15 May 2018

Nigeria: How to Manage Malaria in Pregnancy

Lokoja — Malaria is a major public health problem in Nigeria and contributes to an estimated 11% of maternal mortality, according to the Nigeria Malaria Fact Sheet released by the United States Embassy in Nigeria.

It also accounts for 60% of outpatient visits and 30% of hospitalizations among children under five years of age in Nigeria, the report said.

There are an estimated 100 million malaria cases with over 300,000 deaths per year in Nigeria.

With the high prevalence of malaria amongst pregnant women and its attendant negative impacts on the mother and unborn child, medical experts have said it is important for increased efforts in preventing the disease when pregnant.

According to a gynaecologist and Principal Medical Officer with the Kogi State Specialist Hospital, Lokoja, Dr Adamu Audu, the cause of malaria in pregnancy is just like the cause in any other person.

He said malaria is caused by a parasite called plasmodium and that there are various kinds of plasmodium, with the commonest being plasmodium paspherus.

"There is the likelihood that out of every five pregnant women, about two to three of them may be having malaria," he said, adding "And it is for this reason that some measures are usually taken to avoid malaria in pregnancy because of the effects on the women and the unborn child."

He said malaria in pregnant women would lead to reduction in the growth of the baby and there is likelihood of becoming anemic due to reduction of the red blood cells.

Dr Audu also said the symptoms of malaria in pregnancy are just like the symptoms of malaria in any other person.

"First of all, it starts with fever. It also comes with chills, headache, joint pains and generalised body pains. Sometimes, there could also be vomiting," he said.

According to him, the prevention of malaria for pregnant women is just as it is for other population.

He said to prevent the disease in the general population and pregnant women, people should clear bushes in their surroundings and evacuate stagnant water to stop the breeding of the mosquitoes that carry the parasites that cause malaria.

He said the use of insecticide-treated nets has also been advocated for pregnant women especially, adding "the government usually distributes nets to pregnant women during their antenatal."

He said: "Pregnant women and their children are always advised to sleep under treated nets so as to prevent them from coming in contact with the mosquitoes which carry the malaria parasites."

The physician said another preventive approach done for pregnant women is intermittent therapy. "In this case, pregnant women are given two doses of Fansidar one month apart, and immediately the woman reaches the period we call quickening or the pregnancy is above 12 weeks, we give three doses of Fansidar and all these are aimed at preventing malaria."

However he added that the problem mainly is in the first trimester of the pregnancy where there is need for caution in administering drugs.

"In all the treatments, you have to first diagnose and ascertain that there is malaria before you administer drugs. This can be done using rapid test kits. In the first trimester, drugs like quinine can be used. Above the first trimester, the normal Artemisinin Combination Therapy (ACT) combination can be used for treating pregnant women," he advised

Dr Audu advised women to always seek healthcare once they are pregnant so they can be advised and educated on how to manage malaria.

"They should also try to do some environmental cleanup to keep their surroundings clean and prevent the breeding of malaria vectors," he advised.

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