Abortion

Abortion is the premature exit of the products of conception (the foetus, fetal membranes, and placenta) from the uterus. It is the loss of a pregnancy and does not refer to why that pregnancy was lost.

ACT

Artemisinin-based combination therapy: a combination of artemisinin or one of its derivatives with an antimalarial or antimalarial drugs of a different class. Artemisinin derivatives are not recommended in the first trimester of pregnancy.

Amodiaquine

Antimalarial. Safe to use in second and third trimesters of pregnancy.

Anaemia/anemia

A reduction in the number of circulating red blood cells or in the quantity of haemoglobin. In pregnancy usually defined as < 11 g/dl.

Anopheles

A genus of mosquito, some species of which can transmit human malaria.

Antibiotic

A drug that kills or slows the growth of bacteria or parasites. Example: Doxycycline.

Antibody

Also known as an immunoglobulin (Ig): it is a large Y-shaped protein produced by B-cells that is used by the immune system to identify and neutralize foreign objects such as bacteria, viruses, and parasites.

Antigen

Substance that prompts the generation of antibodies and can cause an immune response; used in vaccines.

Antimalarial

Drug directed against malaria.

Artemisinin-derivatives

Group of antimalarials derived from the Artemisia annua tree (annual wormwood). These include e.g. artesunate, artemether, dihydroartemisinin, artelinic acid, artenimol and artemotil. They can only be used as part of combination therapies. They can be used in the second and third trimesters of pregnancy.

Atovaquone-proguanil

Fixed drug combination antimalarial of atovaquone and proguanil; used for treatment and prevention of malaria. Most common tradename: Malarone. Can be used in second and third trimesters of pregnancy.

Artemether-lumefantrine

Fixed combination drug of artemether-lumefantrine for the treatment of malaria. Most common tradenames: Coartem and Riamet. Can be used in the second and third trimesters of pregnancy. Can only be used in first trimester if the risks associated with treatment outweigh the risks of malaria for the foetus and mother.

Azithromycin

Antibiotic that can also be used for the treatment of malaria in combination with another antimalarial. Can be used in all trimesters of pregnancy.

Burden

The impact of malaria on morbidity and mortality.

Chemoprophylaxis

The use of antimalarial drugs at regular intervals (daily, weekly) to prevent disease from infection with malarial parasites.

Congenital malaria

Malaria in a newborn or infant, transmitted from the mother via the placenta.

CDC

The Centers for Disease Control and Prevention, the US agency charged with health promotion, prevention of disease, injury and disability, and preparedness for new health threats. 

Chloroquine

An antimalarial drug that has been used extensively for the treatment and prevention of malaria; widespread resistance has now rendered it ineffective against P. falciparum, but it still maintains considerable efficacy for the treatment of P. vivax, P. ovale, and P. malariae infections. Chloroquine can be used in all trimesters of pregnancy.

Clindamycine

Antibiotic which is also used as antimalarial in combination with quinine; can be used in all trimesters.

CSA

Chondroitin sulfate A: an inflammatory protein implicated in mediating adhesion of P. falciparum malaria to the placenta.

DDT

Dichloro-Diphenyl-Trichloroethane is an insecticide used for indoor residual spraying (IRS). DDT may be associated with developmental and reproductive toxicity. Risks of IRS must be weighed against benefits of reduced malaria risk.

Doxycycline

A synthetic broad-spectrum antibiotic derived from tetracycline. It is used for malaria prophylaxis, but is not suitable for pregnant women.

EIR

Entomological inoculation rate; a measure of the intensity of malaria transmission in an area.

Edema/Oedema

The swelling of soft tissue as a result of fluid retention in the body. Can present as oedema around the ankles. Some swelling around the ankles can be normal during pregnancy because of the pressure of the foetus on the veins from the legs.

Elimination

The interruption of local mosquito-borne malaria transmission; reduction to zero of the incidence of locally transmitted infection caused by Plasmodia in a defined geographical area as a result of deliberate malaria control efforts; continued intervention measures are required to prevent reintroduction.

Eradication

Permanent reduction to zero of the global incidence of infection caused by Plasmodia as a result of deliberate malaria control efforts; intervention measures are no longer needed once eradication has been achieved.

Fansidar

Brand name for sulfadoxine-pyrimethamine, currently used for intermittent preventive treatment of malaria in pregnancy.

FDA

Food and Drug Administration. The FDA is an agency within the U.S. Public Health Service, which is a part of the Department of Health and Human Services. It evaluates and approves (or rejects) medication for the US market.

Fever

Although a fever technically is any body temperature above the normal 37 degrees C°, in practice a person is usually not considered to have a significant fever until the temperature is 37.5 or 38 degrees C°.

Foetus/fetus

The unborn offspring from the end of the eighth week after conception (when the major structures have formed) until birth. Up until the eighth week, the developing offspring is called an embryo.

