CHAPTER ONE
INTRODUCTION
Malaria is an infections disease caused by a parasite, plasmodium which infects red blood cells. Historical records suggest that malaria has infected human since the beginning of mankind. The name “mal aria” (Meaning bad air in Italian) was first used in English in 1740 by H. Walpole when describing the disease. The term was shortened to malaria in 20th century. Laveran; in 1880 was the first to identify parasites in human blood. In 1889, Ross discovered that mosquitoes transmit malaria.
Malaria continues to be a cause of great suffering in tropical and sub-tropical regions of the world (Brabin, 1989). Currently, it is endemic in about 100 countries affecting 4% of world’s population. Malaria has been eliminated or effectively suppressed in several parts of the world in past decade but is now undergoing resurgence (Gilles, 1987). It is returning to areas from which it had been eradicated as well as spreading into new areas such as central Asia and Eastern Europe. Despite global economic development people are dying from malaria now than 30 years ago.
EPIDEMIOLOGY AND CLINICAL FEATURES
Malaria in pregnancy remain a notable cause of maternal and prenatal morbidity and mortality, often associated with maternal illness, maternal anemia, low birth weight, preterm delivery and prenatal loss especially in the primigravidae. In semi-immune pregnant women, malaria infection may be asymptomatic, pregnant women are at risk of clinical disease compared to non-pregnant women at all levels of endemicity (Harrison, 1995). There is unparasitized blood cells leading to a greater level of anemia than can be explained on the basis of RBCS parasitization alone (who,1991).
Primgravidity is a known risk factor in pregnancy. It only becomes more prevalent in primigravide but also intense (Jimoh, 2003). The peak prevalence of parasitemia will be altered by prior anti malaria injection. In a study from Madan, Papua New Guinea, the peak prevalence in primigravidae studied reached 55% to compared to 86% in other study from Kenya (flemming, 1986). Studies have also suggested that the highest prevalence of infection occurs in the 2nd trimester with inflection rate at delivery and in the postnatal period approximating to levels in non pregnant women possibly due to immunity boosting during pregnancy (Akindele, et al 1993)