Mr. Jeckonia Onyango hope for healthy first born were shattered after his wife suffered malaria in pregnancy which affected their unborn child. She had undergone preventive intermittent treatment for malaria, which is usually recommended for pregnant women especially those in malaria endemic zones like Nyanza, where the couple lived. “The doctor said my wife had malaria when she was pregnant with him,” says Mr Onyango holding his son Nicholaus’ head firmly in place so that he may not knock is head on the chair. The five-year-old was born premature and now has spinal bifida, a developmental congenital disorder caused by the incomplete closing of the embryonic neural tube.
Dr. Lucas Otieno, a Research Officer at the Kenya Medical Research Institute (KEMRI), explains that when malaria attacks a pregnant mother, the parasites hide in the placenta and destroy the organs around the placenta. “This interferes with oxygen and nutrient supply to the unborn foetus which both are necessary for proper development of the unborn baby.” Says Dr. Otieno adding that women who suffer malaria in pregnancy are also likely to develop anaemia.” This reduces oxygen carrying capacity of the blood is reduced. Therefore the oxygen transmitted to the foetus is reduced as well. This can lead to intra-uterine retardation which may trigger pre-term labour and delivery,” says the research Office.
A pre-term baby is not mature enough to breathe on its own, a condition known as respiratory distress. This may cause brain damage and therefore delayed milestones in the baby’s development. The risk is higher with the first pregnancy -like in the case Nicholas’ mother. The risk can however be reduced by taking iron and folic acid available in government health facilities. “After his first birthday I noticed Hii mototo yangu hakui kama watoto wengine wa umri wake (my baby is to not developing like his age mates),” says Mr. Onyango. He was advised to buy a baby walker to help Nicholaus learn to walk but it did not help.
Today the five-year-old undergoes physiotherapy every Tuesday. The cost is high for the father who is works in a hardware store. Iron and Folic acid supplements build up Iron Store for pregnancy women. This averts the risk of Neural tube defects and other micro nutrient deficiencies like hydrocephalus which is a dangerous birth defect. In Malaria endemic countries of Africa anaemia is very common in pregnant women and children under five. Causative factors include iron deficiency and nutritional deficiencies. Mothers are advised by health experts to be should take Folic Acid and vitamin B12 to prevent birth defects. Those planning to conceive or in their first 12 weeks of pregnancy can take IFA supplement each day with a meal to reduce the risk of birth defects such as spinal bifida and hydrocephalus.
Research finding by the Vitamin Unit at the Institute of Molecular Medicine, Trinity College, Dublin shows that Iron and folic Acid Supplements bring about significant reduction for neural tube defects. Professor John Scott the founder and lead researcher states that: “when IFA is taken correctly before and during pregnancy, it can prevent up to 72 percent of these cases.” “The most serious form of neural tube defect is hydrocephalus. If not treated, the baby will not leave long after birth. Babies born with Spinal Bifida face a life with serious multiple disabilities.”
Hydrocephalus also known as water in the brain causes pressure inside the skull and progressive enlargement of the head and mental disability. Hydrocephalus is surgically treated by inserting a tube in the cerebral ventricles to drain the excess fluid.