Resistance to ACT malaria drugs in pregnant women is 35.4% —Study

Despite the priority given to malaria in recent times, too many pregnant women are still infected with malaria and resistance to common malaria drug is on the rise in Kaduna metropolis, a study has found.

The study found that 40.5 per cent of the malaria parasites from these pregnant women were resistant to at least three common malaria medicines. The 2017 study was published in the Tzu-Chi Medical Journal.

In addition, the pregnant women exhibited the highest resistance against chloroquine (94.9 per cent), followed by Artemether (37.9 per cent) then sulfadoxine-pyrimethamine (36.7 per cent) and least resistant to artesunate (35.4 per cent).

The researchers determined the amount of malaria parasite and haemoglobin amounts in the blood samples of 353 randomly selected pregnant women who came for antenatal consultations in four selected health facilities in Kaduna State. Also, antimalarial drug susceptibility tests were done on the samples.

After excluding women with chronic debilitating diseases such as malnutrition and human immunodeficiency virus (HIV) infections, it was found that out of those infected, 5.2 per cent were also anaemic.

According to the study, women in the second trimester had the highest number and percentage of cases of malaria in their blood (64.6 per cent) with the least in women in the first trimester (1.3 per cent).

Also, women with their first pregnancy and less than 18 years had higher malaria parasite levels respectively. Similarly, women who were employed had a relatively higher prevalence of malaria than those who were unemployed.

The researchers suggested that the high level of malaria in the pregnant women could be due to low coverage level and effectiveness of intermittent preventive therapy (IPT) with sulfadoxine-pyrimethamine (SP) that was below 16 per cent for the recommended three doses or perhaps due to increased SP resistance.

To reduce the transmission of malaria, they suggested that the ongoing distribution of Insecticidal treated nets (ITNs) among pregnant women in antenatal clinics in Nigeria should be sustained and be made free of charge.

Malaria is a major cause of ill health and deaths, particularly among pregnant women. According to World Health Organisation, in 2015 alone, there were an estimated 214 million new cases of malaria and 438,000 deaths worldwide.

Of these, Nigeria accounted for up to 25 per cent of global cases and deaths with 500,000 cases in pregnant women.

In most endemic areas, malaria during pregnancy is associated with anaemia in pregnancy. It has been estimated that about 26 per cent of pregnant women develop anaemia due to malaria.

Babies born with malaria also experience devastating effects from the infection. It has been estimated that 1 in every 5 low birth weight deliveries are a consequence of maternal malaria.

This invariably results in poor infant development and survival and has led to approximately 100,000 infant deaths every year.