Preventive Treatment of Malaria in Pregnancy | Blog

Intermittent Preventive Treatment of Malaria in Pregnancy

Intermittent Preventive Treatment of Malaria in Pregnancy

by: Dr. Bharti Minocha
Consultant, Gynecology

Malaria is an infectious disease, transmitted by the bite of infected mosquitoes. It is characterized by colonization of red blood cells in our body by a parasite called plasmodium. Plasmodium is carried by female anopheles mosquito and it reaches into the blood when this mosquito bites a human. Once the parasite enters the body, it multiplies in the liver and then affects the red blood cells. If we talk about the incubation period then, Malaria generally lasts for around 8 to 20 days (max 2 months) after the bite of incubation. This period is characterized by febrile seizures every 2 -4 days. People who get malaria are typically very sick with high fevers, shaking chills, and flu-like illness. Although malaria can be a deadly disease, illness and death from malaria can usually be prevented.

Pregnant women are at a greater risk of malaria because of the changes in women’s immune systems during pregnancy and the presence of a new organ (the placenta) with new places for parasites to bind, pregnant women lose some of their immunity to malaria infection. During pregnancy, Malaria infection can have adverse effects on both mother and fetus. It can cause maternal anemia, fetal death, premature delivery, intrauterine growth retardation, and delivery of low birth-weight infants, a risk factor for death.

What do you understand by Intermittent Preventive Therapy for Malaria?

Intermittent preventive therapy or intermittent preventive treatment (IPT) is a public health intervention aimed at treating and preventing malaria episodes in infants (IPTi), children (IPTc), schoolchildren (IPTsc) and pregnant women (IPTp). The intervention builds on two tested malaria control strategies to clear existing parasites and to prevent new infections.

Intermittent preventive treatment of malaria during pregnancy (IPTp) is a key intervention in the national strategy for malaria control. Sulfadoxine/Pyrimethamine  (SP), the current drug of choice, is recommended to be administered in the second and third trimesters of pregnancy during antenatal care (ANC) visits. IPTp with Sulfadoxine/Pyrimethamine has proven efficacious in reducing the incidence of pregnancy-associated malaria and is currently part of the national malaria prevention program in most countries. However, resistance to Sulfadoxine/Pyrimethamine is increasing. Sulfadoxine/Pyrimethamine now demonstrates inadequate therapeutic efficacy in children <5 years of age and is no longer the drug of choice for treatment and have been replaced by Artemisinin combination therapy.

Aspects important for Malaria Intermittent Preventive Treatment:

  • Intermittent preventive treatment (IPT) with Sulfadoxine-Pyrimethamine is recommended for use in areas with high levels of malaria transmission.
  • More effective anti-malarial drugs need to be evaluated for IPT in both low- and high-transmission settings.
  • The duration of post treatment prophylaxis is likely to be an important determinant of the benefit of IPT.
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