Mosquito-Borne Diseases Hit Young, Pregnant the Hardest

Thursday May 6 2004
By Corinne Purtill

Malaria in pregnant women can cause miscarriages and underweight newborns. Children who suffer from dengue fever can develop severe and often fatal hemorrhages. And both diseases contribute to anemia, a blood condition already affecting more than half of all women and children in Cambodia.

The ravages of malaria and dengue are particularly devastating for pregnant women and children. Already beset by compromised immune systems and rampant malnutrition, those living in remote areas face severe consequences from such diseases, doctors said this week.

Malaria is a parasite that grows inside red blood cells and eventually splits and destroys them. The loss of red blood cells can lead to anemia, a condition that affects nearly two-thirds of Cambodian children—a rate higher than any other country in east Asia and the Pacific, according to a report from the UN Children’s Fund.

In pregnant women, reduced red blood cell flow to the fetus can cause low birth weight. And it is a common  occurrence—58 percent of Cambodian women are iron deficient, and Unicef estimates that 520 pregnant women die each year from severe anemia.

“They are more susceptible to the disease,” said Chan Theary, executive director of the Reproductive and Child Health Alliance, referring to pregnant women with malaria.

In addition, the chronic, high fevers symptomatic of malaria and dengue can cause miscarriages, Dr Phanita Yos, a physician at Naga Clinic in Phnom Penh, said Wednesday.

Most pregnant women in Cambodia are older than 15, drastically reducing their risk of dengue fever, Phanita Yos said. But young children have not yet developed antibodies to the virus, and therefore are more likely to catch the disease.

Dengue fever causes fluid from blood vessels to leak into the tissues, leading to severe dehydration that will cause shock if not treated with intravenous fluid, said Dr Rathi Guhadasan, medical education coordinator at Angkor Hospital for Children in Siem Reap.

And the destruction of blood vessels can cause hemorrhages. Sometimes bleeding is localized to the gums or nose that can be treated with blood transfusions. But in the worst cases, children may suffer from uncontrolled—and frequently fatal—bleeding.

If patients wait until this stage to seek medical care, the hemorrhages are nearly always fatal, Guhadasan said.

Lack of education about malaria and dengue prevention contributes to the prevalence of the diseases in the province’s rural areas, she said.

“They may have a bed net but don’t use it properly,” she said of the residents of the nearest malaria-ridden area, about 30 km from the hospital in Siem Reap town. “A lot of people have the misconception that malaria is transmitted by water, not the mosquito, so they don’t protect themselves.”