If there is one word that probably ought not to be used in describing or referring to Malaria, it should be the word ‘ordinary’ because as regular as ‘everyday malaria’ is, there is hardly anything ordinary about malaria; especially when it gets complicated.
According to the current statistics by the National Malaria Control Program of the Nigerian Health (MoH), Malaria is responsible for 60% of all outpatient visits to our health facilities; 30% of childhood deaths; 25% of deaths in children under one year; and 11% of maternal deaths.
This article is the concluding part of a countdown on the 50 things you should know about the uniqueness of Malaria in Pregnancy as published in the Malaria Edition of HALA Magazine. See the previous list here:
- 50 Things you DID NOT know about Malaria in Pregnancy!
- #Nigerian Mothers: Getting Pregnant in a Malaria-dense Country
- What determines the severity of Malaria in Pregnancy?
When malaria in pregnancy gets Complicated for the Baby
35. Intrauterine Growth Retardation (IUGR). The combined effects of high parasite load and distracting cellular activities at the placenta cumulates in reduced nutrient transportation to the baby
36. Low Birth Weight. Low birth weight (< 2.5kg at term) is an important risk factor for neonatal and infant mortality -19% of which is attributed to malaria in pregnancy.
37. Congenital Malaria. Congenital malaria means that the baby is born ill because he/she is already infected with the parasite from the womb so has symptoms of malaria
38. This is rare so its occurrence is less than 5% because the mother’s antibodies usually cross the placenta to protect the baby to some extent
39. Congenital malaria is more common in areas where malaria transmission is unstable.
When malaria in pregnancy gets Complicated for the Mother
40. Anaemia- meaning a reduction in the oxygen-carrying capacity of the blood because of insufficient red blood cells and it is easy to tilt into severe anaemia in pregnancy.
41. Hypoglycaemia- means low blood sugar and this is usually more likely to occur in pregnancy due to the high energy demands and it can be missed because its symptoms mimic a general feeling of unwell in malaria
42. Therefore, blood sugar monitoring is highly recommended for all pregnant women with P. falciparum malaria, particularly in those receiving quinine treatments.
43. A proper management of maternal hypoglycaemia is important because it can also cause distress to the baby in the womb without any obvious external signs.
Treatment & Prevention of Malaria in Pregnancy
44. Drug Choices. If a pregnant woman has clinical malaria with symptoms, treatment should be similar to any other patient; early detection is important.
45. The use of Oral Quinine at all trimesters is recommended.
46. Artemisinin Combination Therapy (ACT) should be used at the second and third trimesters but it can be used in the first trimester where Quinine is not accessible.
47. Ante-Natal Prevention. All pregnant women should take the nationally recommended curative doses of Fansidar as Intermittent Preventive Treatment (IPTp).
48. Fansidar is routinely given at ante-natal clinics in Nigeria from the 16th week of pregnancy.
49. Two doses of IPT should be received and both should be taken 4 weeks apart.
50. Be Pro-Active. The use of long lasting insecticide-treated nets (LLIN) is also an effective method for prevention as it protects against mosquito bites