By Janet Ogundepo
Malaria infection during pregnancy comes with life-threatening complications and may lead to death of both the mother and her unborn baby if left untreated, physicians have said.
Besides the risk of abortion, the physicians said pregnant women with malaria also stand the risk of falling into a coma.
They also said malaria could kill children when poorly treated, stressing that the risk of death and coma in pregnant women and children was due to their low immunity.
The experts urged Nigerians especially pregnant women and children to present early in the hospital whenever they noticed malaria symptoms.
Malaria, according to the World Health Organisation, is a preventable and curable illness caused by Plasmodium parasites, which spread to people through the bites of infected female Anopheles mosquitoes.
Malaria remained a killer disease and a major public health concern. In 2021, the WHO stated that 194,000 deaths were recorded with 69 million cases around the country.
Reportr Door Healthwise had reported that poverty was the biggest driver of the high prevalence of malaria in Nigeria, also listing ignorance, poor utilisation of insecticide-treated nets and anti-malarial drug resistance as responsible for the high share of global malaria in Africa.
Speaking with Reportr Door Healthwise, a professor of Biochemical Pharmacology at the College of Medicine, University of Ibadan, Oyo State, Olusegun Ademowo, stated that leaving pregnant women and children with symptoms of malaria without treatment could lead to death and coma.
He explained that the risk of death and coma in pregnant women and children was due to their low immunity.
Ademowo also stated that the fatality of untreated malaria in persons from non-endemic areas was different from those from endemic areas.
Endemic areas mean that a particular disease is constantly present in a particular area or region. Nigeria is one of the malaria-endemic countries because it is located in one of the three eco-epidemiological zones of malaria; Afrotropical, Oriental and Palaeartctic.
The don said, “The difference is that the person coming from a non-endemic environment is non-immune because such a person has not been exposed to malaria before. So, the body’s immune system would not be able to fight it and this can easily lead to pathological effects that could lead to a lot of complications and a fatal end.
“For those in the endemic environment, if the malaria is not treated, they have some immunity which develops as one advance in age. This means that children, especially those under the age of five are less immune than adults. The severity is more among children than adults because adults already have developed immune systems but not 100 per cent.”
He further noted that untreated malaria in pregnant women, due to low immunity at this stage, could lead to abortion and or death of both the foetus and mother.
Ademowo reiterated that untreated malaria in general was dangerous and could lead to a fatal end.
“Looking at the different categories of malaria, we have uncomplicated malaria which comes with the regular symptoms of malaria and we call symptomatic, uncomplicated malaria.
“But we also have complicated malaria, which is the one we call severe malaria. It is clinically complicated because the person has all the symptoms, in children; they can have cerebral malaria if untreated. If one has untreated malaria, it could progress to a fatal end,” he said.
Ademowo, a researcher on malaria pathogenesis and molecular resistance, also noted that individuals could test positive for malaria but not show any symptoms of the disease.
He referred to such as, “Asymptomatic malaria are those who have malaria parasite in their system but are not manifesting the symptom but a malaria test on 20-50 per cent of them would show that they are positive.”
The researcher on the pathogenesis of infectious diseases with a focus on malaria, helminth and HIV, stated that there were controversies on whether individuals with asymptomatic malaria should be treated or not since they did not manifest the symptoms.
Ademowo however noted that in some cases, if the person was not treated, the body’s immune system could fight against and eliminate the parasite but emphasised that this could only happen in some adults.
The don emphasised that children who tested positive for malaria without manifesting the symptoms must be treated.
He posited that individuals found to have tested positive for malaria, whether or not they manifested the symptoms, should be treated.
On the consequences of untreated malaria, the Head of Drug and Genetic Research Unit the Institute of Advanced Medical Research and Training, stated that it could affect any organ in the body and manifest clinically in unsuspecting forms.
He added that untreated malaria could affect the liver, kidney, intestine, and gastrointestinal system, and could cause a rise in the blood sugar levels and a drop in the blood level.
On his part, a professor of Pharmacology and Therapeutics at the Department of Clinical Pharmacology and Therapeutics, University of Maiduguri, Borno State, Sulayman Balogun, stated that malaria was curable but if untreated the “malaria parasites freely multiply in the blood and may reach the life-threatening level (parasitaemia) with the risk of affecting vital organs including the brain.”
The researcher on Anti-malaria Burden and Efficacy listed the complications of untreated malaria to include cerebral malaria, kidney failure, liver failure, severe anaemia, shock and even death.
Balogun also said, “All vital organs are at risk due to severe haemolysis and lodging of malaria parasites in small blood vessels (capillaries) that supply blood to tissues and organs. A sudden drop in blood pressure can result from shock, one of the complications of untreated malaria.”
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