One evening, when Rose Akinyi’s infant Jayla Joy refused to eat and would not stop crying, Rose initially believed that her baby had a stomach ache. She administered some mild pain relief medication, but her baby’s condition continued to deteriorate.
“I gave her [additional pain medication] after removing her clothes,” reported Akinyi, a 30-year-old resident of Kisumu, a city situated on the shores of Lake Victoria in western Kenya.
Due to the late hour, she was unable to reach the closest hospital which was several miles away. Her attempts to contact doctors were unsuccessful. The following morning, she was able to reach the hospital on a motorcycle taxi, but by then her baby’s temperature had risen to 39.8C (103.6F). Akinyi expressed her fear of losing her child in that moment.
Akinyi was taken aback by the diagnosis of malaria. She, like most people, believed that her baby would be immune to the disease due to maternal protection.
She expressed concern about her child potentially contracting malaria. Nurses gave her antimalarials and her baby’s fever went away. Healthcare professionals believe that the nine-month-old could have passed away without treatment.
Unfortunately, there is currently no effective way to treat malaria in infants weighing less than 5kg (11lbs), which includes newborns up to approximately three months old. However, a new medication developed by the pharmaceutical company Novartis in Switzerland is currently being tested in Africa and may provide a potential solution.
Agnes Akoth, a nurse in Kisumu where malaria is prevalent, stated that detecting malaria in newborns is challenging as it manifests differently. Infants may not show any symptoms or may display symptoms that are similar to common childhood illnesses, making it difficult to identify early.
Akoth stated that complications may arise due to the parasite multiplying before a diagnosis can be made. In some cases, death may occur.
According to a report on malaria in 2023, the disease is a major contributor to child mortality in Africa and accounts for approximately 80% of all malaria-related deaths on the continent. In 2022, Africa also saw a high number of malaria cases, with 94% of all reported cases occurring there.
While the World Health Organization mandates the testing of malaria in suspected cases, hospitals may not always conduct routine tests on infants due to a lack of diagnostic kits or laboratory personnel.
According to experts in the scientific and medical fields, the belief that mothers provide immunity to infants has resulted in them being excluded from clinical trials for potential treatments. The RTS,S and R21 vaccines, which are used for preventing malaria, have only been evaluated in children who are at least five months old.
The Novartis medication currently in phase 3 testing in Burkina Faso, Kenya, the Democratic Republic of the Congo, Nigeria, Mali, and Zambia shows potential. The findings are projected to be released in early 2024.
“I understand the difficulties faced by healthcare workers in caring for infants,” stated Dr. Bérenger Kaboré, a research associate at the Nanoro Health and Demographic Surveillance System in Burkina Faso and lead investigator of the trials. These trials are being sponsored 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 older babies. These tablets are often cut in half or quarters, which can lead to inaccurate dosing and potential harm to the organs.
There is limited information available on the frequency of newborn malaria, but it is believed to be less prevalent compared to older children. However, it is still not being accurately diagnosed.
According to Nekoye Otsyula, the global medical affairs director at Novartis, the difficulty lies in the fact that people do not consider the possibility of malaria in infants. In some instances, they eliminate the possibility of mothball poisoning before considering malaria, making it the least likely diagnosis for doctors and healthcare workers when dealing with these babies.
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 the year 2022, approximately 35.4 million expecting mothers in 33 African countries with moderate to high malaria transmission were at risk. According to medical professionals, it is crucial to prioritize treatments for newborns in these regions.
Otsyula stated that it is important to diagnose and treat infants with malaria. These children are often overlooked and it is crucial to take action.
Source: theguardian.com
