Pregnancy-Associated Malaria: Evidence and Interventions

Kibibi Muthoni L.

Faculty of Science and Technology Kampala International University Uganda

ABSTRACT

Pregnancy-associated malaria (PAM) is a critical public health concern in endemic regions, particularly sub-Saharan Africa, where it significantly contributes to maternal and neonatal morbidity and mortality. Immunological and hormonal changes during pregnancy heighten women’s susceptibility, especially among primigravidae and those with HIV co-infection. PAM is primarily caused by Plasmodium falciparum, which sequesters in the placenta, impairing nutrient and oxygen transfer and leading to adverse outcomes such as maternal anaemia, miscarriage, stillbirth, preterm delivery, and low birth weight. Globally, more than 125 million pregnancies annually are at risk, with prevalence influenced by geographic distribution, socioeconomic conditions, and immunological factors. Diagnosis remains challenging due to placental sequestration and low peripheral parasitemia, with microscopy and rapid diagnostic tests often missing infections. Molecular techniques and placental histology improve detection but are not widely accessible. Preventive measures recommended by the World Health Organization include insecticide-treated nets (ITNs), indoor residual spraying (IRS), and intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine. These interventions have proven effective in reducing parasite prevalence, maternal anaemia, and adverse birth outcomes, but challenges persist with drug resistance, limited coverage, and sociocultural barriers. Effective management of PAM requires integrated strategies that combine improved diagnostics, equitable access to preventive interventions, and strengthened antenatal care. Addressing PAM holistically is essential to safeguard maternal and child health and accelerate global malaria elimination efforts.

Keywords: Pregnancy-associated malaria, Placental sequestration, Maternal and neonatal outcomes, intermittent preventive treatment (IPTp), and Malaria elimination.

CITE AS: Kibibi Muthoni L. (2025). Pregnancy-Associated Malaria: Evidence and Interventions. Research Output Journal of Biological and Applied Science 5(3):73-86. https://doi.org/10.59298/ROJBAS/2025/537386