Women News Network / June 18, 2014

by Cameron Conaway

Chittagong, Bangladesh, SOUTHERN ASIA: “They prefer to feed on pregnant women.” I heard this statement time and again as I conducted research into malaria, the parasitic infectious disease often referred to as “The world’s perfect killer.”

In 2012 there was an estimated 207 million malaria cases, and despite incredible scientific advances malaria still kills nearly 1 million people each year (predominately impacting pregnant women and children under 5). Though all experienced doctors in the field know of the devastating impact malaria has on pregnant women, the definitive research I was often referred to came from Roger Dobson’s piece for the British Medical Journal in 2000 titled, Mosquitoes prefer pregnant women.

The opening oft-quoted lines are as follows:
“Pregnant women are twice as attractive to malaria carrying mosquitoes as non-pregnant women, according to new research. This added attractiveness is thought to be linked to physiological and behavioural changes and places pregnant women at greater risk of malaria, an important cause of stillbirths, low birth weight, and early infant mortality.

“For the research, 36 pregnant and 36 non-pregnant women were studied in the Gambia. Every night during the study, three women from each group slept alone under a bed net in six identical huts. The following morning the number of mosquitoes from each hut was counted to measure the relative attractiveness of each woman, and it was found that twice as many mosquitoes had been attracted to the pregnant women.”

While the importance of such research should never be overlooked, numbers can’t speak to me like story. And I’ll never forget the story of the pregnant mother I met in the Chittagong Hill Tracts of Bangladesh.

I came expecting to see the clinic. It was the first in the area and, with notepad and pen, I walked through the doors ready to see lab test strips and a few doctors floating around helping people. Those things were present, of course, but burned in my memory is the woman who was slumped in the corner. She barely had the strength to hold her body upright as her newborn clung to her shoulder. Her jaundiced eyes looked up as the doctor called her name.

“Positive. Both.” A colleague nudged me to give confirmation. Both the mother and the baby were suffering from one of the most deadly forms of malaria. And she still had to walk nearly two miles just to get back to her village. Yes, she walked two miles across dirt roads in her broken sandals (with a burning fever) just to get here. Which also means she lost money because she had to leave work to get here. Which means she won’t be able to afford meat for at least another week. Back to rice and whatever greens she can scrounge up, if treatment works.

A smile came over her face. At her smile a perplexed look likely came over my own face because my colleague nudged me again: “She’s smiling because if this had happened a few month ago this clinic wouldn’t have been here.”

In other words, this mother and certainly her newborn baby would have died.

With that she stood up, readjusted her child, flashed a smile as bright as I’d ever seen and began to cry tears of happiness. She and her baby had malaria, but so what. They were both living and now had access to help.

WHO recommends the following package of interventions for the prevention and treatment of malaria during pregnancy:
• use of long-lasting insecticidal nets (LLINs);
• in areas of stable malaria transmission of sub-Saharan Africa, intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP);
• prompt diagnosis and effective treatment of malaria infections.

(Note: Special thanks to YPSA’s Malaria Control Program for their work to end malaria in Bangladesh.)