Training Manual for Preventive Malaria - Ministry of Health

CASE STUDY – DETECTION OF MALARIA AND ANAEMIA IN PREGNANCY
Instructions
Read and analyse this case study individually. When the others in your group have finished
reading it, answer the questions. When all groups have finished, we will discuss the case study
and answer each group developed.
Scenario
Theresa Amoako is 24 years old and reported at the antenatal clinic looking ill and weak. When
the midwife took her history she told the midwife that she was three months pregnant and had
been ill for the past week and although she took two tablets of chloroquine daily for five days,
she had not been improved.
Questions:
1. If you were the midwife, what important physical examination would you carry out?
2. What tests would you carry out and why?
3. What advice would you give to Theresa after treatment and why?
4. What additional measures would you take to ensure that Theresa recovers completely?
Answers:
1. Look for signs of anaemia by looking at the conjunctiva, tongue and nail beds. Examine the
abdomen to confirm that she is pregnant and estimate the period of gestation.
Take her temperature.
2. Send her to the laboratory for Hb, Sickling and blood film for malaria parasites tests. These
tests would enable health worker to confirm that she has malaria and anaemia and its severity. .
3. Theresa would be advised to:
a. Report all illnesses promptly to a skilled care provider because many causes of ill health have
serious consequences to pregnant mothers and their unborn babies (give examples).
b. Avoid self-medication because she might take the wrong dose as she did in her case and also
she would most probably make the wrong diagnosis and delay seeking proper medical treatment.
c. Eat a balanced diet including foods rich in iron and folate (such as meat, fish, liver etc) as well
as foods rich in vitamin A and C (such as dark green leafy vegetables and oranges respectively).
d. Sleep under an ITN to prevent malaria that can lead anaemia.
4. The additional measures I would take would be:
a. Advise her to comply with the treatment regimen as well as benefits and management of side
effects if any arises.
b. Give her an ANC schedule and advise her on the importance of keeping to it.
c. Give her iron and folate supplements
d. Start her on IPT as soon as quickening has occurred.
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