Anaemia and malaria cause severe morbidity and mortality, especially for mothers and infants in the tropics and subtropics. A more precise understanding of these conditions and their interaction is important for improving health.
What is Anemia?
Anemia, a condition in which the number or quality is deficient of red blood cells (RBCs), is characterized by decreased oxygen delivery to tissue and can result in tiredness, weakness, and other health issues. The most common types of anemia are iron-deficiency anemia, vitamin B12 deficiency anemia, and folic acid deficiency anemia.
What is Malaria?
Malaria is a serious disease caused by parasites that are spread to people through the bites of infected female Anopheles mosquitoes. Once inside the body, these parasites mature and multiply in the liver over several days before invading and destroying red blood cells, causing fever, chills, headache, and nausea. Malaria can lead to severe complications and death if left untreated, including seizures, severe anemia, and organ failure.
The Interplay Between Anemia and Malaria
In maternal and child health, the symbiotic relationship between anemia and malaria is especially noteworthy. Each one fuels the other. Sometimes, a sickly child looks like most other children because children can be incredible mimics.
How Malaria Leads to Anemia
- Killing of Red Blood Cells: the malaria parasites attack and disrupt red blood cells, effectively decreasing their total representation in the bloodstream. This destruction directly leads to anemia.
- Immune Response: The body’s response to infection with malaria parasites can also lead to further red blood cell destruction. When the immune system tries to eliminate some of the parasites, it causes even more red blood cell destruction, both of infected and uninfected cells.
- Nutritional: Malaria-induced anorexia and gastrointestinal upsets can result in poor nutritional uptake. In the presence of pre-existing anemia, malaria can lead to decreased hemoglobin levels. In those with iron deficiencies before infection, malaria can worsen nutritional status.
How Anemia Increases Malaria Risk
- Compromised immunity: With anemia, the immune system becomes weak, resulting in people becoming more susceptible to malaria infections. A weakened immune system will have impaired parasite-fighting capacity, and therefore a higher chance of developing malaria.
- Increased Parasite Load: While those with anemia may already be suffering from a compromised immune system, their increased parasite load can make a malaria infection more severe and longer-lasting.
Impact on Maternal Health
Anemia and malaria have particularly severe implications for pregnant women.
- Pregnancy Problems: Pregnant women suffering from anemia have higher chances of developing complications, such as premature delivery, low birth weight of the baby, and maternal mortality. Malaria can exacerbate these problems by leading to severe anemia, either life-threatening for the mother or the baby.
- Placental Malaria: Malaria in pregnancy can cause malaria in the placenta, interfering with the nutrition and oxygen supply to the fetus, leading to absent or abnormal growth of the fetus, preterm delivery, and stillbirth.
- Maternal Mortality: Some women die from severe anemia due to malaria, especially those without adequate access to care. The combined impact of anemia and malaria puts pregnant women at high risk of dying.
Impact on Child Health
Children are also vulnerable to the combined effects of anemia and malaria.
- Chronic anemia puts children and adolescents at risk for cognitive impairment or delayed physical and cognitive development. Repeated infections with malaria also have essential harmful effects.
- Greater Morbidity: Childhood anemia increases the incidence of severe malaria and other infections. This increased susceptibility can bring on frequent hospitalizations and complications into adulthood and old age.
- Mortality risk: severe anemia and malaria are leading causes of mortality. Children with both conditions are at higher risk of death from complications of severe anemia, respiratory distress, and other infections.
Addressing the Issue
Although there is potentially an antagonistic relationship between anemia and malaria, controlling both is best accomplished using a combination of prevention, treatment, and education.
Prevention Strategies
- Mosquitoes: Reducing mosquito populations through nets treated with insecticides, spraying, and elimination of sources of standing water, eg, potholes, also cuts the incidence of malaria.
- Prophylactic Treatment: Pregnant women and young children in high-transmission areas given prophylactic treatment (drugs taken to prevent malaria) will catch the disease less frequently and experience fewer severe complications resulting from malaria.
- Iron Supplementation: Oral iron supplementation in pregnant women and children in areas of endemic malaria could help to minimize iron-deficiency anemia. When malaria causes anemia, administering iron during an acute infection can be dangerous.
- Health education: Communities should raise awareness about malaria prevention methods, its symptoms, and the importance of seeing a doctor promptly. This can help reduce the incidence of the disease and lessen the risk of anemia that often accompanies it.
Treatment Strategies
- Quick Diagnosis and Treatment: Rapid diagnostic tests and effective antimalarial medications for anemia related to malaria if the malaria diagnosis is made quickly.
- Anemia Management: With regards to anemia, its systemic causes including iron deficiency, have to be tackled with a diet and iron supplement where applicable. In the instance of extreme anemia, there may be a need for blood transfusion.
- Integrated care: integrated and coordinated care to an individual at risk for or with malaria and anemia can improve their health Integrated care consists of joined-up care for malaria (and in a health system. Providers work together so a patient with malaria and anemia receives good care.
The association between anemia and malaria has huge implications for maternal and child health, with malaria exacerbating anemia, and anemia as a consequence of malaria. Reducing the burden of both anaemia and malaria will require a concerted effort including consistent prevention and treatment of both, along with education to reduce malaria exposure. Improving access to care and implementing more effective approaches to addressing these two overlapping conditions still has great potential to improve the health of mothers and their children.
