Scientists have found that malaria, a well-known disease which affects nearly half of the world's population, can not only be fatal but also has the potential of showing no visible symptoms in pregnant women. Although seemingly beneficial to mom, what the parasite fails to reveal is the detrimental effects it causes the unborn child. With its ability to cross the placental barrier, malaria can act as a silent predator and do significant damage to a developing fetus, and even mom as well.
According to the Centers for Disease Control (CDC), there are five different types of the malaria parasite that can enter the bloodstream and infect humans: Plasmodium falciparum, P. vivax, P. ovale, P. malariae, and P. knowlesi (Plasmodium falciparum being the most fatal). The parasite works as any parasite does and thrives by seizing control of its host. In simple terms, malaria enters the bloodstream and with the help of some special proteins, attaches itself to red blood cells and does a complete renovation of the cells themselves. This is problematic because red blood cells are important for oxygen transport throughout the body.
Imagine you are "Oxygen" and you are downtown New York, late for a business meeting at "The Liver". You flag down a cab (i.e. a red blood cell) and all of a sudden some stranger named malaria jumps in the cab and speeds off, leaving you stranded on the busy street. Not only is this a major inconvenience, but you were really needed at that business meeting and everyone will suffer because you aren't there!
Generally, malaria looks similar to the flu. With its fever, nausea, vomiting, diarrhea, chills, headache, muscle aches, and fatigue, why wouldn't you guess the flu? Unlike the flu, however, it can cause anemia (from the hijacking of red blood cells) and even jaundice because malaria thrives in the liver. The CDC warns that "if not promptly treated, the infection can [also] become severe and may cause kidney failure, seizures, mental confusion, coma, and death".
So, why is it that some people, specifically pregnant women for our discussion, can be completely asymptomatic while this parasite takes over internally? To explain that, scientists Ingrid Chen, Sian E. Clarke, et al., studied the causes of asymptomatic malaria and what can be done to prevent and cure it. In their research and publication, Asymptomatic Malaria: A Chronic and Debilitating Infection That Should Be Treated, they state that "so-called “asymptomatic” malaria infections have been recognized for many years, and result from partial immunity (sometimes referred to as “premunition”), which controls but does not completely eliminate the infection". In other words, pregnant women have an immune system, it is just suppressed, so it works in keeping the infection at bay but not well enough to fight it off entirely.
Once entering a pregnant woman's body, as previously stated, the parasite has the ability to cross the placental barrier, thus infecting the developing fetus. According to a Consultant Medical Parasitologist, Professor Wellington Oyibo, once inside the fetus, malaria has the ability to "cause spontaneous abortion, ... bring about the poor development of the [fetus] causing what is called 'intrauterine growths reduction or retardation', meaning within the placenta itself, the [fetus] is not growing the way it should grow" (for more on what Oyibo had to say click here). As for mom, with asymptomatic malaria, the main concern apart from the baby is anemia, a condition caused by the lack of red blood cells.
It's no secret that malaria is a disease that shouldn't be trifled with, but there are options for mothers in countries where the parasite is prevalent to help protect themselves and their babies. There are antimalarial medications that can be taken during pregnancy but just like any medication, they aren't 100% effective. For those mothers who have the option to stay away from highly prone areas (here is where malaria is found), it is the safest and most effective option at preventing the infection and transmission of this disease.