Malaria in pregnancy.

It is estimated that, nearly five billion episodes of clinical malaria occur worldwide each year. The disease causes about three million deaths annually with Africa suffering 90% of this burden.'it is also estimated that 25 million women fall pregnant in the malaria-endemic areas of Africa each year.2 Most o f the deaths due to malaria in Africa are in pregnant women and children under the age of five years.3 Plasmodium falciparum causes the most severe malarial illness and most cases in Africa are caused by this species of the malaria parasite.3The prevalence of Plasmodium falciparum infection among pregnant women in rural areas in parts o f Africa can be very high. Verhoff and co-workers found a prevalence ofplasmodium falciparum malaria of 35.3% among primigravidae and 13.6% in multigravidae in a study done among pregnant women in rural Malawi.4 Women who live in areas of high or moderate (stable) malaria transmission have a degree of immunity to malaria whereas women who live in areas of low (unstable) malaria transmission usually have no immunity to the disease.5 Pregnancy is known to cause a lowered capacity for type 1 immune response.6 This reduces immunity to diseases such as malaria, tuberculosis and leishmaniasis.