Malaria During Pregnancy in Ghana: Symptoms, Risks, Prevention, and Treatment
Description: Learn about malaria during pregnancy in Ghana, including symptoms, risks to mother and baby, prevention, testing, treatment, and when to seek urgent medical care.
Medical disclaimer: This article is for educational purposes and does not replace antenatal care, diagnosis, or treatment from a qualified healthcare professional.
Introduction
Pregnancy is a special period when a woman’s body undergoes major physical and hormonal changes. These changes can also affect how the immune system responds to infections. In malaria-endemic areas such as Ghana, this makes malaria during pregnancy an especially important health concern.
Malaria during pregnancy can affect both the mother and developing baby. WHO states that pregnancy reduces a woman’s immunity to malaria, increasing the risk of illness, anemia, severe disease, and death. Maternal malaria is also associated with increased risks of miscarriage, stillbirth, premature delivery, and low birth weight.
The good news is that malaria during pregnancy can be prevented and treated. A combination of antenatal care, insecticide-treated mosquito nets, recommended preventive treatment, appropriate testing, and prompt treatment can significantly reduce the risks.
For pregnant women and families in Ghana, understanding malaria is therefore not simply about avoiding mosquitoes. It is about protecting two lives—the mother and the developing baby.
What Is Malaria During Pregnancy?
Malaria during pregnancy refers to malaria infection occurring while a woman is pregnant.
The infection is caused by Plasmodium parasites, which are transmitted primarily through the bites of infected female Anopheles mosquitoes.
After a mosquito bite, malaria parasites enter the bloodstream and undergo stages of development before infecting red blood cells.
Pregnancy can make malaria more dangerous because physiological and immunological changes may increase susceptibility to infection and complications.
This means a pregnant woman should take fever and suspected malaria seriously rather than automatically assuming it is a minor illness.
A Brief History of Malaria and Pregnancy
Malaria has affected pregnant women in Africa for centuries.
Before modern malaria diagnosis and treatment became available, infection during pregnancy could have devastating consequences.
The development of:
- Antimalarial medicines
- Mosquito-control programs
- Insecticide-treated nets
- Antenatal care
- Preventive treatment
- Laboratory diagnosis
has transformed malaria management.
Modern malaria programs increasingly focus not only on treating women who become sick but also on preventing infection and its complications during pregnancy.
WHO currently recommends a package of interventions for malaria prevention and control during pregnancy, including insecticide-treated nets, prompt effective treatment, and intermittent preventive treatment in areas with moderate-to-high P. falciparum transmission.
Why Is Malaria More Concerning During Pregnancy?
Pregnancy can reduce a woman’s immunity to malaria.
As a result, infection can produce more serious consequences than it might in some non-pregnant adults.
Possible complications include:
- Maternal anemia
- Severe malaria
- Maternal illness
- Maternal death
- Miscarriage
- Stillbirth
- Premature delivery
- Low birth weight
WHO specifically identifies increased risks of anemia, severe disease, and death for pregnant women, along with adverse outcomes for the fetus and newborn.
This is why malaria prevention should begin as early as possible during pregnancy.
Symptoms of Malaria During Pregnancy
Symptoms may include:
- Fever
- Chills
- Sweating
- Headache
- Weakness
- Muscle aches
- Joint pain
- Nausea
- Vomiting
- Loss of appetite
- Dizziness
- General fatigue
However, pregnancy itself can cause tiredness, nausea, headaches, and other symptoms.
That makes it particularly important not to assume that every pregnancy symptom is malaria—or that every fever is simply a normal pregnancy symptom.
Testing and professional assessment are important.
Can Malaria Occur Without Obvious Symptoms?
Yes.
Some malaria infections may not present with the classic combination of fever, chills, and sweating.
A pregnant woman can therefore benefit from routine antenatal care and malaria-prevention measures even when she feels healthy.
Preventive care is important because the consequences of malaria during pregnancy can extend beyond the mother’s immediate symptoms.
Malaria and Anemia During Pregnancy
Anemia is already a major concern during pregnancy because the body has increased requirements for blood and nutrients.
Malaria can make the situation worse.
Malaria parasites infect red blood cells and can contribute to their destruction.
The resulting anemia may cause:
- Fatigue
- Weakness
- Dizziness
- Shortness of breath
- Reduced ability to perform normal activities
Severe anemia can become dangerous for the mother and may contribute to poor pregnancy outcomes.
This is one reason antenatal care commonly includes attention to anemia prevention and management alongside malaria prevention.
How Can Malaria Affect the Baby?
Maternal malaria can affect pregnancy and fetal development.
WHO identifies associations between malaria during pregnancy and:
- Low birth weight
- Premature delivery
- Stillbirth
- Spontaneous abortion
A low-birth-weight baby may face increased health risks, making prevention of malaria during pregnancy an important component of maternal and newborn health.
Malaria During the First Trimester
The first trimester is an especially important period because major fetal development occurs during this stage.
If a woman develops suspected malaria during early pregnancy, she should seek professional medical advice promptly.
Importantly, pregnant women should not choose antimalarial medicines themselves.
