Malaria is one of the most common health challenges for pregnant women in Nigeria. Although malaria can be life-threatening, it is preventable. Malaria in pregnancy is managed with the use of simple behaviour changes and medication.
Let’s consider the causes, treatment and prevention of malaria in pregnancy.
What Causes Malaria?
Malaria is caused by a parasite carried by the female anopheles mosquito. These mosquitoes transmit the parasite to humans when they bite us. They prefer to bite at dusk and dawn.
So far, the strains of malaria parasites identified include Plasmodium Malariae, Plasmodium Ovale, Plasmodium Vivax and Plasmodium Falciparum. Even though Plasmodium Falciparum is the most lethal strain, Plasmodium Vivax, on the other hand, is the most common, and has a tendency to remain latent in the liver and placenta causing relapses of malaria.
During pregnancy, women have a decreased immunity that places them at a higher risk of contracting malaria. In addition to this, the weather condition in Nigeria also plays a major part. During the rainy season, mosquitoes grow faster and the spread of malaria increases.
Pregnancy and Malaria
Malaria is common in pregnant women. Their immune system during pregnancy does a poor job of protecting mums from the infection. Once they get into the blood stream, the parasites love to hide and multiply in the placenta. ⠀
Immunity is lowest during pregnancy in the second and third trimesters. Therefore, extra caution is needed at these times.
Signs and Symptoms of Malaria
The basic signs and symptoms of malaria include:
- Muscle aches
- Tummy aches
- Weakness / Fatigue
Note that some mums may have the parasites and not experience symptoms. They can still pass malaria to their growing babies.
Risk factors of malaria in pregnant women
- Living in a region where malaria is common
- Living in a dirty environment : A dirty environment provides a good breeding space for mosquitoes. If a pregnant woman is living in an area that is dirty and/or there are collections of stagnant water around, she has a very high risk of contracting malaria. Mosquitoes breed in stagnant water collected in disused containers, vehicle tires, clogged up gutters and so on.
- Blood transfusion: Receiving blood from someone who has malaria or has just been treated for malaria puts the pregnant woman at risk for malaria. The baby also has a chance of contracting the malaria from the mother’s blood in severe cases.
How Is Malaria In Pregnancy Treated?
Malaria treatment for pregnant women should be done under proper medical guidance. Your treatment depends on your age, pregnancy stage, and severity of symptoms.
Your doctor is in the best position to tell you what drug to use at that particular time. This is because certain malaria medications are unsafe in the first trimester. So be sure you are not pregnant or in the early stages before taking them. Others, if taken too close to delivery can cause jaundice in the newborn. However, the WHO recommends sulfadoxin- pyrimethamine as a drug of choice for prevention and artemisinin based combination for treatment of pregnant women with malaria.
Please, avoid over-the-counter drugs at all times. Ensure that your doctor is well informed regarding all matters pertaining to your health during your pregnancy .
- Stay in a clean environment. Eliminate stagnant water completely and make sure that your garbage is properly disposed.
- Use of long acting insecticide treated mosquito nets while sleeping and mosquito repellent is encouraged.
- When you’re using mosquito repellents, ensure you use in the appropriate quantity specified by the manufacturer. An excess use of repellent does not equal an extra kill effect on the mosquitoes, rather, you are placing your health at a higher risk.
- Wear light-coloured clothes as much as possible. This is because mosquitoes are more attracted to dark colours. Ensure your dresses are full-length and long-sleeved especially at night.
- The World Health Organisation recommends intermittent preventive treatment in pregnancy (IPTp) for all pregnant women. This is with a medication called sulfadoxine and pyrimethamine(SP) (Fansidar) for mums who don’t react to sulfur. From the second trimester, this is to be taken twice in pregnancy for regular mums and 3 times for HIV positive mothers. This treatment reduces the number of episodes of malaria. It reduces the chances of anaemia in mum and baby as well as infant death. Your doctor will advise on the dosage and timing.
Effects of Malaria on Pregnancy
- Anaemia : The parasite makes us ill by destroying the oxygen carrying red blood cells starving the tissues of the fuel they need to function and thrive. This explains the weakness and fatigue associated with malaria
- Miscarriages ⠀⠀⠀
- Low birth weight: Malaria can cause poor growth and malformations in the baby
- Still birth
- Malaria in the newborn: The new born also has a risk of coming down with malaria after getting infected through the placenta.
Take care of your surroundings and ensure that your environment is clean at all times. Please try and get your doses of preventive anti-malaria medication during your antenatal care period. Not all fevers are malaria. It’s important that ill mums get tested to be sure before taking malaria medication. Call or visit the clinic whenever you feel unwell. Please avoid the use of over-the-counter drugs at all costs.
- Romita P (2017). Malaria During Pregnancy. Accessed on 21st August, 2020 from https://www.google.com/amp/s/parenting.firstcry.com/articles/a-guide-to-malaria-during-pregnancy/%3famp
- WHO, 2017. Malaria in pregnant women, Geneva: WHO.
- WHO, 2014. “WHO policy brief for the implementation of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP).” [Online] Available at: https://www.who.int/malaria/publications/atoz/iptp-sp-updated-policy-brief-24jan2014.pdf?ua=1 [Accessed 30th August 2020].