Prevention of Malaria in Pregnancy GTG Flashcards
What the 3 mains type of malaria?
Plasmodium Falciparum, viva and ovale
What proportion of malaria is cause by P falciparum, where most commonly found?
79% West Africa (Nigerai/Ghana)
Most dangerous
What proportion of malaria is cause by P vivax, where most commonly found?
5.5% Asia (India Subcontinent)
Relapsing remitting
What proportion of malaria is cause by P ovale?
2% Relapsing remitting
Risk of malaria in pregnancy
Susceptibility to infection
Severe anaemia
Severe cerebral malaria
Maternal + fetal mortality
Reduction in birth weight
Miscarriage, PTB, stillbirth
Placental parasiaemia
Women with little/no immunity more at risk
Which gravida of pregnancy is at high risk?
Primps - higher rates of parasitaemia, risk of malaria decreases with number of pregnancies
What to do if pregnant woman planning a trip to endemic area?
Advice to postpone trip if possible
Seek advice from centra with expertise on malaria risks
How long after trip should malaria be considered a differential if fever or flu-like illness?
Over 1 year
What is the ABCD or malaria prevention
Awareness of risk
Bite prevention
Chemoprophlyaxsis
Diagnosis and prompt Tx
Risk of malaria in Oceania, Sub-sarah Africa and Indian subcontinent?
Oceania 1:20
Sub-sarah Africa 1:50
Indian subcontinent 1:500
What factors impact malaria risk?
o Level of transmission in area
o Time of year (rainy or dry)
o Prescence of drugs resistant strains
o Rural/urban sleepovers
o Lenth of travel
o Take up of malaria prevention intervetions
How to prevent mosquito bites?
- Skin repellents, knock-down mosquito sprays, insecticide- treated bed nets, clothing and room protection.
o Repellents 50% DEET 24 hours/day
o Knock down mosquito sprays – permethrin and pyrethroids sprays to kill resting mosquitoes
o Insecticide bed nets – long lasting pyrethroid
o Clothing that covers the body and forms barrier
Which chemoprophylaxis is considered safe in 2nd/3rd trimester?
Mefloquine 5mg/kg once a week
Chloroquine/proguanil - most areas now resistant
Continue 4 weeks after return
Should any chemoprophylaxis be taken in 1st trimester?
No, should stop the chemoprophylaxsis for excretion time before becoming pregnant
Half life and excretion time of mefloquine?
14-21 days
Excretion 3 months
