Mosquitos and Mothers

In Africa, pregnancy means death. Unacceptably high rates of maternal mortality plague Africa, making maternal health one of the worst public health issues of the 21st century. Sadly, it does not get the attention it deserves from developed countries because maternal mortality has been all but eradicated by strong healthcare systems and high quality of care. Maternal mortality is an issue greatly impacted by poverty and disease, and many African mothers are struggling to stay alive.

Maternal mortality is driven by many factors such as the increasing burden of non-communicable diseases, but one disease stands out: malaria. In sub-Saharan Africa, malaria is responsible for 10,000 maternal deaths a year. More than 25 million pregnant women are at risk of contracting malaria annually. These numbers may not capture the true impact of malaria on pregnant women, as a study in Mozambique found that 10% of maternal deaths were caused by malaria. In parts of the world where malaria is endemic, it can be responsible for up to 25% of deaths. 

Malaria’s enormous impact on maternal mortality makes it clear that treating malaria in conjunction to adequate pregnancy care is vital in ensuring the survival of mothers and newborns. Pregnant women with malaria usually experience more severe symptoms and worse birth outcomes. Rather than having healthy births, these malaria-infected mothers often experience miscarriage, premature delivery, and high neonatal death rates. Malaria is responsible for 25% of severe anemia during pregnancy, and anemia puts women at higher risk of hemorrhaging during delivery.

Malaria prevention in pregnancy is surprisingly simple, but not many pregnant women have access to anti-preventative care. To reduce mosquito bites, pregnant women are provided with insecticide-treated bed nets (ITNs). Intermittent presumptive treatment (IPT) with antimalarial medications administered at least twice during pregnancy is recommended by the WHO. However, a recent survey among postpartum women in rural Uganda found that only 31% of women used an ITN during pregnancy, and only 36% had received two doses of IPT. Jhipego, a non-governmental organization, is gathering data on maternal mortality in Nigeria. Says Emmanuel Otolorin, the County Director of Jhipiego, “Every pregnant woman should take an anti-malaria drug at least twice in pregnancy, whether or not she has symptoms of malaria, because we know that when they don’ thave symptoms of malaria, they have malaria parasite in their blood.” Clearly, there is a great deal of pregnant women not receiving the treatment they need.

Malaria is one of the most challenging diseases we face in Africa, but it is important to realize its enormous impact on maternal wellbeing. It is the most common cause of maternal mortality in sub-Saharan Africa but we can easily prevent it. This problem has been long neglected but commitment toward reducing the impact of malaria in pregnancy will improve the health of mothers and newborns.

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