Medication selection during pregnancy requires consideration of:
- Pregnancy stage
- Type of malaria
- Severity
- Local treatment recommendations
- Drug safety
- Other medications
- Individual medical circumstances
WHO updated its evidence review in 2024 and now recommends artemether-lumefantrine as the preferred treatment for uncomplicated P. falciparum malaria in the first trimester, based on available safety evidence.
This is an important example of why old information found online may no longer reflect current recommendations.
Malaria During the Second and Third Trimesters
Malaria can remain dangerous throughout pregnancy.
Pregnant women should continue:
- Sleeping under an insecticide-treated mosquito net
- Attending antenatal appointments
- Following recommended preventive treatment
- Seeking prompt care for suspected malaria
- Following prescribed treatment
WHO recommends intermittent preventive treatment with sulfadoxine-pyrimethamine in malaria-endemic areas of Africa, beginning in the second trimester, with doses separated by at least one month and the objective of receiving at least three doses.
Malaria Prevention During Pregnancy
Prevention is one of the most important parts of protecting pregnant women.
1. Sleep under an insecticide-treated mosquito net.
Pregnant women should sleep under an appropriate insecticide-treated net consistently.
WHO states that insecticide-treated nets are safe for use during pregnancy and recommends using them as early in pregnancy as possible and continuing through pregnancy and the postpartum period.
This is a simple intervention, but consistency matters.
A mosquito net sitting folded in a cupboard cannot protect anyone.
It needs to be used.
2. Attend Antenatal Care
Antenatal care provides opportunities to:
- Monitor the mother’s health
- Monitor fetal development
- Screen for important conditions
- Discuss malaria prevention
- Receive recommended preventive treatment
- Identify anemia
- Receive health education
Ghana’s malaria guidance incorporates malaria prevention into antenatal services. Ghana Health Service’s current resource hub includes national guidance covering malaria diagnosis, treatment, pregnancy management, and chemoprevention.
3. Follow Recommended Preventive Treatment
In Ghana, intermittent preventive treatment during pregnancy has historically been implemented with sulfadoxine-pyrimethamine (SP).
The Ghana national malaria guidance available through the Ghana Health Service describes IPTp-SP beginning around 16 weeks of gestation, with subsequent doses at least four weeks apart and a minimum of three doses during pregnancy.
However, pregnant women should not purchase and self-administer preventive medicines based on an internet article.
A qualified healthcare worker should determine eligibility and administer or supervise treatment according to current national guidance.
4. Reduce Mosquito Exposure
Additional practical measures can include:
- Using window screens where practical
- Keeping sleeping areas protected
- Following local mosquito-control recommendations
- Avoiding unnecessary exposure to mosquitoes
- Supporting environmental sanitation
No single measure should be viewed as providing perfect protection.
Combining interventions is more effective.
5. Seek Care Quickly When Fever Develops
A pregnant woman with a fever should not automatically assume:
“It is just pregnancy.”
Nor should she assume:
“It must be malaria.”
Both assumptions can be problematic.
Fever can have many causes.
The safest approach is appropriate medical assessment and testing.
How Is Malaria Diagnosed During Pregnancy?
Malaria diagnosis may involve:
- Rapid diagnostic testing
- Microscopy
- Clinical assessment
WHO recommends parasite-based diagnosis where possible using quality-assured tests.
Testing helps distinguish malaria from other conditions that can produce fever.
Pregnancy itself does not mean every fever is malaria.
How Is Malaria Treated During Pregnancy?
Treatment depends on several factors, including:
- Whether malaria is confirmed
- The parasite involved
- Severity of disease
- Stage of pregnancy
- Current national guidelines
- Previous medication
- Other medical conditions
Treatment of severe malaria during pregnancy is an emergency and requires urgent professional care.
Uncomplicated malaria also requires appropriate treatment because untreated infection can progress and harm both mother and baby.
Women should not use:
- Leftover antimalarial medicines
- Another person’s prescription
- Unverified online treatment combinations
- Unknown herbal preparations
without professional medical advice.
Why Herbal Self-Treatment Can Be Risky
Traditional remedies are widely used in many African communities.
Some people may believe:
“Because it is natural, it cannot harm the baby.”
That is not a safe assumption.
The safety of an herbal preparation during pregnancy depends on factors such as:
- Its actual ingredients
- Concentration
- Dose
- Contamination
- Interactions with medicines
- Effects on pregnancy
- Quality control
Pregnant women should discuss any herbal product with a qualified healthcare professional before using it.
Severe Malaria During Pregnancy
Severe malaria is a medical emergency.
Warning signs can include:
- Confusion
- Loss of consciousness
- Seizures
- Difficulty breathing
- Severe weakness
- Persistent vomiting
- Severe anemia
- Abnormal bleeding
- Jaundice
- Very little urine
- Rapid deterioration
If a pregnant woman develops these symptoms, she needs urgent medical attention.
Do not wait for a home remedy to work.
Do not delay hospital treatment because the woman is “only experiencing pregnancy weakness.”
Can Malaria Cause Miscarriage?
Malaria during pregnancy is associated with an increased risk of adverse pregnancy outcomes, including spontaneous abortion.
