One evening, Rose Akinyi became concerned when her baby Jayla Joy refused to eat and wouldn’t stop crying. She initially believed her newborn was experiencing stomach problems and gave her some mild pain relief, but the situation only deteriorated.
“I provided [additional pain medication] to Akinyi, a 30-year-old from Kisumu, a city located on Lake Victoria in western Kenya, as she was experiencing intense heat and discomfort.”
Akinyi was unable to reach the closest hospital, located miles away, due to the late hour. Despite her attempts to contact doctors, she received no response. When she finally arrived at the hospital the following morning on a motorcycle taxi, her baby’s temperature was 39.8C (103.6F). Akinyi recalls feeling worried that she might lose her child at that point.
Akinyi was taken aback by the diagnosis of malaria. She, like others, had thought that her baby would be immune to the disease due to maternal protection.
She expressed concern about her child possibly contracting malaria, but was relieved when nurses provided antimalarial treatment and her child recovered from the fever. Medical professionals state that the nine-month-old could have possibly passed away without intervention.
Babies who weigh less than 5kg (11lbs), typically newborns up to three months old, do not have access to treatment for malaria. However, a new medication being tested in Africa by the pharmaceutical company Novartis, based in Switzerland, may provide some potential for improvement.
Agnes Akoth, a former nurse in Kisumu where malaria is prevalent, stated that malaria in newborns may have varying presentations, making it difficult to diagnose in a timely manner. Infants may not exhibit any symptoms or their symptoms may be similar to other common childhood illnesses, leading to misdiagnosis.
Akoth stated that by the time a diagnosis is reached, the parasite may have replicated and resulted in further issues. She also mentioned that some individuals may even pass away.
In Africa, according to a 2023 report on malaria, the disease is responsible for a significant number of child deaths and accounts for approximately 80% of all malaria-related deaths on the continent. In 2022, Africa also saw 94% of reported malaria cases.
Despite the World Health Organization’s mandate for testing in regions with suspected malaria, hospitals often fail to conduct routine tests on infants due to limited availability of diagnostic kits or laboratory personnel.
Researchers and healthcare professionals argue that the belief that mothers pass on immunity to their babies has resulted in them being excluded from clinical trials for treatments. The RTS,S and R21 vaccines, which have been approved for preventing malaria, have only been studied in children who are five months old or older.
The Novartis medication currently in its third phase of testing in Burkina Faso, Kenya, the Democratic Republic of the Congo, Nigeria, Mali, and Zambia shows potential. We can anticipate results by early 2024.
Dr. Bérenger Kaboré, a research associate at the Nanoro Health and Demographic Surveillance System in Burkina Faso, expressed his understanding of the challenges faced by health workers in treating infants. He is the principal investigator for the trials, which are backed by the PAMAfrica Consortium and jointly funded by the European & Developing Countries Clinical Trials Partnership and Medicines for Malaria Venture.
Currently, infants who are diagnosed with malaria are given antimalarial tablets that are meant for larger infants. These tablets are often cut in half or quarters, which is not a precise method and can lead to overdoses and potential harm to the organs.
There is insufficient information about the frequency of newborns with malaria, but it is believed to be less common than in older children and often goes undetected.
According to Nekoye Otsyula, the global medical affairs director at Novartis, the difficulty lies in the fact that many do not consider the possibility of malaria in infants. In certain instances, doctors or healthcare workers will first consider other causes, such as mothball poisoning, before considering malaria as a potential diagnosis for the infant.
Findings on the extent of maternal immunity protections vary, but the risk of malaria to a newborn rises when a mother contracts the disease during pregnancy, or where the newborn is exposed to mosquitoes because the family doesn’t have insecticide-treated bed nets.
In 2022, approximately 35.4 million expecting mothers in 33 African countries with moderate to high levels of malaria were at risk of contracting the disease. Healthcare professionals emphasize the importance of prioritizing treatments for newborns.
According to Otsyula, it is crucial that we diagnose and treat infants with malaria. They are often overlooked and action must be taken to address this issue.
Source: theguardian.com
