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Why malaria and pregnancy don’t mix

By Chioma Obinna

Mary Ogu was 20 weeks pregnant when she developed malaria. A resident in one of the slums in Lagos where mosquitoes breed freely,   Mary does not sleep under Insecticide Treatment Nets, ITNs, and takes no precautions such as the recommended treatment for malaria for pregnant women.

Every pregnant woman should take necessary precaution against malaria infection.
Every pregnant woman should take necessary precaution against malaria infection.

No one had told her of the need to take Intemittent Preventive Treatment, IPT, so when she developed a fever and headache she suspected malaria and went to a nearby hospital for a  test.

“While I was waiting for the lab results, my condition worsened. I lost my appetite and I was extremely thirsty,” she said.” Her troubles ranged from headaches and body aches to difficulty to walk. She decided to go to the hospital.

“It happened in a flash. I was 20 weeks pregnant. I had gone to my doctor for check up a week before and I was told my pregnancy was progressing well and that the baby was showing normal movements.”

Mary was shocked when it was discovered she was having spontaneous abortion.  In the emergency room, the doctors discovered that many of her red blood cells were infected  with the malaria parasite  indicating a rather severe episode. Over the  next few days Mary remained very ill and weak; at a point she had a miscarriage.

Bolanle Agbo’s case is not different.  Six weeks into  pregnancy she had malaria. She never accessed treatment until it was discovered that the foetus was no longer breathing. Bolanle was induced and in the process it was discovered she had malaria. Unfortunately, it affected the foetus.

Experts say Mary and Bolanle would have been okay if they had followed the recommendation for prevention of malaria according to the World Health Organisation, WHO,  and the Federal Government of Nigeria,. Administering Sulphadoxine-Pyrimethamine (SP)) for intermittent preventive treatment under direct observation of a skilled service provider as well as consistently sleep under the long lasting insecticidal nets (LLINs) or taking recommended medicines would have helped.

Statistics  show that malaria contributes about 11 percent to death of pregnant women globally and is also a major contributory factor to anaemia during pregnancy with about 22 per cent mortality rate.

Malaria in pregnant women can lead to complications including jaundice, anaemia, haemorrhage, enlargement of the spleen, and kidney failure. If a pregnant woman has malaria, the consequence is that it poses a greater risk of stillbirth, miscarriage, low birth weight babies and neonatal death. There is also a small risk of the baby being born with malaria. Most babies remain unharmed but in very rare cases the baby can get the disease through the placenta.

In the views of the Head, Case Management, National Malaria Elimination Programme, NMEP, Dr. Godwin Ntadom, pregnant women are more vulnerable to malaria because of their low immunity.

“The major reason malaria is dangerous during pregnancy is because most times it does not affect the woman. The parasite prefers the blood in the placenta due to the high nutrients found in it so it stays in the placenta, and because the blood in the placenta is separated from the blood of the woman, she does not get sick and as such she never gets to know she has malaria until she is tested.”

He said the blood in the placenta has a lot of nutrients which attracts the malaria parasite.

“The moment a pregnant woman is bitten by a mosquito, the parasite enters her body and settles in the placenta taking whatever food meant for the unborn child. As such, the baby may starve to death and it may also lead to the death of the woman. Babies that survive from malaria parasite are born underweight or malnourished, which is a major cause of infant mortality.

“The best way out is for pregnant women to prevent themselves from malaria. The moment a woman gets pregnant, she is advised to visit a health facility for intermittent preventive treatment  that will prevent her from contracting malaria. She is also advised to always sleep under a treated mosquito net.”

Further, Ntadom said: “Most pregnant women may not have  symptoms because the parasites are within the placenta.    And they are actually fighting the baby in the womb.  And that is why the pregnant woman should for the sake of the baby in her womb take IPT.

“Every pregnant woman living in Nigeria except the few  that may not be able to take it,  as from three months, she should begin to take it monthly or three times before delivery.”


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