The Burden of Malaria in Pregnancy and Intervention Strategies – A Review

Abstract

Malaria infection during pregnancy results in poor maternal and foetal outcomes, especially maternal anaemia and low birth weight infant. Anaemia results from depletion of erythrocytes which are attacked by the malaria parasites. Low birth weight is primarily a consequence of intrauterine growth restriction (IUGR). The pathologic disarray of placental basal structure following intense infiltration of leucocytes into the placenta is known to mediate IUGR. Identifying other pathogenic factors which may be present would greatly improve the intervention strategies. In this review, the burden of malaria infection and malaria in pregnancy (MIP), histological and pathologic changes in parasitized placenta and protection against MiP are discussed with reference to infection with Plasmodium falciparum. The level of utilization of intervention measures, the need for urgent assessment of new anti-malarial drugs (e.g. artemisinin-based combination therapies, ACTs) in pregnancy and the problem posed by poor detection of placental parasitaemia are highlighted.

Keywords: anaemia, intrauterine growth restriction, low birth weight, malaria, Plasmodium falciparum

Nigerian Journal of Pharmaceutical Research, Vol. 9 No 1 pp. 82 - 91 (February 2011)