Pregnant women with malaria at risk of anaemia –Study


A new study has revealed that pregnant women from sub-Saharan Africa with malaria and HIV have a higher risk of anaemia than those without the infections.

The study was published in a peer-reviewed scientific journal, BMC Pregnancy and Childbirth.

The researchers say the findings may have implications for efforts to reduce the risk of death in pregnant women and preventing low birth weights in children.

The findings, the researchers said, could also help in reducing neurocognitive impairment in children due to anaemia.

The lead researcher and a doctoral student in epidemiology at the college, Dr. Paddy Ssentongo, says co-infections of HIV and malaria are common among expectant mothers in sub-Saharan Africa.

In the study, the researchers analysed demographic and health surveys from 2012 and 2017 across seven countries in sub-Saharan Africa.

They examined blood samples from 947 pregnant women, ages 15 to 49 years old.

They said that results showed that malaria was associated with an increased prevalence of anaemia during pregnancy.

Also that he prevalence of anaemia was higher in pregnant women with malaria and HIV coinfections (60 per cent) than in pregnant women without infections (45 per cent).

“Pregnant women in sub-Saharan Africa suffer a double burden of malaria and HIV infections, and these infections interact with each other to cause anaemia.

“Multipronged strategies to prevent and treat malaria and HIV in pregnant women are critical to ensure the survival of mothers and their unborn babies”, Ssentongo said.

The researchers equally noted that “Malaria leads to an increase in HIV viral load, a decline in the level of immune cells and an increase in inflammation.

“Also, malaria increases the rate of disease progression from HIV to AIDS. HIV contributes to more frequent and more severe cases of malaria and increases the density of malaria parasites.

This leads to either the destruction of the red blood cells, reduced iron absorption or reduced rate of formation of new red blood cells in the bone marrow.”

The researchers listed preventative strategies for anaemia in pregnancy due to malaria and HIV to include the use of trimethoprim-sulfamethoxazole (co-trimoxazole), a malaria prophylactic treatment, in addition to antiretroviral therapy, which they say both lower the odds of coinfection.

“Also, vector control using insecticide-treated bed nets and residual spraying is effective. Although intermittent preventive treatment with sulfadoxine/pyrimethamine has been shown to be effective in parts of Africa, intermittent preventive treatment should be avoided in pregnant women, who are on antiretroviral therapy and co-trimoxazole prophylaxis, because of the risk of adverse drug reactions”, they added.

According to the World Health Organisation, the most common causes of anaemia include nutritional deficiencies, particularly iron deficiency, though deficiencies in folate, vitamins B12 and A are also important causes; haemoglobinopathies; and infectious diseases, such as malaria, tuberculosis, HIV and parasitic infections.

WHO says anaemia is a serious global public health problem that particularly affects young children and pregnant women.

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The UN health agency estimates that 42 per cent of children less than five years of age and 40 per cent of pregnant women worldwide are anaemic.

The President, Federation of African Nutrition Societies, Prof. Ngozi Nnam, had in a recent interview said that inadequate nutrition in pregnancy could lead to the poor brain development of babies due to anaemia.

Nnam, a professor of Community and Public Health Nutrition at the University of Nigeria, Nsukka, had said a pregnant woman was supposed to feed well and have adequate diets at all times for optimal development of the foetus.

“Poor nutrition will cause inadequate development of the baby because nutrients are required for cells of the foetus to develop properly.

“Nutrient such as iron is very important in the development of the cells.

“When a pregnant woman stops taking foods rich in iron, she will be deficient in iron and that deficiency will affect the foetus and the cells will not form properly and this will lead to malformation when the baby is born.

“Folate is also an important nutrient. If a woman is not eating properly and not taking enough foods that are rich in folate during pregnancy, the woman will be deficient in body.

The implication is that it will lead to poor development of the baby,” he said.

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