This literature review examines the implementation of preventive measures to reduce malaria among pregnant mothers in Uganda. The review analyzes 3 studies published within the last 10 years that show lower rates of malaria among mothers who used mosquito nets, repellents, indoor residual spraying and intermittent preventive treatment, compared to those who did not implement these measures. The review concludes that preventive measures are critical to reducing the high burden of malaria during pregnancy in Uganda and decreasing adverse birth outcomes.

1. MUNI UNIVERSITY
FACULTY OF TECHNOSCIENCE
BACHELOR OF NURSING SCIENCES
NURSING TRENDS AND ISSUES
STUDENT: OYIRWOTH GEOFREY
REG NO: 2018/U/NSM/012/G
LECTURER: ASSUSI E. MILDRED
DUE DATE: 26th APRIL 2020
Assignment:
Literature review on reduction/mitigation of malaria in pregnant mothers through
implementation of preventive measures in Uganda.

2. • Introduction
Malaria during pregnancy is a major cause of maternal morbidity and mortality worldwide and
leads to poor birth outcomes like, low birth weights, premature delivery/miscarriage, congenital
infection and neonatal/fetal mortality. Pregnant women are three times more likely to develop
severe disease than non-pregnant women acquiring infections from the same area. This literature
review focuses on mitigation of morbidity and mortality of malaria in expectant mothers through
implementation of malarial preventive measures. The literature review shows that there is low
incidence and prevalence of malaria among the expectant mothers who indulge implementation
of the malarial preventive measures like using mosquito repellants, using long lasting treated
mosquito nets and draining stagnant water around their homes than those who ignored the
preventive measures. It’s therefore clear that implementation of preventive measures
reduces/mitigates the incidence of malaria among expectant mothers. This paper reviews three
(3) articles published in the last 10 year.
• Background
According to WHO, malaria infection during pregnancy is a significant public health problem
with substantial risks for the pregnant woman, her fetus, and the newborn child and it is the
major preventable cause of mortality among the pregnant women and causing adverse birth
outcomes in Uganda (Okiring et al, 2019). The most rampant species of malaria in Uganda is
P.faciparum, which causes mortality and morbidity. The disease is transmitted by female
anopheles mosquito and the transmission cycle can be cut by using simple preventive measures
like using long lasting treated mosquito nets, using mosquito repellants, spraying insecticides,
draining stagnant water and to some extend using an intermittent preventive treatment for
pregnant mothers using combination therapy of sulfadoxine-pyrimethamine in the early phase of
pregnancy (Ibecheozor, 2014). In an area of high malaria transmission, prim-gravid women and
those belonging to the poorest households, living in traditional homes and with the least
education had the greatest risk of malaria during pregnancy.
Therefore to curb down the burden of this disease, the implementation of the preventive
measures has to be taken serious, social and environmental factors should be maintained also.

3. Expectant mothers have to use long lasting treated mosquito nets, using mosquito repellants,
spraying insecticides, draining stagnant water and to some extend using an intermittent
preventive treatment for pregnant mothers using combination therapy of sulfadoxine-
pyrimethamine in the early phase of pregnancy so that malaria can be reduced during pregnancy.
• Methods
In this literature review, Google scholar was used as the search engine from which 3 articles
were obtained and used as the sources of information. The articles were obtained by use of some
key words such as malaria, Uganda, rural populations, expectant mothers, mortality, morbidity,
reducing malaria in pregnant mothers, malarial preventive therapy. Google scholar presented a
number of articles but only the three were chosen because they were in line with the topic of
interest. They were also chosen because they were published in the last 10 years and presented
information about Uganda. They therefore suited the requirements of the literature review.
• Literature review
All the 3 articles reviewed show that the burden, morbidity, mortality, and severity of maternal
malaria in the rural and urban populations across Uganda. The articles are focused on
implementing preventive measures to mitigate incidence if malaria disease by the expectant
mothers through using simple methods which are inexpensive yet very vital.
This study is one of the first to examine the association between household characteristics and
malaria in pregnancy in Uganda. Each year, more than 30 million pregnancies at risk of malaria
occur in sub-Saharan Africa (Odongo et al, 2016). They studied the burden of malaria in
pregnant mothers and found out that malaria was more prevalent in those who did not implement
the preventive measures, those who did not sleep under treated mosquito nets, used the sprays
and the preventive treatment of sulfadoxine-pyrimethamine combination in early phase of
pregnancy, these are the people who are concentrated in the rural areas whereas those who
observed the implementations had a low incidence and burden of maternal malaria. These

4. authors also implemented the distribution of insecticide treated bed nets (ITNs) and an increased
public education on the usage of the nets and preventing malaria during pregnancy.
• Conclusion
In an area of high malaria transmission, prim-gravid women and those belonging to the poorest
households, living in traditional homes and with the least education had the greatest risk of
malaria during pregnancy. Implementation of preventive measures and treatment of malaria
during pregnancy has to be taken serious to avoid mortality, morbidity and associated adverse
birth outcomes.
• References
• De Beaudrap, P., Turyakira, E., White, L. J., Nabasumba, C., Tumwebaze, B.,
Muehlenbachs, A., ... &Piola, P. (2013). Impact of malaria during pregnancy on
pregnancy outcomes in a Ugandan prospectivecohort with intensive malaria screening
and prompt treatment. Malaria journal, 12(1), 139.
• Muhindo, M. K., Kakuru, A., Natureeba, P., Awori, P., Olwoch, P., Ategeka, J., ...
&Mpeka, B. (2016). Reductions in malaria in pregnancy and adverse birth outcomes
following indoor residual spraying of insecticide in Uganda. Malaria journal, 15(1), 437.
• Odongo, C. O., Odida, M., Wabinga, H., Obua, C., &Byamugisha, J. (2016). Burden of
placental malaria among pregnant women who use or do not use intermittent preventive
treatment at Mulago Hospital, Kampala. Malaria research and treatment, 2016.