QUESTION:

I am laboratories man. My question is the risk of P. falciparum especially for mother and children is very high.  How can we reduce this risk?

ANSWER:

That’s a crucial question for malaria control. Certainly, as you say, the risk of severe malaria is much greater for young children and for pregnant women. As such, these high risk groups should be targeted during prevention campaigns, as well as for diagnosis and treatment.

There are several methods of prevention, which are suitable for all types of malaria, including P. falciparum. Probably the most effective, and also the most simple, is through the proper use of insecticide-treated bednets. These are often handed out at antenatal clinics to pregnant women, but ensuring that the nets are used properly is more difficult. Proper training, and emphasising that children and pregnant women will benefit most from reduced exposure to mosquitoes, is required. For more on the difficulties and challenges of bednet distribution, you can see Hugo Gouvras’ comment on an earlier question in this Q&A forum – see here: http://www.malaria.com/questions/free-malaria-bednet

The other main method for malaria prevention is through the use of prophylactic drugs, although these have to be taken every day, and so the cost is usually prohibitive for residents of malarial areas. In these areas, there have been successful trials of so-called SP IPT, which stands for sulfadoxine-pyrimethamine intermittent protective treatment. In this regime, malaria in pregnant women is prevented by administering intermittent doses of sulfadoxine-pyrimethamine; usually two doses during the pregnancy (one in the second and one in the third trimester), but monthly doses have also been tested. More frequent doses may be better for women who are also HIV positive, some studies have shown.

Intermittent preventative treatment has also been trialled on young children as a way of reducing the severity and frequency of malarial episodes when the child is most vulnerable. I’m not up to date on the most recent studies on this work, so will ask another one of our experts to comment on the efficacy of IPT, both in children and pregnant women.

Thanks for the question!