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Malaria and syphilis are leading infectious causes of stillbirth

Staff writer |
Losing a child late in pregnancy is a cause of extraordinary grief and for many reasons, stillbirths are routinely under-reported.

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That has made it difficult to quantify the global burden, to determine the various causes, and to develop appropriate interventions to tackle the problem.

New research on ending preventable stillbirths, published in the Lancet medical journal, estimates that 2.6 million pregnancies ended in stillbirth worldwide last year. Of these, 98 percent occurred in low- and middle-income countries.

Malaria and syphilis are responsible for more stillbirths than any other infections, causing more than 420,000 stillbirths between them every year.

"In sub-Saharan Africa, three of every 10 stillbirths are due to malaria or syphilis. Although these figures are grim, there is reason for hope. We know how to intervene," Matthew Chico and Rosanna Peeling, London School of Hygiene & Tropical Medicine write.

An anti-malarial medication called SP (sulphadoxine-pyrimethamine) should be given to pregnant women who live in areas with moderate to high malaria transmission to help protect against malaria, and in turn, safeguard against a range of associated problems including stillbirth, preterm birth, low birthweight, maternal anaemia, and neonatal death.

This is part of the Global Call to Action recommended by the World Health Organization.

The best course of action is to provide SP at a cost of just $0.20 per course until a better option is available, coupled with using insecticide-treated bednets at night to prevent the malaria-transmitting mosquitoes from biting women.

As for syphilis, around 4 or 5 percent of pregnant women in East and Southern Africa are infected with it. A recent study in Tanzania showed 25 percent of pregnant women with untreated infection delivered a stillborn baby and 50 percent of all stillbirths were attributed to syphilis in women who had not been screened.

A second study in the same setting showed that treatment with a single dose of penicillin before 28 weeks of pregnancy cured maternal and congenital syphilis and prevented stillbirth and low birthweight attributable to the infection. The cost of intervention was just $1.4 per woman screened.

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