Malaria in pregnancy. Prevention and treatment
Translated from Italian, “malaria” means “bad air”. This disease represents a group of infectious diseases that can be transmitted to humans through the bite of an Anopheles mosquito. Malaria is accompanied by severe chills and fever, splenomegaly (enlarged spleen), enlarged liver. Annually, 400-500 million people become infected with malaria, and about 3 million die. For humans, only four types of malaria are pathogenic, namely, P. malariae and P. vivax, P. ovale and P. falciparum. Malaria is passed from a sick person to a healthy person by several ways, among which are transmission from a sick person to a healthy person through the bloodsucking of female mosquitoes, blood transfusion and intrauterine transmission. According to the World Health Organization, about 3 billion people are at risk of contracting malaria. Of these, about 90% live in Africa. Infant mortality from malaria is about 20%, and 60% of cases of spontaneous abortion are attributable to this disease. The maternal mortality rate from malaria makes 10-50%.
Due to the high incidence of malaria in Africa, women during pregnancy become more vulnerable to this disease, as they have reduced immunity, and the life of the unborn child depends on their condition. Malaria during pregnancy is a huge problem that needs to be addressed urgently. Miscarriages, stillbirth, premature births and babies with low birth weight are the consequences of malaria suffered during pregnancy.
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Malaria during pregnancy is a huge problem that needs to be addressed urgently. Miscarriages, stillbirth, premature births and babies with low birth weight are the consequences of malaria suffered during pregnancy.
Prevention of malaria in pregnancy
Prevention of malaria in pregnant women in regions with widespread malaria is an integral part of antenatal care.
The World Health Organization recommends that women during pregnancy adhere to certain preventive measures that will help to reduce the risk of the disease:
- sleep in rooms where windows and doors are covered with a net or net canopy, preferably impregnated with an insecticide;
- dress from dusk until dawn so as not to leave arms and legs open;
- treat open skin areas with a repellent, especially when staying outdoors in the evening and at night;
- proper case management;
- in case of malaria, early treatment order;
- in areas where moderate or high levels of malaria are observed, periodic prophylactic treatment with sulfadoxine/pyrimethamine.
Current data from malaria-endemic countries indicate that periodic prophylactic treatment with sulfadoxine/pyrimethamine results in a reduction in the quantity of small-for-date newborns and a raise in the average weight of newborns.
In areas of malaria-endemic Africa, periodic prophylaxis with sulfadoxine/pyrimethamine is recommended for all pregnant women. Drug prophylaxis should be started in the second trimester of pregnancy, carried out with an interval of at least 1 month so that the pregnant woman receives at least 3 doses of the drug.
The incubation period of malaria ranges from seven days to three years. Symptoms and signs include fever, chills, sweating, hemolytic anemia, and splenomegaly. Diagnosis by detecting Plasmodium in a peripheral blood smear and diagnostic rapid tests. Treatment and prevention depend on the type of pathogen and drug sensitivity and include artemisinin-based combination therapy, a fixed combination of atovaquone and proguanil, as well as regimens containing chloroquine, quinine and mefloquine. Patients infected with P. vivax and P. ovale also receive primaquine to prevent relapse.
Malaria during pregnancy should be treated immediately. It is always necessary to remember that the risk of malaria to the fetus is significantly greater than the effect of antimalarial drugs. However, it is necessary to prescribe the least harmless drugs during pregnancy. Please, remember - your health and the health of your child is in your hands!