Malaria remains one of the most dangerous yet preventable threats facing pregnant women across sub-Saharan Africa. In endemic regions, pregnancy carries not only hope, but also a silent risk that can endanger both mother and unborn child.
The danger often hides in plain sight. Early signs, fever, fatigue, headaches and body aches, are easily dismissed as normal pregnancy discomfort, allowing the illness to progress unnoticed.
This overlap leads to delays in seeking treatment, giving the infection time to cause serious complications.
According to Dr Fredrick Kairithia, a consultant obstetrician and gynaecologist at Calgary Healthcare in Nairobi, malaria in pregnancy behaves differently from typical infections.
“When a woman becomes pregnant, her immunity naturally goes down. It makes it easier for malaria parasites to thrive in her body, especially for first-time mothers who have not built enough resistance,” he explains.
One of the most serious complications is maternal anaemia. Malaria destroys red blood cells, leaving a woman weak, dizzy and at risk of life-threatening complications.
“Severe anaemia can lead to heart strain, complications during delivery, and even maternal death if not managed early,” Dr Kairithia warns.
Malaria in pregnancy can also harm the baby. Parasites build up in the placenta, reducing oxygen and nutrients and leading to low birth weight, a major cause of infant illness and death.
Dr Josephine Okwoyo explains that placental malaria is especially dangerous because it often shows no symptoms in the mother, yet silently affects foetal growth, resulting in premature or underweight babies.
In high-risk areas like Kisumu County, where mosquito breeding is common due to water bodies such as Lake Victoria, many cases go unnoticed. Colleta Achieng’ recalls mistaking malaria symptoms for normal pregnancy fatigue until a routine check-up revealed the infection.
For some mothers, the impact is severe. Naliaka, a 27-year-old from Trans Nzoia County, recalls how malaria nearly cost her baby’s life. She delayed seeking care due to distance and transport costs, assuming it was normal fatigue.
“By the time I went to hospital, I was very weak. My blood levels were low, and my baby was not growing well,” she says.
She later received treatment and delivered safely, but her baby was born underweight and required special care.
In some cases, the consequences are more devastating. Malaria during pregnancy can lead to miscarriage, stillbirth or premature delivery, outcomes that carry deep emotional loss for families.
In Kenya, malaria is largely concentrated in 14 lake and coastal endemic counties: Kisumu, Siaya, Homa Bay, Migori, Busia, Vihiga, Bungoma, Kakamega, Lamu, Taita Taveta, Kilifi, Tana River, Mombasa and Kwale.
Prevention remains the strongest line of defence.
The use of insecticide-treated mosquito nets is one of the simplest and most effective measures.
Dr Okwoyo stresses that every pregnant woman should sleep under a treated mosquito net nightly, describing it as a simple habit that can save two lives. She also highlights intermittent preventive treatment (IPTp), administered during antenatal visits to clear and prevent malaria infections.
However, many women miss clinic visits due to distance, cost or fear of side effects, while others seek care only when already very ill. Environmental factors such as stagnant water and poor drainage further fuel infections.