# E-DRUG: Re: Malaria prophylaxis during pregnancy (9)

**URL:** <https://talk.edrugplus.org/t/e-drug-re-malaria-prophylaxis-during-pregnancy-9/3369>\
**Category:** e-drug\
**Created:** [August 27, 1998, 5:39pm UTC](https://talk.edrugplus.org/t/e-drug-re-malaria-prophylaxis-during-pregnancy-9/3369 "1998-08-27T17:39:48Z")\
**Posts on this page:** 1\
**Page:** 1

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**Author:** ![Dr\_Eberhard\_W\_Lisse](https://avatars.discourse-cdn.com/v4/letter/d/b782af/32.png) [@Dr\_Eberhard\_W\_Lisse](https://talk.edrugplus.org/u/Dr_Eberhard_W_Lisse)\
**Post date:** [August 27, 1998, 5:39pm UTC](https://talk.edrugplus.org/t/e-drug-re-malaria-prophylaxis-during-pregnancy-9/3369/1 "1998-08-27T17:39:48Z")

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E-drug: Re: Malaria prophylaxis during pregnancy (9)  
----------------------------------------------------------

We are moving away from the initial question, travel of a (most  
likely) non immune pregnant woman to an endemic area to the question  
of how to combat Malaria.

This is an extremely interesting one. Not only because we are failing.

I do stand by my strong advice, not to travel. Never mind prophylaxis  
and barrier methods. DO NOT TRAVEL! Malaria in pregnancy is SCARY!!

That said, \*IMPREGNATED\* mosquito nets are absolutely vital. They can  
be manufactored indigenously, there are several community based "Mossi  
Net" activities in Namibia, with excellent results.

Quality of drugs is another issue.

Regular supply. Very interesting, logistics that is ...

But one issue should also be addressed, the Primary Health Care  
guidelines (originating from the WHO?) implying to our PHC staff that  
it were possible to diagnose Malaria clinically.

Besides the fact that this is raising resistance like you cannot  
believe, the Health Information System (where every case of raised  
temperature is marked down as Malaria) of course masks the extent of  
the resistance. What happens is that 36 month old children have 26  
health contacts and were given 24 times Chloroquine, without a single  
lab confirmation. (And we got us health passports so we at least know  
a bit of what is going on).

A figure of 10% resistance was quoted by MoHs management on TV the  
other day, when in fact the number is close to 100% of lab confirmed  
cases.

Lab confirmation is not expensive. It is a logistical problem, which  
can be insurmountable, I conceed that. I am, however, quite convinced  
that you can train semi literates to have extremely good results. Do  
external quality control and pay them according to their specificity  
and sensitivity.

greetings, el

PS: Just for interest's sake: We had our first child in Oshakati, both  
of us used Chloroquine and Proguanil, slept under an impregnated net,  
used the incense. And of course I was the one who got it anyway :-)-O

--  
Dr. Eberhard W. Lisse\ / Swakopmund State Hospital  
\<el@lisse.NA\> \* | Resident Medical Officer  
Private Bag 5004 \ / +264 81 1246733 (c) 64 461005(h) 461004(f)  
Swakopmund, Namibia ;\_\_\_\_/ Domain Coordinator for NA-DOM (el108)

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