HIV/AIDS, Tuberculosis, and Malaria in Pregnancy

Abstract

HIV/AIDS, tuberculosis (TB), and malaria (ATM) are 3 major global public health threats that undermine development in low-and middle-income countries [1]. Approximately 5 million lives are lost annually as a result of these infections, with substantial humanitarian, economic, and social impact, which is still not fully measured [1]. The three infections are not only associated with poverty but also occur in the same geographic zone and have major public health implications [2]. The consequences of interactions between the diseases are particularly serious for reproductive health. They often intersect in pregnancy, resulting in poor maternal and fetal outcomes. As access to their treatment is increasing in low-income countries and new and cheaper alternative drugs are being deployed, there is also the potential for interactions between their treatments, which affects the efficacy of each drug. The co-infected pregnant women are at a very high risk of anaemia and infection of the placenta; hence a considerable proportion of children born to women with HIV, TB and malaria infection have low birth weight and are more likely to die during infancy [3–5]. Also, there is the risk of mother to child transmission of the infections. Globally, an estimated 342,900 maternal deaths occur annually and more than 99% of these occur in low-and middle-income countries [6]. It is barely four years to the target for the attainment of Millennium Development Goal (MDG) 5, which seeks to reduce the maternal mortality ratio (MMR) by three-fourths. The three leading causes of these deaths have remained hemorrhage, infections, and hypertensive disorders [6, 7]. Local and regional variations do exist, however in sub-Saharan Africa, and Asia, infection as a result of HIV epidemic, resurgence of TB, and the ubiquitous malaria is a major cause [7]. Malaria is the most common of the three infections and it is estimated that over 50 million women are exposed to the risk of malaria in pregnancy annually [8]. Malaria infection in pregnancy results in substantial maternal, fetal, and infant morbidity and mortality, accounting for 75 000– 200 000 infant deaths yearly [9]. It causes diverse adverse pregnancy outcomes, including maternal anaemia and low birth weight due to preterm delivery and fetal growth restriction. Pregnant women are more susceptible than non-pregnant women to malaria, and this susceptibility is greatest in the first and second pregnancy. Susceptibility to malaria during pregnancy probably represents a combination of im-munological and hormonal changes associated with pregnancy , combined …

DOI: 10.1155/2012/140826

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Cite this paper

@inproceedings{Ezechi2012HIVAIDSTA, title={HIV/AIDS, Tuberculosis, and Malaria in Pregnancy}, author={Oliver Chukwujekwu Ezechi and Karen Odberg Petterson and Josaphat Kayogoza Byamugisha}, booktitle={Journal of pregnancy}, year={2012} }