Background: Yearly 50 million women worldwide are exposed to the risk of malaria during pregnancy. 30 million of these women live in Africa south of Sahara, which are high endemic areas of plasmodium falciparum malaria. Pregnancy reduces natural immunity, and therefore the women are vulnerable for severe malaria infection, anemia and placental parasittemia. This is also a danger to the unborn child which can suffer intrauterin growth retardation and death.
Objectives: To investigate maternal morbidity and mortality during pregnancy in Africa south of Sahara caused by malarial infection, WHO and Kenyan guidelines for malaria in pregnancy and efficiency of these recommendations. We also discuss the challenges when putting these preventive strategies into action.
Methodes: Searches performed using Cochrane Library, The Lancet, Pubmed, The American Journal of Tropical Medicine, WHO, The Norwegian Medical Journal, Wikepedia and Google. 42 articles were considered.
Results and conclusion: Improvement of prevention of malaria during pregnancy is possible and necessary. WHO and Kenyan guidelines recommend preventive treatment with sulfadoxine-pyrimethamine (SP) twice during pregnancy, insecticide nets and treatment of symptomatic malaria. These strategies are safe and can reduce maternal and fetal morbidity and mortality caused by malaria, but because of increasing resistant towards present antimalarial drugs one need further investigation on new medication. Poor national organization of health care, lack of financial recourses and qualified health workers, extreme poverty but also cultural barriers are challenges in implementation of current and new guidelines. It is necessary to improve reporting health systems, financing systems and the accessibility of health care in both rural and urban areas of Kenya.