Malaria in the Pregnant Traveler

May 19, 2020Journal of travel medicine

Malaria infection in pregnant travelers

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Abstract

Pregnant travelers have increased susceptibility to malaria, which can lead to severe illness and complications.

Pregnant women without protective immunity are at higher risk of severe malaria when traveling to endemic areas.
Travel to malaria-endemic regions may result in complications such as low birthweight and fetal loss.
Preventive measures, including mosquito repellents and careful monitoring for symptoms, are critical for pregnant travelers.
Chloroquine and mefloquine are accepted for use during pregnancy, but their effectiveness may be limited by regional resistance and contraindications.
DEET and permethrin are considered safe for pregnant women and are important for preventing malaria and other infections.

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Pregnant travelers face numerous risks, notably increased susceptibility to or severity of multiple infections, including malaria. Because pregnant women residing in areas non-endemic for malaria are unlikely to have protective immunity, travel to endemic areas poses risk of severe illness and pregnancy complications, such as low birthweight and fetal loss. If travel to malaria-endemic areas cannot be avoided, preventive measures are critical. However, malaria chemoprophylaxis in pregnancy can be challenging, since commonly used regimens have varying levels of safety data and national guidelines differ. Furthermore, although chloroquine and mefloquine have wide acceptance for use in pregnancy, regional malaria resistance and non-pregnancy contraindications limit their use. Mosquito repellents, including N,N-diethyl-m-toluamide (DEET) and permethrin treatment of clothing, are considered safe in pregnancy and important to prevent malaria as well as other arthropod-borne infections such as Zika virus infection. Pregnant travelers at risk for malaria exposure should be advised to seek medical attention immediately if any symptoms of illness, particularly fever, develop.

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Malaria in the Pregnant Traveler

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