Malaria deadlier for pregnant teens than adults, study shows
Adolescent girls are twice as likely to get infected and die of malaria during pregnancy as adult women.
What you need to know:
- Adolescent girls are twice as likely to get infected and die of malaria during pregnancy as adult women.
- The study observed that adolescents were two times more likely to have malaria during pregnancy, 2.28 times to experienced peripheral and 1.97 times placental malaria infection at delivery compared to adults.
- Eighteen per cent of the participants were HIV-positive. All had monthly antenatal visits and one postnatal visit.
Adolescent girls are twice as likely to get infected and die of malaria during pregnancy as adult women, a new study has revealed.
A study done in five sub-Saharan Africa countries — Benin, Gabon, Mozambique, Tanzania, and Kenya — revealed that adolescent girls are 1.7 times more likely to become ill with malaria during pregnancy and are at increased risk of being infected at the time of delivery, which can lead to death.
The research published last week in the National Library of Medicine analysed 5,800 pregnant women who participated in two clinical trials conducted in five countries.
Of the total, 1,201 were adolescents, mean age of 17 years, and most of them (74 per cent) pregnant for the first time. The rest were adult women (mean age 27 years), the vast majority of whom had been pregnant before.
The study observed that adolescents were two times more likely to have malaria during pregnancy, 2.28 times to experienced peripheral and 1.97 times placental malaria infection at delivery compared to adults.
Eighteen per cent of the participants were HIV-positive. All had monthly antenatal visits and one postnatal visit.
The study conducted by ISGlobal’s Maternal, Child, and Reproductive Health Initiative between 2009 and 2014 with the results released last week followed the women monthly until the postpartum visit (one month to six weeks after delivery).
Parasitemia
Clinical episodes during pregnancy, peripheral parasitemia at delivery, and placental malaria were some of the outcomes in adolescents.
Parasitemia is the quantitative content of parasites in the blood.
“Adolescent girls were more likely than adult women to present with clinical malaria during pregnancy, peripheral parasitaemia at delivery and placental infection,” says Clara Menéndez, director of ISGlobal’s Maternal, Child and Reproductive Health Initiative.
The study is the first to compare the burden of malaria in pregnant adolescents to that in pregnant adults. Malaria is among the top causes of death in adolescent girls (10 to 19 years) globally.
Adolescent motherhood is associated with an increased risk of adverse maternal and neonatal outcomes. Early malaria infections can be particularly harmful. The interaction of malaria, adolescence, and pregnancy is especially relevant in malaria-endemic areas, where rates of adolescent pregnancy are high.
According to World Health Organization guidelines, the drug prevention of malaria during pregnancy does not adequately cover the first trimester of gestation in high-transmission areas.
To prevent malaria in pregnancy in high-transmission areas, the international health agency recommends insecticide-treated nets and intermittent preventive treatment in pregnancy (IPTp), which are usually provided to women at the first anti-natal visit, leaving them unprotected during the first months.
Originally, IPTp consisted of the administration of two doses of sulfadoxine-pyrimethamine (SP) from the second trimester of pregnancy, with at least one month between doses.
Although ensuring better coverage over pregnancy, these new recommendations still apply to mid- and late pregnancy only.
There is a need to dedicate efforts to prevent pregnancy in adolescents living in regions with malaria and to ensure that they have access to adequate information and tools to avoid contracting the disease in case of pregnancy, the researchers say.
