THE CURRENT MANAGEMENT OF MALARIA IN PREGNANCY
Malaria remains a major Health challenge, especially in Sub-Saharan Africa where it is a great contributor to maternal and perinatal morbidity and mortality. The burden is great and has necessitated the need for evolution in management strategies to combat the disease and its effects in pregnancy.
The current management is directed at mitigating the impact of the determinants & confounders of reduced effectiveness such as maternal (compliance with ANC, HIV infection, Age and gravidity) or in the health system (Quality / Access to care, DOT, SP quality, and high concomitant dosage of FA), in addition to consideration of other factors such as ...view middle of the document...
WHO Recommendations – Case Management
It is preferable that treatment for malaria should not be initiated until the diagnosis has been established by laboratory investigations. "Presumptive treatment" without the benefit of laboratory confirmation should be reserved for extreme circumstances (strong clinical suspicion, severe disease, impossibility of obtaining prompt laboratory diagnosis)( CDC treatment guide lines, April 2011)
Currently, Simple Malaria in Pregnancy (In all trimesters) can be safely treated with the use of Mefloquine (CDC recommendation, SEPT 2011.) mefloquine has been recatigorised as a class B drug Similar to general population. The drugs of choice are now Quinine Sulphate + Clindamycin, Arthemeter/Lumefantrine(Coartem), Atovaguone – Proguanil (Malarone), Artesunate + Amodiaquine.
Complex Malaria in Pregnancy can be treated in all trimesters, with the use of Quinine, Artesunate.
Exchange Blood Transfusion (EBT) if > 10% of Parasite density may also have a role in the current...