Malaria in pregnancy.

In its booklet 'Tropical Diseases 1990' the World Health Organization (WHO) Division of Control of Tropical Diseases (CTD) said, "Malaria remains the most important of the tropical diseases--widespread throughout the tropics, but also occurring in many temperate regions". The size of the malarial scourge was estimated as: number of people infected 267 million; clinical cases 107 million/year; mortality 1-2 million/year; number of people at risk 2100 million. Immunity to malaria is reduced in pregnancy. This makes the disease particularly dangerous for pregnant women, especially for nulliparae. Malaria causes a significant portion of the large number of perinatal and maternal illnesses and deaths in the tropical countries. It is the leading cause of indirect obstetric deaths. Even so, it is impossible to measure its full impact in this respect. It may masquerade as anaemia. A maternal death may be attributed to obstetric haemorrhage, when in fact it was malarial anaemia which tipped the scales. Fortunately, the disease can be prevented through chemoprophylaxis and personal protection. This is one of the most rewarding functions of antenatal care.