Gestational age

Relates to the age of an embryo or foetus (or newborn infant).  In human obstetrics, gestational age is often defined as the time elapsed since fourteen days prior to fertilization. This is approximately the duration since the woman's last menstrual period (LMP) began. There is also a further distinction between the calendar gestational age, and the developmental gestational age determined by comparing an embryo or foetus to the average age of others that were at the same stage of development.

GIS

Geographic Information system.

GMP

Global Malaria Programme: the malaria programme of the World Health Organization.

Gravida

A gravida is a pregnant woman.

Gravidity

Gravidity indicates the number of times a woman has been pregnant, regardless of whether the pregnancies were interrupted (by abortion, or fetal death) or resulted in a live birth. The current pregnancy is included in this count.

HIV

Human immunodeficiency virus.

Hypoglycaemia

Blood glucose less than the lower value of normal. Blood sugar below 70 mg/dL is considered low. Hypoglycemia is common in malaria in pregnancy. In addition, quinine treatment can stimulate insluin secretion, reducing blood glucose.

Intra-uterine growth retardation (IUGR)

Intrauterine growth retardation or restriction (IUGR) refers to the poor growth of a baby while in the mother's womb during pregnancy. Specifically, it means the developing baby weighs less than 90% of other babies at the same gestational age.

Immunity

The condition of being immune to a certain condition. This can be innate (from birth) or conferred by a previous infection or immunization.

Infant

Child between the age of 1-12 months.

Insecticide

A chemical used specifically to kill or control the growth of insects.

IPTp

Intermittent preventive treatment in pregnancy: the administration of a full course of an antimalarial treatment to pregnant women at specified time-points regardless of whether or not they are known to be infected. Sulfadoxine-pyrimethamine is currently recommended for IPTp by WHO.

IRS

Indoor residual spraying: a treatment of the interior of houses with insecticide to kill mosquitoes which land and rest on the walls.

ISTp

Intermittent screening and treatment in pregnancy: screening of a pregnant woman for malaria at each antenatal clinic visit, and treatment of positive cases with an effective antimalarial. For pregnant women the treatment drug may vary according to gestation and geographic location.

ITN

Insecticide treated net: a net which has been treated with insecticide to kill mosquitoes which come to rest on its surface.

LLN or LLIN

Long-lasting insecticide treated nets: a factory-treated mosquito net made with netting material that has insecticide incorporated within or bound around fibers; these nets are designed so as not to require re-treatment with insecticide during its recommended life (average duration of 3 years) under field conditions but this ultimately depends on usage.

LMP

Last menstrual period.

Low birth weight

A birth weight less than 2500 grams.

Malaria

An infectious disease caused by protozoan parasites from the Plasmodium family that can be transmitted by the bite of a female Anopheles mosquito or, more rarely, by a contaminated needle or via blood transfusion. Plasmodium falciparum causes the most severe malaria infections, some of which are fatal.

Maternal

Pertaining to the mother (e.g. maternal mortality rate) or related through the mother (e.g. maternal grandparents) or inherited from the mother (e.g. maternal X-chromosome).

Mefloquine

Antimalarial that is used for treatment and prophylaxis. Safe to use in second and third trimester. Probably safe in first trimester, although there is some ongoing debate about this (References: Schlagenhauf et al 2012 Clinical Infectious Diseases 54(11): e124-31, Nevin 2012 Clinical Infectious Diseases 55(8): 1167-8, Nevin 2012 Biology of Reproduction 87(3):65).

M&E or Monitoring and Evaluation

Monitoring and evaluation. Monitoring: routine tracking of key elements of programme performance through record keeping, regular reporting, surveillance systems or surveys. Evaluation is the episodic assessment of a programme and the extent to which a particular intervention may be linked to a specific output or result.

Miscarriage

Inadvertent loss of a pregnancy before the foetus is viable. A considerable proportion of pregnancies end in a miscarriage. Also called a spontaneous abortion.

Multigravidae

A multigravida or more specifically a gravida 2 (also secundigravida), gravida 3, and so on, is a woman who has been pregnant more than one time.

Multipara

A woman who has given birth more than once.

Neonate or newborn

An infant in the first 28 days after birth.

Nulligravida

A nulligravida or gravida 0 is a woman who has never been pregnant.

Oedema/edema

The swelling of soft tissue as a result of fluid retention in the body. Can present as oedema around the ankles. Some swelling around the ankles can be normal during pregnancy because of the pressure of the foetus on the veins from the legs.

PAM

Pregnancy associated malaria.

Parity

The number of times that a woman has given birth to a foetus with a gestational age of 24 weeks or more, regardless of whether the child was born alive or was stillborn.

