National Malaria Day is celebrated annually on 26 April. In the three years of fighting the COVID-19 pandemic, the mainland has also worked tirelessly to "eliminate malaria".
Malaria is a disease caused by mosquito bites transmitting malaria parasites in the tropics and subtropics. In general, the incubation period from human infection with Plasmodium malaria to the onset of the disease is 9-14 days. The main symptoms include chills, fever, sweating, body aches, etc., and severe ones may even appear coma, shock and liver and kidney failure. If you do not receive treatment in time, you may be life-threatening due to delay in your condition [1].
Although human control of malaria transmission has a long history and experience, malaria still shows frequent signs of outbreaks worldwide. The WHO has made statistics that in tropical Africa, especially sub-Saharan Africa, malaria is still one of the most serious threats to people's health, and among them, anemia in children and pregnant women in endemic areas, as well as premature births and infant deaths occur frequently [2].
Malaria is the leading cause of anaemia in pregnant women, especially in the first trimester. After pregnant women have malaria, the malaria parasite resides in red blood cells, destroying a large number of red blood cells and causing persistent hemolysis. However, the harm of malaria parasites is far more than this, after the red blood cells are destroyed, the iron can not return to the plasma for bone marrow to make hemoglobin, further aggravating the body load of pregnant women. At the same time, the placenta is the most concentrated place of Plasmodium falciparum, and its intervillial vascular cavity and cavernous layer gather the large trophozoites and fissorts of the parasite, and eventually form an embolic lumen, so that the placenta causes fetal death, miscarriage, premature birth, etc. due to lack of oxygen and nutritional disorders [3].
Compared to the average person, pregnant women are more than three times more likely to be bitten by mosquitoes and then develop malaria. There are three reasons for this:
First of all, mosquitoes like carbon dioxide, pregnant women have a higher breathing rate, will exhale more carbon dioxide, thereby increasing the risk of being bitten and infected;
Secondly, after pregnancy, pregnant women have an elevated body temperature and are prone to sweating, and body temperature and the odor emitted by the body are just an important trigger for mosquitoes to attack.
In addition, due to the increase in the level of intraheroles in the blood of pregnant women during pregnancy, the immunity of pregnant women decreases. This often causes pregnant women to develop malaria attacks from their original state of illness [4].
In recent years, maternal health issues have received attention, and many experts and scholars have explored ways for pregnant women and babies to stay away from malaria from the perspective of prevention and treatment.
At the level of drug prevention, scholars around the world have developed effective drugs to reduce the complication of malaria during pregnancy: A report in the United Kingdom shows that giving pregnant women regular doses of antimalarial drugs can greatly reduce the risk of life-threatening birth problems due to mosquito-borne diseases and sexually transmitted infections, and increasing the dose of drugs can reduce the risk of infant death [5]. Mainland scholars have found that the incidence of malaria and abnormal pregnancy outcomes was significantly lower in pregnant women than in the control group after routine iron supplementation and folic acid supplementation. Therefore, folic acid supplementation during pregnancy and continued addition of iron and folic acid as one of the auxiliary drugs after malaria are effective [6]. In addition, the WHO recommends that antimalarial drugs be given orally in two intermittent intervals before and after delivery in pregnant areas of high endemic areas to reduce malaria parasite load in pregnant women [7]. In areas with high malaria incidence, preventive drugs such as pyrimethamine, piperaquine, and chloroquine can be taken under the guidance of a doctor before pregnancy.
At the physical prevention level, countries advocate for pregnant women to fully use safe mosquito repellents, long-lasting mosquito nets, and long clothes and trousers to reduce the chance of mosquito bites. At the same time, we also need to do a good job of household protection, always prepare anti-mosquito drugs, and pay attention to environmental hygiene.
If pregnant women find abnormal symptoms such as chills and high fever, they can go to the hospital in time, and the doctor will provide chloroquine, artemether and artemisinin drugs according to the specific situation of malaria. Once infected with malaria, it should be taken in full amounts according to medical advice to avoid recurrence and drug resistance. Malaria can be completely cured by scientific treatment, and expectant mothers need not panic too much.
Many diseases that we thought were distant are actually lurking all around us. For the sake of children and for the sake of our own health, prevention can avoid the risk of malaria in 10,000.
Sincerely wish all pregnant mothers a good pregnancy, actively protect their own and their baby's health, and safe birth.
bibliography:
[1] Yang Hong. Malaria and pregnancy: selection of epidemiology, pathophysiology and control regimens[J]. Foreign Medical Parasitic Diseases Fascicle 1995:22(4)156 .
[2] CHEN Wujun. Clinical analysis of malaria in 38 pregnant women[J]. People's Military Doctor 1995: 713 .
【3】 World Health Organization．Division of Control of Tropical Diseases．Severe and Complicated Malaria［M］．Trans R Soc Trop Med HyG 1990：84：254
[4] HU Guoqiang. Malaria epidemic and control strategies in pregnant women in Harrah's region of Africa[J]. Foreign Medical Social Medicine Fascicle.1999:16(2):82 .
[5] Clin Infect Dis., March 2017 online version
[6] WANG Xuejia. Clinical observation of the effects of iron supplementation and folic acid in malaria complicated by pregnancy[J].Advances in Modern Obstetrics and Gynecology Vol. 10, No. 1, Prog J Obstet Gynecol Jan, January 2001. 2001Vol． 10No． 1
【7】World Health Organization．Guidelines for the treatment of malaria ［S］．ISBN9789241546942，（WHO ／HTM ／MAL ／ 2006．1108），2006： 1－204
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