If pregnant women can be infected with all species of parasite Plasmodiumat the origin of malaria in humans, it seems that they exhibit an increased susceptibility to two species: P. falciparum (present in Africa especially, America and forested Asia), with a risk of severe malaria access, and P. vivax (in Asia, America, East Africa). It has been shown that female Anopheles, mosquitoes that carry malaria, prefer to bite pregnant women.
This preference is not without consequence, as explained by Professor Camus, who publishes the recommendations to travelers in terms of prevention against malaria for the Institut Pasteur de Lille. ” The maternal malaria P. falciparum, and more rarely at P.vivax, may be responsible for a flow birth weight in newborns. The infection can also lead to a miscarriage, or lead to a premature delivery “. The doctor points out that women bitten during their pregnancy could present the early symptoms of malaria infection up to three months after their return from the tropical country, compared to eight to twenty days for children and adults, including non-pregnant women.
What chemoprophylaxis for malaria in pregnant women?
Like the rest of the population, pregnant or breastfeeding women must respect certain practical recommendations for the prevention of malaria. Taking a preventive medication must however be done with caution.
“The treatment regimen is roughly the same,” explains Prof. Camus. The same drugs are used, except doxycycline which is contraindicated. “
Theantimalarial atovaquone / proguanil (generic Malarone) is often preferred because it can be used both during pregnancy and breastfeeding if the breastfed child weighs at least 5kg.
Which repellent to choose?
The so-called “mechanical” preventive measures are the same as for the rest of the population: wear long and loose clothing, turn on the air conditioning at night, sleeping under an impregnated mosquito net, eliminate residual water bodies.
Alone the use of skin repellents is at risk, this is why the health authorities publish the list of products that can be applied to the skin of a pregnant or breastfeeding woman. Sure this list (from the “Health recommendations for travelers 2019”, page 49), it should be remembered that only the DEET concentrated at 10 or 50% maximum, the IR3535 20% concentrated maximum and the KBR3023 20% concentrated maximum can be used in pregnant women.
The doctor warns, however, “It is above all the number of applications per day that counts, because these products pass through the skin. The younger the fetus, the fewer applications will have to be made per day. “
For these products, three daily applications are sufficient and recommended.
Remember that pregnant women can travel to the tropics, but this period of life should be extra vigilant and require a lot of attention.