CHAPTER ONE
INTRODUCTION
Malaria is an infections disease caused by a parasite, plasmodium which infects red blood cells. Historical records suggest that malaria has infected human since the beginning of mankind. The name “mal aria” (Meaning bad air in Italian) was first used in English in 1740 by H. Walpole when describing the disease. The term was shortened to malaria in 20th century. Laveran; in 1880 was the first to identify parasites in human blood. In 1889, Ross discovered that mosquitoes transmit malaria.
        Malaria continues to be a cause of great suffering in tropical and sub-tropical regions of the world (Brabin, 1989). Currently, it is endemic in about 100 countries affecting 4% of world’s population. Malaria has been eliminated or effectively suppressed in several parts of the world in past decade but is now undergoing resurgence (Gilles, 1987). It is returning to areas from which it had been eradicated as well as spreading into new areas such as central Asia and Eastern Europe. Despite global economic development people are dying from malaria now than 30 years ago.
EPIDEMIOLOGY AND CLINICAL FEATURES
Malaria in pregnancy remain a notable cause of maternal and prenatal morbidity and mortality, often associated with maternal illness, maternal anemia, low birth weight, preterm delivery and prenatal loss especially in the primigravidae. In semi-immune pregnant women, malaria infection may be asymptomatic, pregnant women are at risk of clinical disease compared to non-pregnant women at all levels of endemicity (Harrison, 1995). There is unparasitized blood cells leading to a greater level of anemia than can be explained on the basis of RBCS parasitization alone (who,1991).
Primgravidity is a known risk factor in pregnancy. It only becomes more prevalent in primigravide but also intense (Jimoh, 2003). The peak prevalence of parasitemia will be altered by prior anti malaria    injection. In a study from Madan, Papua New Guinea, the peak prevalence in primigravidae studied reached 55% to compared to 86% in other study from Kenya (flemming, 1986). Studies have also suggested that the highest prevalence of infection occurs in the 2nd trimester with inflection rate at delivery and in the postnatal period approximating to levels in non pregnant women possibly due to immunity boosting during pregnancy (Akindele, et al 1993)
CAUSATIVE AGENT OF MALARIA
Malaria is caused by five (5) species of plasmodium. They are as follows:
plasmodium vivax (p. vivax) – This species is milder and generally not fatal. However, infected people still need treatment because their untreated progress can also cause a host of health problems. (Rogreson et al 2007)
Plasmodium  Malariae ( P. Malaria) This species also is milder and not fatal. The infected person should be properly treated to avoid further health problems. This species is known to stay in the blood of the affected for several years (WHO, 2008).
Plasmodium  Ovale (P. Ovale) -  It is also mild and as well need adequate treatment to avoid serious health condition. It stays in the liver of the affected person even for years without symptoms. (Neeru, 2005)
Plasmodium Falciparum (P. Falciparum) This is the most serious form of the disease. It is most common in Africa, especially sub-saharan Africa. It needed thorough and adequate treatment of the affected person (Okwa, 2003).
Plasmodium knowlesi (P. Knowlesi). This causes malaria in macaques but can also infect humans.
INCUBATION PERIOD OF PLASMODIUM
This refers to how long it takes from initial infection to the appearance of symptoms. This generally depends on the type (species) of parasite.
P. falicparum      -       9 to 14 days
P. Vivax             -       12 to 18 days
P. vivax             -       12 to 18 days
P. malaria -       18-40 days
However, incubation periods can vary from as little as 7 days to several months for P. vivax and p. ovale
SIGNS AND SYMPTOMS
The signs and symptoms of malaria typically begin 8-25 days following infections. However, symptoms may occur later in those who have taken antimalaria medication as prevention. The signs and symptoms may include the following
Fever
Shivering
Joint pain (Arthralgia)
Vomiting
Hemolytic anemia
Jaundice
Convulsion
Sudden coldness followed by rigor
Severe headache
Enlarged spleen etc.