Malaria Alert for Pregnant Women

Malaria is one of the health problems that remains a challenge in Indonesia, especially in vulnerable groups such as pregnant women. Changes in the immune system during pregnancy make pregnant women more easily infected with malaria, which can have serious impacts such as anemia, premature birth, low birth weight, and maternal and infant mortality.

In Papua Province, malaria cases in pregnant women showed an increase from 2,782 cases in 2019 to 2,816 cases in 2020. In Jayapura City, similar cases are recorded consistently every year with a percentage of around 0.9-1%. This condition emphasizes the need for more attention to malaria prevention and control efforts in pregnant women in endemic areas.

What is Malaria?

Malaria is a blood-borne disease caused by Plasmodium spp. with Plasmodium falciparum (P. falciparum) being the deadliest species (World Health Organization [WHO], 2020). Pregnant women, especially expectant mothers, are at high risk of developing severe malaria due to P. falciparum,. Anopheles mosquitoes are the type of mosquitoes that transmit malaria from one person to another. Not all Anopheles mosquitoes transmit malaria, but if they bite a person with malaria, they can transmit it. Once they bite another person, the cycle of spreading malaria from mosquitoes to humans will continue.

Why are pregnant women vulnerable to malaria?

Pregnant women are more susceptible to falciparum malaria, and symptoms can be more severe than those of non-pregnant women. Many parasites are found in the placenta, presumably because the immune response in this area is weakened. During pregnancy, the immune system is weakened because the mother's body has to “accept” the fetus, which is considered a foreign body. Hormones such as progesterone and cortisol also play a role in suppressing the work of immune cells.

Malaria symptoms

The main symptom of malaria infection is fever, which is thought to be related to the rupture of parasites in blood cells (schizogony process) and the release of cytokines or other toxins. In areas with high transmission (hyperendemic), people with malaria may not show symptoms of fever despite having parasites in the blood (parasitemia). The hallmarks of malaria include periodic fever, anemia, and enlarged spleen (splenomegaly). Other early symptoms include fatigue, headache, muscle or bone pain, loss of appetite, and mild diarrhea. However, the severity of malaria symptoms in pregnant women is strongly influenced by their immune level, which is usually determined by the intensity of malaria transmission in the area where they live.

Prevention of Malaria in Pregnant Women

1. Chemoprophylaxis (drug prevention) :

• It is recommended for pregnant women who live in or will travel to endemic areas, It does not provide total protection, but it can lower blood levels of parasites, prevent complications, and increase the baby's weight.

• Chloroquine is a relatively safe drug during pregnancy, at a dose of 300 mg per week. Administration begins one week before departure, continues while in the endemic area, and continues for up to four weeks after return.

2. Reduce the risk of mosquito bites:

• Using insecticide-treated mosquito nets when sleeping.

• Applying anti-mosquito medication on the skin.

• Keeping the environment clean so that it does not become a breeding ground for mosquitoes.

3. Vector (mosquito) control:

• Eliminate adult mosquitoes by spraying insecticides.

• Killing mosquito larvae in stagnant water (fogging or larvicide).

4. Increase body resistance:

• Maintain a good diet and rest.

• Increase body resistance through vaccination.

Given the high risk and serious impact of malaria on pregnant women, especially in endemic areas such as Papua, prevention efforts are very important. Education about the symptoms, modes of transmission, and prevention strategies need to be continuously improved, both in health facilities and in the community. Regular check-ups, use of insecticide-treated bed nets, and safe chemoprophylaxis during pregnancy can help reduce the incidence and complications of malaria. Collaboration between health workers, local governments and communities is needed to protect pregnant women and future generations from the threat of malaria.

If you are pregnant and in a malaria endemic area, or experiencing symptoms such as fever and weakness, consult K-Lab Medical Center immediately. We are ready to help with proper examination and treatment services. Contact us on WhatsApp at 081381367915.

Source:

1. Dinas kesehatan Kota Jayapura. Laporan Tahunan Program Malaria (Rekap Data Malaria) 2021. Jayapura; 2021.

2. CDC – Malaria

3. Frontiers - Malaria in Pregnancy: From Placental Infection to Its Abnormal Development and Damage

4. Eddy Suparman, Aloysius Suryawan. Malaria pada Kehamilan. Juni 2004