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Malaria During Pregnancy
Pregnant women are particularly vulnerable to malaria. In areas where malaria
is common, health ministries now strive to make malaria prevention part of
normal antenatal care.
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Pregnant women are particularly vulnerable to malaria. Pregnancy
(especially the first and second pregnancies) decreases immune
defenses against infectious diseases. In addition, the placenta
offers a safe harbor where malaria parasites can develop, relatively
protected from the woman’s immune defenses.
Malaria during
pregnancy affects both the mother and her fetus. Plasmodium
falciparum, the agent of severe malaria, causes the
most extensive damage. Infection with P. falciparum during
pregnancy increases the mother’s risk of developing
severe disease and anemia, and increases the risk of stillbirth
and prematurity. Infants born from such pregnancies are more
likely to have low birth weight, which decreases their chances
of survival.
To minimize the impact of malaria during pregnancy:
- Pregnant women living in areas without malaria risk (such
as the United States) should defer travel to malaria risk
areas, if at all possible.
- Pregnant women living in malarious areas should receive
extra protection against the disease.
In areas with high malaria transmission (such as Africa South
of the Sahara), ministries of health strive to implement the recommendations
of the World Health Organization (WHO)  (33
KB/1 page) for pregnant women:
- Intermittent preventive treatment (IPT) with at least 2
doses of antimalarial drugs after quickening (time of pregnancy
when the mother can feel the fetus move), not to exceed once
per month
- Use of insecticide-treated mosquito nets (ITN) throughout
pregnancy and during the postpartum period (period after
childbirth)
- Prompt and effective case management of malaria illness
These interventions are most often offered in the antenatal
care system, together with other health interventions such as
tetanus immunization, iron supplementation, and other routine
antenatal care. (WHO recommends a schedule of 4 antenatal clinic
visits, with 3 visits after quickening.)
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A pregnant woman during a prenatal consultation
in Malawi receives
sulfadoxine-pyrimethamine for intermittent preventive treatment
of malaria (IPT). The plastic bag on the table holds an insecticide-treated
bed net, another method for protecting her against malaria. |
In areas with lower malaria transmission, such as Asia, Latin
America, and parts of West Africa, less information is available
on the severity of the problem. In many of these areas, another
parasite species, P. vivax, is often found but its
potential impact during pregnancy is less well known.
Ministries of health and their partners (such as WHO and CDC)
have developed a rapid
assessment methodology to
measure the health burden of malaria in pregnancy, and to determine
what interventions are most suitable within the existing antenatal
care system. This methodology is currently being introduced
during workshops that aim to train investigators and to allow
different countries to share their experiences in prevention
and management of malaria in pregnancy.
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Workshop participants in Mali learn Epi
Info, a basic program for epidemiologic investigations.
The workshop was conducted at the Malaria Research and Training
Center (MRTC) in Bamako, Mali, in August 2004. Participants
came from Mali, Senegal, Mauritania, Niger and Madagascar.
Facilitators came from the WHO
Regional Office for Africa (WHO/AFRO), CDC, and MRTC. |
Prepared in collaboration with the Regional
Medical Research Center for Tribals (RMRCT - ICMR) in Jabalpur ,
India, and the Malaria Research and Training Center (MRTC)
in Bamako, Mali.
Page last modified : September
16,
2004
Content source: Division of Parasitic Diseases
National Center for Zoonotic, Vector-Borne, and Enteric Diseases (ZVED)
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