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TIPS ON MALARIA

  • HOW CAN MOSQUITOES BE CONTROLLED?

    Mosquitoes around the home can be reduced significantly by minimizing the amount of standing water available for mosquito breeding. Residents are urged to reduce standing water around the home in a variety of ways.

  • HOW CAN I PROTECT MYSELF FROM MOSQUITO-BORN DISEASES?

    The best way is to avoid being bitten by mosquitoes.This can be accomplished using personal protecting  while outdoors when mosquitoes are present. Treated bed nets should be used sleeping. Mosquito repellent should be used when outdoor.

  • WHO ARE AT RISK?


    Nearly half of the world’s population is at risk of getting malaria. Pregnant women are particularly at risk of malaria. Children under 5 years are at high risk of malaria.
     

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Malaria: A DISEASE OF MANY PARTS

By Sade Oguntola, Nigeria

Malaria  affects  millions  of  pregnant women  each  year .  African  women bear the brunt of this disease during  Mtheir first pregnancy and are likely to lose  the  semi-immunity  normally  found  in adults.

“There  is  the  tendency  for  people  to  see malaria as ordinary, but  it  is a serious disease. The mother and the baby could be seriously affected  if  it  is  not  properly  and  promptly treated. The risk to the mother includes low blood  level  (anaemia)  in  pregnancy, which could become severe and necessitate blood transfusion,”  Dr.   Kayode  Afolabi ,   a Consultant  Obstetrician  and  Gynaecologist at the University College Hospital, Ibadan, in Nigeria's Oyo State, has said.

“In  the  case  of  the  unborn  baby,  malaria could lead to miscarriage, referred to in the medical parlance as  spontaneous abortion, depending on the stage at which the malaria
occurs,” Dr Afolabi added.

“The baby may be born premature, with a low  birth  weight  due  to  retarded  growth while  in  the womb.  This  is why  the use of malaria medications is always considered an important  issue and emphasis  is placed on  its prevention. Currently, we are embarking on the prevention of malaria in pregnancy with two  to  three  doses  of  the  prescribed
a n t ima l a r i a l   d r u g   ( s u l f a d o x i n e -pyreimethamine)  during  pregnancy. 

This starts  after  the  first  three  months  of pregnancy  when  it  is  certain  that  the medication would not cause any deformity  in the developing child  in  the womb,” he said.

Research  shows  that  pregnant  women attract  twice  the number of mosquitoes as non-pregnant  women,  which  probably increases  their  risk  of  contracting malaria.

In  these  young  mothers,  the  Plasmodium falciparum  (a parasite  that  causes malaria)
accumulates  in the placenta, causing them to become  short  on  blood.  The  children  of
infected mothers often are underdeveloped or  babies  with  lower  birth weights. Sometimes, children of  such mothers with  severe malaria  are  delivered  as premature babies or die while  still  in  the womb.

But  that  is  not  all  about  the effects  of  malaria  during pregnancy.   One  of   the consequences of malaria has been shown  in new research to  include  pre-eclampsia (very high blood pressure and protein  loss  in  the  urine), which  carries  high  risks  for
both  mother  and  child  for wome n   i n   t h e i r   f i r s t pregnancy.

Pre-eclampsia  is  thought  to be  more  common  in  some parts  of  the  world  where there  is  severe  malaria problem and  it has often been speculated  that  there  might be a connection. Malaria is more common in a  first  pregnancy  and  so  is  pre-eclampsia.

Dr .  Afolabi  described  pre-eclampsia  as  a condition  in  pregnancy  where  the  woman has  high  blood  pressure  coexisting  with protein  in  urine.  What  is  obvious  to  the human eyes  is  that  they appear blown up.
 
“Looking  at  them,  their  whole  body  is swollen,  especially  their  face,  hands  and feet,” he declared. He  said  so many  things could predispose a woman  to pre-eclampsia.
“It  is a disease  that  is common  in women who are  getting  pregnant  for  the  first  time  or those  that  are  getting  pregnant  for  a  new husband,  even  though  they  have  had
previous  pregnancies  or  deliveries  in  the past.”

In addition, he said  that “it  is common among women  who  before  pregnancy  have  had
other  medical  problem  like  diabetes, hypertension  or  even  kidney  problems.

Women who have multiple pregnancies are equally prone  to developing  the problem.”
Dr . Afolabi  described  malaria  and  pre- eclampsia  as  two  common  problems  of pregnant women,  stressing  that  there  is  a possibility of malaria contributing to cases of pre-eclampsia  in women.

He  also  touched  on  another  effects  of malaria  in  pregnancy.  This  is  where  a pregnant  woman  who  has  malaria  could have  a  high  concentration  of  malaria parasites  developing  in  the  placenta.  The placenta  is  the  cord  attaching  the  unborn
baby to the mother and this cord supplies it with oxygen and nutrients from the mother .

When  a  pregnant  woman  has  a  high concent rat ion  of   malaria  parasi tes developing  in  the placenta, she  is said  to have 'placental malaria'. This  is very harmful  to  the mother and to the unborn baby; it  leads to low  birth  weight  and,  in  Africa  alone,  is estimated to be responsible for the deaths of about 200,000 infants every year . A woman who  is  pregnant  for  the  first  time  is most likely to suffer from placental malaria, and to have  her  placenta  become  highly  infected and extremely  inflamed.

Dr .  Afolabi  explained  that  in  a  situation where a woman has a high  load of malaria parasites  in the placenta, the effectiveness of the placenta in carrying oxygen and nutrient supplies  to  the baby would be affected.

“Due to the high load of malaria parasite in the placenta, there could be damage to the placenta in such a way that it could predispose the mother  to pre-eclampsia,” he said.

Pre-eclampsia  itself  is a serious complication of pregnancy and affects one  out  of  every  10  pregnant women  in Nigeria  according  to Dr. Bukola Fawole, a Consultant obstetrician and Gynaecologist at  the University College Hospital  (UCH)  Ibadan. The condition  is often silent and shows up unexpectedly during a routine blood pressure check
and urine test, but according to Dr . Fawole  it cannot be out rightly said to be due  to malaria.

“Right now, we do not know if there is a direct connection between malaria parasites within the placenta leading to pre-eclampsia.,” Dr Fawole says.

”What  we  know  is  that  when  there  are malaria  parasites  in  the placenta, it has its own problems. It leads to reduced growth of the baby and in very severe situations the baby may end up dying right in the womb.” says Dr . Fawole.

Researchers  from  the  USA,  UK  and  Tanzania  investigating  the possibility that malaria might  lead to pre-eclampsia found out that first-time young mothers, having placental malaria increased the risk of hypertension about  three-fold.

Pregnant women with pre-eclampsia are usually advised to take time off  work,  have  bed  rest,  take  medication,  and  sometimes  even hospitalised to keep the blood pressure under control. Unfortunately, the only “cure” for the disease is delivery of the baby, but it is in the best interest of the babies to be kept  in the womb as long as possible.

Sometimes it is in the best interest of the mother to deliver the baby before  term.
 

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