing malaria in pregnancy. Intermittent preventive treatment in pregnancy iptp with sulfadoxinepyrimethamine is used to prevent malaria, but resistance to this drug combination has decreased its efficacy and new alternatives are needed. Malaria prevention and control in the african region. Over the past 10 years, knowledge of the burden, economic costs, and consequences of malaria in pregnancy has improved, and the prevalence of malaria caused by plasmodium falciparum has declined substantially in some geographical areas.
Malaria infection during pregnancy is a significant public health problem with substantial risks for the pregnant woman, her fetus, and the newborn child. Download pdf version of parts formatted for print cdcpdf pdf, 82 kb. Since 2010, mortality rates among children under 5 have fallen by 34 per. While the overall consequences of malaria in pregnancy on maternal and birth outcomes have been documented, the effect of malaria in early pregnancy before iptp administrationremains poorly explored. Malaria in pregnancy geneva foundation for medical education. It is hyper endemic in ghana and among pregnant women, it accounts for17. All malaria infections in pregnancy should be treated promptly with safe and efficacious antimalarial drugs to prevent harmful effects on the. Kenya has adopted the world health organizations threepronged strategy for combating malaria in pregnancy mip. The physiological changes of pregnancy and pathological changes due to malaria have a deleterious effect on the course of each other. In 2 nd half of pregnancy, there may be more frequent paroxysms due to immunosuppression anemia. Malaria is a maternal, newborn and child health issue because these groups of people are most at risk for infection. Outcome and complications of malaria in pregnancy gomal journal of medical sciences julydecember 2008, vol. In most endemic areas of the world, pregnant women are the main adult risk group for malaria.
In addition, malaria parasites sequester and replicate in the placenta. Issues related to the prevalence, epidemiology, pathogenesis, clinical manifestations, diagnosis, and outcome of malaria in pregnancy are discussed separately, as are general details on treatment of uncomplicated and severe malaria. Pam is caused primarily by infection with plasmodium falciparum, the most dangerous of the four species of malaria causing parasites that infect humans. Of these 61 per cent 266,000 were children under 5 years of age. Malaria remains one of the most preventable causes of adverse birth outcomes. Who strategy for malaria in pregnancy, by level of transmission. In low transmission areas, when nonimmune pregnant women become infected, malaria infection may become severe and lifethreatening, requiring. The plasmodium falciparum parasite causes the most severe malaria symptoms and most deaths.
Previous studies have shown that plasmodium falciparum malaria infection was higher in early than in late pregnancy 19, 20. Malaria in nigeria malaria is a major public health problem in deaths than any other country in the world. Malaria associated maternal illness and low birth weight is mostly the result of plasmodium falciparum infection and occurs predominantly in africa. Atypical manifestations of malaria are more common in pregnancy, particularly in the 2 nd half of pregnancy fever.
Guidelines for the diagnosis, treatment and prevention of malaria in pregnancy have been developed as a companion document to this framework. In malaria endemic areas in africa, intermittent preventive treatment with sulfadoxinepyrimethamine iptpsp is recommended for all pregnant women. It is estimated to affect between 350 to 500 million people annually and accounts for 1 to 3 million deaths per year. Prevention of malaria in pregnancy the lancet infectious. This translates into a daily toll of nearly 730 children under age 5. This sheet talks about whether exposure to malaria may increase the risk for birth defects over that background risk. Effects of malaria during pregnancy, labour and puerperium. Prevention and control of malaria in pregnancy jhpiego. Patient may have different patterns of fever from afebrile to continuous fever, low grade to hyper pyrexia. Malaria during pregnancy is a major public health concern and an important contributor to maternal and infant morbidity and mortality in malaria endemic countries. Malaria is a multiorgan disease and can present with splenomegaly, thrombocytopenia, nausea and vomiting, diarrhea, hypoglycemia, lactic acidosis, cerebral malaria, severe anemia, and renal failure.
Pregnant women, babies, young children and the elderly are particularly at risk. Most of these deaths occurred in subsaharan africa. Furthermore, studies outside of africa have increased the evidence base of plasmodium vivax in pregnancy malaria. In high transmission areas, malaria in pregnancy is most common in firsttime mothers and prevalence and densities of parasitaemia both decline. Malaria in pregnancy occurred significantly more in women who failed to adhere to subsequent doses of iptp than in those who adhered 24. Many countries in subsaharan africa have made significant progress toward achieving their malaria in pregnancy mip program goals. Recommended interventions for malaria prevention and control during pregnancy policies for malaria prevention and control during pregnancy in areas of stable transmission should emphasize a package of intermittent preventive treatment and use of insecticidetreated nets and ensure effective case management of. Who recommendation on intermittent preventive treatment of. Pregnant women constitute the main adult risk group for malaria and 80% of deaths due to malaria in africa occur in pregnant women and children below 5 years. Pdf risk factors for malaria in pregnancy in an urban. Malaria in pregnancy is an obstetric, social and medical problem requiring multidisciplinary and multidimensional solution.
