Malaria in pregnancy.

It is estim ated that, nearly five b illion episodes o f clinical m alaria occur w orldw ide each year. The disease causes about three m illion deaths annually w ith A frica suffering 90% o f this bu rden .'it is also estim ated that 25 m illion w om en fall p regnant in the m alaria-endem ic areas o f A frica each year.2 M ost o f the deaths due to m alaria in A frica are in p regnant w om en and children under the age o f five years.3 Plasmodium falciparum causes the m ost severe m alarial illness and m ost cases in A frica are caused by this species o f the m alaria parasite.3The prevalence o f Plasmodium falciparum infection am ong pregnant wom en in rural areas in parts o f A frica can be very high. V erhoff and co-w orkers found a prevalence o fplasmodium falciparum m alaria o f 35.3% am ong primigravidae and 13.6% in multigravidae in a study done am ong pregnant w om en in rural M alaw i.4 W omen who live in areas o f h igh or m oderate (stable) m alaria transm ission have a degree o f im m unity to m alaria whereas w om en w ho live in areas o f low (unstable) m alaria transm ission usually have no im m unity to the disease.5 Pregnancy is know n to cause a low ered capacity for type 1 im m une response.6 This reduces im m unity to diseases such as m alaria, tuberculosis and leishm aniasis.