Research two decades ago showed that malaria infection in pregnant Gambian women increased the health risks for mother and baby. A new study by the Medical Research Council Laboratories in Fajara shows that the situation has not improved. Why have policy-makers failed to implement strategies to protect pregnant women?

Every year about 24 million African women become pregnant in areas where the risk of malaria is high. They are more likely than other adults to become infected and this increases the risk of poor pregnancy outcome.

This study involved 313 mothers and their babies at Bansang Hospital in the rural eastern area of the Gambia. This is the second largest referral hospital in the country, serving around 300 000 people. None of the women were taking drugs to prevent malaria infection.

The study showed that:

• The mean age of these pregnant women is 23.7 years.
• The overall prevalence of placental malaria infection is 51 percent.
• Women are most susceptible to malaria infection in their first pregnancy.
• Malaria infection of the placenta is associated with premature delivery. Babies are four times more likely to have a low birthweight. The average reduction in weight is 320g. Placental malaria also doubles the risk of stillbirth delivery.

These results emphasise the need for improved management of pregnancy and labour in the Gambia. Since the first study 20 years ago, several trials have produced recommendations on strategies to tackle maternal malaria. This serious public health problem may persist due to a lack of collaboration between scientists and policy-makers or because existing policy is not fully implemented.

The researchers suggest that policy-makers should:

• implement effective malaria control strategies for pregnant women, including the use of insecticide-treated bednets, and drugs to prevent and treat malaria
• ensure that control measures start as early as possible in pregnancy
• strengthen their working links with researchers
• conduct community-level research to guide programmes, and monitor and evaluate success.

Source(s):
‘Influence of placental malaria infection on foetal outcome in the Gambia: twenty years after Ian McGregor’, Journal of Health and Population Nutrition 20 (1): 4-11, by B. Okoko et al., 2002

Funded by: UK Medical Research Council

id21 Research Highlight: 5 September 2002

Further Information:
Brown Okoko
Medical Research Council Laboratories
PO Box 273
Banjul
The Gambia

Contact the contributor: okokobrown@hotmail.com

Medical Research Council

Other related links:
See id21's collection of links relevant to infectious diseases.

See id21's collection of links relevant to maternal and child health.