As complications of severe malaria can occur within hours or days of the first symptoms. Malaria primarily affects low and lower income countries and within endemic countries, the. Its typically transmitted through the bite of an infected anopheles mosquito. Impact of plasmodium falciparum malaria and intermittent. Malaria in pregnancy in rwanda report of a prevalence study.
In africa, malaria infection in pregnancy is a major threat to the lives of mothers, fetuses, and infants. Senegals successes and remaining challenges for malaria in pregnancy programming vii executive summary introduction and background. Effective interventions have been put in place to protect this highly vulnerable population over the past few years. Elimination of the malaria parasites that caused the treated illness. Malaria in pregnancy mip is a major, preventable cause of maternal morbidity and poor birth outcomes. Apuzzio department of obstetrics and gynecology, division of maternal fetal medicine, umdnjnew jersey medical school. Malaria during pregnancy is a major cause of maternal morbidity. For pregnant women diagnosed with uncomplicated malaria caused by.
Artemisinin, diagnosis, malaria, plasmodium, pregnant, treatment. The first national diagnosis and treatment guidelines were developed in may 2005 following a consensus meeting held in nairobi1 and updated in january 2011. Malaria infection in pregnant women is associated with high risks of both. This compares with 215,000 deaths per year in nigeria from hivaids. Malaria in pregnancy mip is a major, preventable cause of maternal. Risk factors for malaria in pregnancy in an urban and periurban population in western kenya. A combination of two or more classes of antimalarial drug with unrelated mechanisms of action. Apuzzio department of obstetrics and gynecology, division of maternal fetal. When the transmission is high, maternal anaemia is common, and infant low birth weight due to foetal growth restriction andor premature delivery is frequent 2. Determination of the infecting plasmodium species for treatment purposes is important for three main reasons. Malaria in pregnancy national malaria control programme. Malaria and pregnancy are mutually aggravating conditions. To prevent the adverse outcomes of mip, who recommends the use of insecticidetreated mosquito nets itns, and effective case management of malaria and anaemia in pregnant women.
Malaria infection during pregnancy is a major public health problem in tropical and subtropical regions throughout the world. In africa, a metaanalysis showed threecourse or monthly iptp with. Malaria in pregnancy zambia national malaria elimination. Malaria is the second most common cause of infectious diseaserelated death in the world, after tuberculosis. Pregnancy associated malaria pam or placental malaria is a presentation of the common illness that is particularly lifethreatening to both mother and developing fetus. In people with g6pd deficiency, consider giving primaquine base at 45 mg once a week for 8 weeks, with close medical supervision for potential primaquineinduced haemolysis. Treatment of malaria during pregnancy and postpartum. Malaria infection during pregnancy is a major cause of maternal and neonatal death in zambia and throughout tropical and subtropical regions of the world. Malaria during pregnancy has been most widely evaluated in africa, south of the sahara where 90% of the global malaria burden occurs. Malaria poses a serious health risk to the pregnant woman but the unborn child is. Malaria in pregnancy the burden of malaria in pregnancy globally, an estimated 3.
Tips to boost immunity during pregnancy the other possible reasons are loss of immunity. In low transmission areas, when nonimmune pregnant women become infected, malaria infection may become severe and life. A study was made to determine the prevalence of malaria infection among pregnant women on admission in imo state specialist hospital owerri between july to august 2012. Malaria is currently the most common parasitic infection. Outcome and complications of malaria in pregnancy original. In every pregnancy, a woman starts out with a 35% chance of having a baby with a birth defect. Blood samples were collected from the patients and a thick blood film made. Prevalence and associated risk factors of malaria in the. This makes the expectant woman vulnerable to malaria. In 2017, there were 219 million malaria cases that led to 435,000 deaths. In addition, repeated malaria infections make young children more susceptible to other common childhood illnesses, such as diarrhoea and respiratory. The diagnosis and treatment of malaria in pregnancy rcog. Ppt malaria in pregnancy powerpoint presentation free. While the mechanism is poorly understood, pregnant women have a reduced immune response and therefore less effectively clear malaria infections.
Malaria in pregnancy mip is a serious health risk for the pregnant woman e. Malaria infection in pregnant women is associated with high risks of both maternal and perinatal morbidity and mortality. Malaria is a serious illness that can be fatal if not diagnosed and treated quickly. Pregnancy weakens a womans immune system in general due to decreased immunoglobulin synthesis. Malaria continues to take a great toll on our pregnant women and their babies. Treatment of uncomplicated and severe malaria during pregnancy.