Preventing malaria during pregnancy

Saving the lives of mothers and babies

By Lorry Izula-Mpindu

Malaria, a disease caused by parasites spread by the Anopheles mosquito, is one of the leading causes of sickness and death in the world. The World Health Organization estimates that the disease accounts for close to 3 million deaths per year worldwide, with the highest burden of the disease concentrated in African countries. In 2017, 92% of all malaria cases and 93% of malaria-related deaths occurred in Africa. Five countries account for over 50% of the global burden of malaria and four of them are African countries. Pregnant women and children under five are disproportionately at a greater risk of acquiring and dying from malaria. An estimated 25 million pregnant women in Africa are at risk of contracting malaria during their pregnancy and 25% of malaria-related deaths in high malaria regions occur in pregnant women. Malaria is also responsible for at least 10,000, and up to as much as 200,000 neonatal deaths per year worldwide. In pregnant women, malaria-related risks include miscarriage, premature delivery, babies with low birth weight, anemia and increased infant mortality. (Statistics from the World Health Organization world malaria report 2018. (March 27, 2019). Available from: https://www.who.int/news-room/fact-sheets/detail/malaria.)

Preventing malaria in pregnancy is therefore a core focus of the United Methodist Imagine No Malaria (INM) program. As the UMC works toward the Abundant Health goal of reaching one million children with life-saving interventions by 2020, prevention of malaria in pregnancy continues to be a key intervention to ensure that both women and their unborn babies survive this preventable disease. United Methodist partners throughout Africa have been addressing malaria prevention in pregnancy through low cost interventions, such as providing long-lasting insecticide treated bed nets (LLINs) and malaria prophylaxis (preventive drugs) to all pregnant women. The World Health Organization recommends at least four doses of a malaria prophylaxis through intermittent preventative therapy in pregnancy (IPTp) for all women during their pregnancy. United Methodist partners in Nigeria, Liberia and Sierra Leone have been working toward increasing IPTp program in all their health facilities to reduce malaria contraction during pregnancy. The following success stories of malaria prevention through IPTp are cause for celebration.

Nigeria

Mrs. Justina Jeremiah (left) and Mrs. Naomi Babaji at Worom Maternity Clinic in Nigeria. Photo: Moses Alikali, Malaria Coordinator, Nigeria

Justina Jeremiah and Naomi Babaji both attended the Worom Maternity clinic in Nigeria, where they received the recommended four doses of IPTp to prevent malaria in pregnancy. Babaji commented: We attended Antenatal Care (ANC) here in Worom Maternity. We were given IPT 1,2,3, and 4, and we delivered our babies successfully. We did not get malaria during our pregnancy. Before now, we always had malaria during our pregnancies. I have had two miscarriages because of complications when I was pregnant. We both appreciate the IPT because it prevents us and our babies from getting malaria.  

Babaji and Jeremiah are only two of many women who have received IPTp during their ANC (also known as prenatal care) visits, which prevented them from acquiring a deadly disease during their pregnancies.

Liberia

A traditional birth attendant (left) accompanied the patient at the Weala Clinic. Mother and child are doing well in this photo an hour after a safe vaginal delivery. Photo: Lango Toe, Liberian UMC Health Board

My name is Meme Seyon, I live in Nyonbaes town, one hour away from the Weala Clinic in Liberia. I am 28 years old and this is my third baby. For my first two pregnancies, I didn’t go to the clinic for checkups and when time came for delivery, I delivered my babies, but they both died right after I gave birth. My babies were born weak and yellow. I was usually attended to by an elder lady who delivers most of the babies in the town. 

Since last year, I have seen people visit our town wearing white T-shirts with a Methodist symbol on it. These people always talk to us about the importance of visiting the hospital/clinic, especially pregnant women and children, because they say malaria can kill both baby and Ma (mother). The doctor people can treat both mama and baby by giving three white tabs (IPTp). When I was five-months pregnant, I started visiting the Methodist clinic (Weala Clinic). The nurse told me the importance of visiting the clinic for treatment and check-ups during my pregnancy. She told me the three tablets I received during my visits would prevent malaria for me and the baby, because if I get malaria the baby inside me will get sick and could die. I visited the clinic four times before delivery and the nurse gave me three white tablets whenever I came for a checkup.

Meme now has a healthy baby because of the ongoing support of the Abundant Health and Imagine No Malaria programs in her community.

Sierra Leone

IPTp is the standard of care in Sierra Leone. The national policy guidelines for IPTp require a pregnant mother to take at least three treatment doses of an effective IPtp drug during routine ANC visits.

Regina Tucker, a 24-year-old pregnant woman, previously contracted malaria in pregnancy, which caused severe anemia, low birth weight and fetal loss in her pregnancies. During her last pregnancy, she visited UMC Mercy Hospital on her first ANC visit and during routine check-ups, Regina tested positive for malaria. She was treated and then given malaria prophylaxis, which she took on the spot. Regina also received a long-lasting insecticide treated bed net (LLIN). She said; The midwife advised me to sleep under the bed net at all times during the pregnancy period and to continue attending the ANC.

Regina relaxing after delivery in her home. Photo: INM, UMC Mercy Hospital, Bo, Sierra Leone

I was feeling dizziness when I first visited the hospital but after receiving the treatment and prophylaxis, I felt well and stable. From that time, the usual complaints and problems I normally experience during pregnancy have become a thing of the past. It is very good for all pregnant women to take IPTp because it helps to prevent malaria. I recommend that pregnant women attend all their ANC visits, because if there are any complications in pregnancy, they will be detected on time and treated immediately. 

These stories show that antenatal care services, which include health education and the recommended doses of IPTp, give pregnant women an opportunity to carry a healthy pregnancy to full term. Preventing malaria in pregnancy reduces the risk of complications and gives a mother an opportunity for a safe delivery of a healthy baby.

Lorry Izula-Mpindu is the program associate for Imagine No Malaria, with Global Health, Global Ministries. Stories from Nigeria, Liberia and Sierra Leone were contributed by the United Methodist health boards in those countries.