PCR

Polymerase Chain Reaction; biochemical technology in molecular biology to amplify a single or a few copies of a piece of DNA across several orders of magnitude, generating thousands to millions of copies of a particular DNA sequence.

Paediatric

Pertaining to children.

Piperaquine

Antimalarial. Combined with dihydroartemisinin. Safety in pregnancy not yet fully defined.

Placenta

A temporary organ joining the mother and foetus, the placenta transfers oxygen and nutrients from the mother to the foetus, and permits the release of carbon dioxide and waste products from the foetus. It is roughly disk-shaped, and at full term measures about seven inches in diameter and a bit less than two inches thick. The upper surface of the placenta is smooth, while the under surface is rough. The placenta is rich in blood vessels. Can host malaria parasites, particularly among women in their first and second pregnancies.

Plasmodium

The parasite which causes malaria (paludism). Plasmodium is a protozoan, a single-celled organism able to divide only within a host cell.

Plasmodium falciparum

Malaria caused by this species (also called malignant or falciparum malaria) is the most dangerous form of malaria, with the highest rates of complications and mortality. P. falciparum can adhere to the placenta.

Plasmodium vivax

The most frequent and widely distributed cause of recurring malaria. Less virulent than P. falciparum, but can have severe complications as well. Does not adhere to the placenta, but can cause adverse effects in pregnancy.

Plasmodium ovale

Rare cause of malaria compared to P. falciparum, or P. vivax. Not much known about pathology in pregnancy.

Plasmodium malariae

Rare cause of malaria compared to P. falciparum, or P. vivax. Not much known about pathology in pregnancy.

PMI

President's Malaria Initiative (USA).

Pregnancy

The state of carrying a developing embryo or foetus within the female body. This condition can be indicated by positive results on an over-the-counter urine test, and confirmed through a blood test, ultrasound, detection of foetal heartbeat, or an X-ray. Pregnancy lasts for about nine months, measured from the date of the woman's last menstrual period (LMP). It is conventionally divided into three trimesters, each trimester approximately three months long.

Premature

Infant born before 37 weeks gestational age.

Preterm birth

Birth of a baby of less than 37 weeks gestational age. 

Primigravida

A woman in her first pregnancy.

Primipara

A woman who has given birth once.

Proguanil

Antimalarial used for prophylaxis only. Can be used in pregnancy. Used to be combined with chloroquine for prophylaxis.

Prophylaxis

Use of a drug for the prevention of a disease or condition.

Pyrethroids

A pyrethroid is an organic compound similar to the natural pyrethrins produced by the flowers of pyrethrums (Chrysanthemum cinerariaefolium and C. coccineum). Pyrethroids now constitute the majority of commercial household insecticides. In the concentrations used in such products, they may also have insect repellent properties and are generally harmless to human beings in low doses but can harm sensitive individuals. These insecticides are used to treat mosquito nets.

Quinine

A drug used to treat malaria, obtained from the bark of the cinchona tree. It is used mainly for treatment of severe malaria. It is safe to use in all trimesters of pregnancy.

Quickening

Stage in pregnancy when the pregnant woman feels the first foetal movements (usually around 18 weeks).

RBM Partnership

The Roll Back Malaria Partnership is a mechanism to facilitate and coordinate the planning and implementation of activities of individual partners to avoid duplication and fragmentation and to ensure optimal use of resources. Partners are malaria-endemic countries, bilateral and multilateral development partners, the private sector, local and global nongovernmental organizations, community-based organizations, foundations, and research and academic institutions. Each one maintains its independent function while at the same time contributing to RBM.

RDT

Rapid diagnostic test: RDTS for malaria comprise malaria antigen detection tests which are a group of commercially available tests that allow the rapid diagnosis of malaria by people who are not otherwise skilled in traditional laboratory techniques for diagnosing malaria or in situations where such equipment is not available.

Splenomegaly

Enlargement of the spleen, associated with any disease process that involves abnormal red blood cells being destroyed in the spleen such as malaria.

SP

Sulfadoxine-pyrimethamine: antimalarial drug mainly used for intermittent preventive treatment in pregnancy. Adult dose consists of a single dose of three tablets. Not recommended in the first trimester of pregnancy.

Stillbirth

A stillbirth occurs when the foetus dies in the uterus. 

Tetracycline

An antibiotic which is also used for treatment of malaria combined with other antimalarials. Not recommended for use in pregnancy.

Therapy

The treatment of disease.

Transmission intensity

The rate at which people in a given area are infected with malaria parasites by mosquitoes. In the WHO malaria report is it defined as: Low transmission - reported malaria case incidence from all species is less than one per 1000 population per year, but greater than zero, High transmission- the reported malaria case incidence from all species is one or more per 1000 population per year.

WHO

World Health Organization: malaria falls under the Global Malaria Programme in WHO