However, not every miscarriage is caused by malaria.
Pregnancy loss can have many causes.
If a pregnant woman experiences:
- Vaginal bleeding
- Severe abdominal pain
- Fainting
- Severe weakness
- Fever
- Fluid leakage
- Other concerning symptoms
She should seek medical assessment promptly.
Can Malaria Cause Premature Birth?
Yes, maternal malaria is associated with increased risk of premature delivery.
This is one reason prevention during pregnancy is so important.
The goal is not merely to prevent a mother from experiencing fever. It is also to protect pregnancy outcomes.
Can Malaria Cause Low Birth Weight?
Yes.
WHO identifies maternal malaria as a risk factor associated with low birth weight.
Low birth weight can make newborns more vulnerable to health complications.
Preventing maternal malaria can therefore contribute to protecting newborn health.
Common Myths About Malaria During Pregnancy
Myth 1: Pregnant women should avoid mosquito nets because the insecticide is dangerous.
False.
WHO recommends insecticide-treated nets as an important malaria-prevention intervention during pregnancy.
Myth 2: Every pregnant woman with a fever has malaria.
False.
Fever can have many causes.
Myth 3: Malaria is only dangerous in the last months of pregnancy.
False.
Malaria can cause problems throughout pregnancy.
Myth 4: You should stop malaria prevention once you feel healthy.
False.
Prevention is intended to reduce the risk of infection before illness develops.
Myth 5: Herbal medicine is automatically safe during pregnancy.
False.
Pregnancy changes the safety considerations for medicines and other substances.
Myth 6: One preventive dose is enough for the entire pregnancy.
Not necessarily.
Recommended preventive treatment involves scheduled doses according to current national and WHO guidance.
Practical Malaria-Prevention Routine for Pregnant Women in Ghana
Every night
- Sleep under an insecticide-treated mosquito net.
- Keep the sleeping area protected from mosquitoes.
- Follow recommended mosquito-control measures.
At every antenatal visit
Ask your healthcare provider about:
- Malaria prevention
- Preventive treatment
- Anemia
- Medication safety
- Any fever or recent illness
- Other pregnancy concerns
If you develop a fever
- Seek medical assessment.
- Ask about malaria testing.
- Follow the prescribed treatment.
- Monitor for worsening symptoms.
If severe symptoms occur
Seek emergency medical care immediately.
Frequently Asked Questions
1. Is malaria dangerous during pregnancy?
Yes. It can increase the risk of maternal illness, anemia, severe malaria, and death, as well as adverse outcomes for the baby.
2. Can a pregnant woman sleep under an insecticide-treated mosquito net?
Yes. WHO recommends insecticide-treated nets as an important prevention measure during pregnancy.
3. When does malaria preventive treatment start during pregnancy?
WHO recommends IPTp-SP beginning in the second trimester in malaria-endemic areas of Africa, with doses at least one month apart and an objective of at least three doses.
Ghana’s national guidance specifies a first dose around 16 weeks of gestation and subsequent doses at least four weeks apart.
4. Can malaria cause anemia during pregnancy?
Yes. Malaria can contribute to anemia, which can be particularly concerning during pregnancy.
5. Can malaria harm the unborn baby?
Yes. Maternal malaria is associated with increased risks, including low birth weight, premature delivery, and stillbirth.
6. Should a pregnant woman self-medicate for malaria?
No. She should seek professional medical advice and appropriate testing and treatment.
7. Can malaria cause miscarriage?
Malaria is associated with an increased risk of spontaneous abortion, but miscarriage has many possible causes.
8. Is malaria treatment safe during pregnancy?
Some antimalarial medicines are recommended during pregnancy, but the appropriate medicine depends on the type and severity of malaria and the stage of pregnancy. WHO’s recommendations have evolved as evidence has developed.
9. Can a pregnant woman take herbal malaria medicine?
She should not assume that an herbal product is safe simply because it is natural. Discuss it with a qualified healthcare professional first.
10. What should I do if I am pregnant and have a fever?
Seek medical assessment promptly. Do not assume the fever is automatically malaria or simply a normal pregnancy symptom.
Conclusion
Malaria during pregnancy is a serious but preventable health problem.
The infection can affect the mother through anemia and severe illness and can also increase the risk of complications affecting the pregnancy and newborn.
The strongest approach combines:
Antenatal care, mosquito net use, recommended preventive treatment + appropriate testing + prompt treatment.
Ghana has established national malaria guidance covering prevention and management during pregnancy, while WHO continues to update international recommendations as new evidence becomes available.
The most important message for pregnant women is simple:
Do not wait until malaria becomes severe before seeking help.
Call to Action
If you are pregnant and develop a fever, chills, unusual weakness, or other symptoms that could indicate malaria, contact a qualified healthcare provider promptly and ask about appropriate testing.
Keep your antenatal appointments, use your insecticide-treated mosquito net every night, and follow the preventive treatment schedule recommended by your healthcare team.
If you develop confusion, seizures, difficulty breathing, loss of consciousness, or another severe symptom, seek emergency medical care immediately.
Protecting the mother also helps protect the baby.
