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    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.


    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.


    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 in Pregnancy

A programme aimed at reducing malaria cases in pregnant women in part of Kenya still faces a lot of challenges an expert on malaria has revealed

Christine Ayuyo said the program's implementation still faces a number of challenges including Traditional Birth Attendants' failure to refer pregnant women whom they are offering services to health facilities forAnte-Natal Care.

Ayuyo works as a Monitoring and Evaluation Technical Officer at Access Uzima with Jhpiego, an international non-profit health organization affiliated with Johns Hopkins University.

Speaking in Kisumu recently during a conference on malaria by the Kenya NGOs Alliance Against Malaria (KeNaam), Madam Ayuyo said documentation regarding malaria cases in pregnant women in most of the health facilities across the country is a big challenge.

She said the uptake of the Intermittent Preventive Treatment (IPT) by expectant mothers as a preventive measure in preventing malaria disease during pregnancy is still low at the community level.

“The Malaria In Pregnancy program is being implementation in Nyanza, Western and Coast regions of Kenya still faces a lot of challenges that includes the low uptake of IPT at the community level hence the need to scale it up at the grass root level,” she said.

She observed that most pregnant mothers do visit the health facilities to seek Ante-Natal Care when it is already late thus hampering the fight against malaria during pregnancy.

The Monitoring and Technical officer said some of the clients for the IPT do not swallow the Fansidar at the health facility while it is being given to them for the treatment of malaria during the pregnancy period, adding that the little stock of the drug is also a draw back to the program.

She added that poor access to health facilities across the mentioned regions still hinders the implementation of the program. Ayuyo further added that knowledge gaps among the service provides who operate at the Ante Natal Clinics is also a challenge to the control of malaria in pregnant mothers.

Research Studies have shown that pregnancy increases the risks of malaria infection and women in their first and second pregnancies together with all the HIV infected women who are at a greater risk of malaria infection.

Malaria in Pregnancy has a number of effects like maternal anaemia, low birth weight, still birth or abortion and can cause death.

There are two approaches to preventing malaria in pregnancy: intermittent preventive treatment (IPT) and the use of insecticide treated bed nets.

IPT involves providing pregnant women with three protective doses of a safe antimalarial drug and the most commonly used drug is the sulfadoxine-pyrimethamine combination generally known as SP.

Experts say it may however be unnecessary to expose pregnant women with little risk of malaria to IPT so that efforts are then on ensuring that 100 per cent of the pregnant women in those high risk areas get IPT.

“Through antenatal clinics, IPT is being focused in the three regions with intense malaria transmission. However insecticide treated bed nets distribution for pregnant women will continue in all regions where it is ongoing,” said Dr Elizabeth Juma, Head of the National Malaria Control Programme (NMCP).

The logic of giving IPT to all pregnant women, irrespective of malaria risk, is perhaps based on the fact that the drug is cheap.

But the wastage involved in mass distribution of the drugs is huge. These resources would be better used in ensuring that those pregnant women at high risk of malaria actually receive IPT on time. This has not been happening.

Kilifi, for example, is within the high- risk zone where pregnant women are expected to receive three doses of IPT during their pregnancy, but the figures are not encouraging.

To reap maximum benefits from IPT, a pregnant woman needs to take a minimum of two doses.

In this case of Kilifi, and in other high-risk areas, funds that would otherwise be spent on buying and distributing the drugs to mothers in low-risk areas who do not need them, can be used to increase awareness in order to have more mothers and children benefit from the drugs.

At the same time, the funds can be used to ensure that those who fail to show up for a repeat IPT visits at the antenatal clinic are followed up at home and given the medicine and also encouraged to sleep under an insecticide treated bed net.

When malaria strikes during pregnancy, it can causesevere anemia in the mother, a low-birth-weight baby and the likelihood of impaired child development in the baby's future. In sub-SaharanAfrica alone, approximately 25 million pregnant women are at risk of Plasmodium falciparum infection every year.

Approximately one in four women shows evidence of placental infection at the time of delivery.

Unfortunately, a large fraction of infection remains undetected and untreated.

This is because by the time the woman is infected with malaria parasite, this parasite due to its preference for the placenta targets the womb. In fact, it is the womb that will first show signs of malaria before the body starts to recognise it.

BY Dickson Odhiambo

Eighth Edition