Monday, February 8, 2010

Malaria, Maternity and Childbirth: Challenges and solutions in Kenya

Every year, there are 300-550 million cases  of malaria1 resulting in over a million deaths worldwide. A large portion of these cases and deaths occur in Sub-Saharan Africa and particularly affect children. In the North Rift Valley of Kenya, where HealthRight International has implemented programs on HIV/AIDS, malaria and maternal and neonatal health, malaria is the leading killer of children and pregnant women. Already facing limited access to health care, pregnant women are also at a higher risk of malaria infection as pregnancy reduces the body’s ability to fight disease.  Once infection occurs, malaria increases the chance of death or illness for both the mother and child.

Risks of endemic and epidemic malaria

Depending on the level of transmission in an area, a malaria infection can affect the mother and fetus in different ways. In areas of high transmission , where malaria is endemic, adult women have developed clinical immunity. In these areas, such as Central and North Pokot where HealthRight works, a malarial infection will be asymptomatic but can cause severe maternal anemia as well as parasitic infection in the placenta. When located in the placenta, the parasites impede the flow of nutrients between mother and fetus causing low birth weight, which decreases the chance of infant survival.

In areas of low transmission , or epidemic-prone regions, like Marakwet and West Pokot, women have not acquired immunity and if infected will more likely develop severe malaria. This poses direct risks to both mother and fetus. The fetus is at heightened risk for low birth weight, spontaneous abortion, premature delivery and neonatal death. The mother is at risk for maternal anemia and death from severe malaria. Pregnant women in epidemic prone regions have a 2-3 times2 higher risk of developing severe malaria than non-pregnant women from the same area. In sub-Saharan Africa, malaria infection causes an estimated 400,000 cases of severe maternal anemia  annually3

Lasting solutions in Kenya’s North Rift Valley

In order to reduce the burden of malaria infection among pregnant women, HealthRight is working in partnership with the Kenya Ministry of Health to provide prevention services according to WHO

standards, including insecticide-treated mosquito nets and anti-malaria medication during antenatal visits. HealthRight is also working to train, monitor and mentor health care providers at hospitals, health centers and dispensaries to improve diagnosis and treatment services.

Along with high rates of malaria infection, Kenya also has a national prevalence of HIV/AIDS of 7.4%. HIV-positive women and children are at greater risk for malaria infection as HIV weakens the immune system. HIV interferes with malaria treatment and also contributes to anemia and low birth rate . Because of this increased risk, HealthRight is working to incorporate malaria treatment and diagnosis into its efforts to serve HIV-positive patients.

Learn more about HealthRight’s Partnership for the Prevention and Treatment of Malaria.