Expectant mothers have been advised to register at any Primary Health Centre (PHC) close to them and get free sulfadoxine-pyrimethamine (SP) provided by the government to be malaria free.

The Head, Case Management Branch, National Malaria Elimination Programme, Dr Godwin Ntadom, gave the advice during an event to assess the impact of malaria programmes in Nigeria held by the National Malaria Elimination Programme, Federal Ministry of Health.

Ntadom, who represented Dr. Bala Mohammed Audu the National Malaria Elimination Programme (NMEP) National Coordinator, said: “Malaria during pregnancy increases neonatal mortality by lowering birth weight, whereas fever in the week before birth has a further independent effect in addition to inducing premature birth. The prevention of malaria in pregnancy and, thus, of malaria-attributable low birth weight should increase the survival of young babies. A number of randomised controlled trials of preventive antimalarial measures during pregnancy have confirmed this causal effect by showing that preventing malaria increases birth weight.’’

He urged expectant mothers to treat malaria with sulfadoxine-pyrimethamine (SP) and sleeping under Long Lasting Treated Insecticide Net (LLTIN).

“Female anopheles is not a parasite because it does not bite humans to get its own meal. Both male and female mosquitoes feed on plant nectar, fruit juices and liquids that ooze from plants. Female anopheles bites humans to get blood meal to nourish its developing fertile eggs. The eggs need some iron requirement. And when an infected anopheles mosquito bites, it transmits malaria to its host.’’

He said malaria infection during pregnancy is a problem with risks for the expectant woman, her fetus, and the newborn child. Malaria-associated maternal illness and low birth weight is the result of Plasmodium falciparum infection.

“The symptoms and complications of malaria in pregnancy vary according to malaria transmission intensity in the given geographical area, and the individual’s level of acquired immunity. In high-transmission settings, where levels of acquired immunity tend to be high, P. falciparum infection is usually asymptomatic in pregnancy.

‘’Yet, parasites may be present in the placenta and contribute to maternal anaemia even in the absence of documented peripheral parasitaemia. Both maternal anaemia and placental parasitaemia can lead to low birth weight, which is an important contributor to infant mortality. In high-transmission settings, the adverse effects of P. falciparum infection in pregnancy are most pronounced for women in their first pregnancy.”

He said it was for this that the World Health Organisation (WHO) recommended the following for either the prevention or treatment of malaria during pregnancy: the use of LLINs and SP.

Ntadom explained: “WHO recommends IPTp-SP in all areas with moderate to high malaria transmission in Africa. As of October 2012, WHO recommended that this preventive treatment be given to all pregnant women at each scheduled antenatal care visit starting as early as possible in the second trimester (i.e. not during the first trimester). WHO recommends a schedule of four antenatal care visits.

“Based on available evidence, IPTp-SP remains effective in preventing the adverse consequences of malaria on maternal and fetal outcomes even in areas where quintuple mutations linked to SP resistance are prevalent in P. falciparum. Therefore, IPTp-SP should still be administered to pregnant women in such areas. IPTp reduces maternal malaria episodes, maternal and fetal anaemia, placental parasitaemia, low birth weight, and neonatal mortality. Furthermore, all pregnant women should receive iron and folic acid supplementation as a part of routine antenatal care.’’

Source: The Nation

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