United States Department of State (Washington, DC)
Kathryn Mcconnell
22 April 2011
Washington — In the past, Adissa Silga didn’t like to take the then-recommended drug that would protect her from getting malaria during pregnancy because she didn’t like its side effects or the length of time she needed to take it to get a full dose.
For her current pregnancy, Silga visits her local health center in Pouytenga, Burkina Faso, and gets a different medicine that will prevent her from getting malaria and its associated anemia. She needs to take it only twice.
Silga is one of many women in malaria-endemic countries where local health care workers have received malaria control training from Jhpiego, a nonprofit health affiliate of Baltimore-based Johns Hopkins University. Working with the U.S. Centers for Disease Control, Jhpiego coordinates malaria prevention policies with Burkina Faso’s National Malaria Control Program and carries them to local clinics that provide malaria education, diagnosis and treatment throughout the country. Since 2009, the program has received funding from the U.S. Agency for International Development (USAID) through its Maternal and Child Health Integrated Program.
If all front-line health workers can diagnose malaria with appropriate tests, deliver timely malaria control services and document achievements, “we will be closer to actually seeing the progress and impact that is the theme of World Malaria Day 2011,” said William Brieger, an international health specialist at Jhpiego and a faculty member of Johns Hopkins. World Malaria Day is April 25. Ending deaths from malaria is a goal of the U.S. Global Health Initiative.
Approximately 40 percent of the world’s population — mostly those living in low-income countries — are at risk for malaria, Brieger said. In Burkina Faso, about 3 million cases of malaria are reported annually among a population of about 16 million.
Malaria is especially dangerous for pregnant women and their unborn children. It is caused by a parasite that attacks and kills the red blood cells of humans, which can lead to anemia. If a pregnant woman becomes infected, the disease can be transmitted through her blood to the fetus, leading to stunting at birth or stillbirth.
“When women become pregnant, especially for the first time, they lose their built-up immunity to the disease,” Brieger said. A reduced level of healthy red blood cells leads to anemia, which leads to death or various internal-organ health problems. It is associated with retarding the growth of the fetus and lower child-survival rates.
The World Health Organization estimates that malaria causes nearly 1 million deaths a year, mostly among African children. The disease is a major cause of lost work productivity in endemic countries, Brieger said. Jhpiego is a partner of the Roll Back Malaria initiative launched in 1998 by the WHO.
Jhpiego works in about 20 malaria-endemic countries. Most are in sub-Saharan Africa. Its approach follows WHO guidelines. Jhpiego trains health care workers to teach community members to use insecticide-treated bed nets. Health care workers are also trained to provide women with regular care and give the malaria-prevention drug sulfadoxine pyrimethamine to women during the second and third trimesters of pregnancy. The drug has fewer side effects than the previously recommended chloroquine.
During her previous pregnancies, Silga was treated with chloroquine, which meant swallowing three tablets weekly up to six weeks after delivery. She often forgot to take the medicine and sometimes avoided it because it caused dizziness and itchiness. So she often contracted malaria. Since then, mosquitoes have become resistant to the drug.
Silga now needs only two doses of the new drug during her pregnancy. Since she receives the treatment at the health center during her regular pregnancy care visits, she doesn’t forget to take the medicine and has not contracted fever or malaria.
Jhpiego also trains health care workers to diagnose malaria and promptly treat pregnant women who test positive with an artemisinin combination therapy. “The combination idea is based on the fact that parasites can develop a resistance to a single drug,” Brieger said. “Combine two drugs and there is a better chance of killing the parasite.” Artemisinin is derived from a plant used by Chinese herbalists to treat fevers.
Under the supervision of health care workers, trained volunteers extend the capacity of health centers into communities. “Community members are definitely excited that they can get these services close by, especially in rural areas where malaria is most endemic and people may live far from a health center or the health center is closed,” Brieger said.
Jhpiego teaches health care workers to document the number of people who use the interventions and keep track of their health center’s supplies so they don’t run out.
“Health workers love to get new knowledge,” Brieger said. “It makes them feel more confident in their ability to help people.”
AllAfrica – All the Time
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Help to Keep Pregnant Women Malaria-Free