Pregnancy-associated Malaria, Challenges and Prospects in Sub-Saharan Africa

Abstract

Pregnancy-associated malaria remains a major risk to the pregnant woman, her foetus and infants in sub-Saharan Africa. Infection by Plasmodium falciparum significantly affects maternal, foetal and neonatal wellbeing. Maternal anaemia, low birth weight, preterm labour, spontaneous abortion, and maternal and neonatal mortalities are some of its consequences. It complicates maternal immunological responses and possibly also selfishly preempts foetal immunological responses by transplacental communications. Therefore, the impacts may extend well beyond the duration of pregnancy and the immediate period post-delivery. Effective case management and prevention continue to yield positive results, but challenges still remains especially in sub-Saharan Africa. The challenges of antenatal service provision, compliance with intermittent preventive treatment at pregnancy with sulfadoxine-pyrimethamine (IPTp-SP), widespread SP resistance, and resistance to insecticide treated nets (ITNs) and insecticides continue to complicate efforts at PAM control in sub-Saharan Africa. Hopefully, the Global Technical Strategy for Malaria 2016-2030 will comprehensively consider these challenges and improve the prospect of every pregnant woman in sub-Saharan Africa.

Malaria knowledge and its associated factors among pregnant women attending antenatal clinic of Adis Zemen Hospital, North-western Ethiopia, 2018

“…Every year in Sub-Saharan Africa there are about 25 million pregnancies which are at risk for malaria infection[14, 15]. In Ethiopia, the burden of malaria during pregnancy remains a public health importance, including its complication for the newborn and mother.…”

Utilization and Associated Factors of Insecticide Treated Bed Net among Pregnant Women Attending Antenatal Clinic of Addis Zemen Hospital, North-Western Ethiopia: An Institutional Based Study

“…Studies indicate that in estimation 25 million pregnancies are at risk of developing malaria in sub-Saharan Africa every year. With this high number of pregnancies which are at risk, the consequence of malaria is very high for both the mother and the child in terms of morbidity and mortality [12–14].…”

Asymptomatic malaria infection impact on maternal anemia in Delta State, Nigeria

“…Malaria parasite asymptomatic state in a high burden malaria area have implication in maintaining the parasite circle and delaying the malaria elimination and eradication program (Berzosa et al, 2018;Katrack, et al, 2018). Although malaria infection in the SSA (a high burden malaria region) is mostly asymptomatic due to the acquired immunity via repeated exposures, it is still highly associated with maternal anemia, still birth, LBW babies, preterm deliveries, maternal and neonatal complications, and death (Aguzie, 2018;Balami et al 2021;Bardaji et al, 2017;Omer et al, 2017). The observed high prevalence of mild (+) parasitaemia in this study aligns with the report by Quakyi et al (2019) that low density parasitaemia is common in high burden malaria regions.…”

“…Malaria accounts for a substantial burden on health facilities, depletion of household income, low labor productivity, and national gross domestic product (GDP; WHO, 2019). The implications of asymptomatic malaria among parturients in deterring control efforts and maintaining the parasite cycle have widespread reports (Aguzie, 2018;Bardaji et al, 2017;Omer et al, 2017). Reports have associated pregnant women with the parasite's reservoir and delaying the extermination of the disease (Aguzie, 2018;Camona-Fonseca & Arango, 2017).…”