Abstract
BackgroundChildren represent a high-risk group for malaria worldwide. Among people in Thailand who have malaria during childhood, some may have multiple malaria attacks during their lifetime. Malaria may affect neurological cognition in children, resulting in short-term impairment of memory and language functions. However, little is known regarding the long-term effects of malaria infection on cognitive function. This study examines the long-term impact of malaria infection on school performance among school children living in a malaria-endemic area along the Thai–Myanmar border.MethodsA retrospective cohort study was conducted among school children aged 6–17 years in a primary-secondary school of a sub-district of Ratchaburi Province, Thailand. History of childhood malaria infection was obtained from the medical records of the sole malaria clinic in the area. School performance was assessed by using scores for the subjects Thai Language and Mathematics in 2014. Other variables, such as demographic characteristics, perinatal history, nutritional status, and emotional intelligence, were also documented.ResultsA total of 457 students were included, 135 (30 %) of whom had a history of uncomplicated malaria infection. About half of the malaria-infected children had suffered infection before the age of four years. The mean scores for both Mathematics and Thai Language decreased in relation to the increasing number of malaria attacks. Most students had their last malaria episode more than two years previously. The mean scores were not associated with duration since the last malaria attack. The association between malaria infection and school performance was not significant after adjusting for potential confounders, including gender, school absenteeism over a semester term, and emotional intelligence.ConclusionsThis study characterizes the long-term consequences of uncomplicated malaria disease during childhood. School performance was not associated with a history of malaria infection, considering that most students had their last malaria infection more than two years previously. These findings indicate that the impact of uncomplicated malaria infection on school performance may not be prolonged.
Highlights
Children represent a high-risk group for malaria worldwide
Previous studies suggested that childhood malaria infection is associated with poor school performance [14,15,16,17,18]
The long-term effect of malaria infection on cognitive function, as indicated by school performance in mathematics and language, was assessed among children living in an area of low malaria transmission
Summary
Children represent a high-risk group for malaria worldwide. Among people in Thailand who have malaria during childhood, some may have multiple malaria attacks during their lifetime. Malaria infection may affect cognitive performance, which leads to impairment of memory and language functions [10,11,12,13]. Multiple attacks of uncomplicated malaria in childhood may affect cognitive function and school performance [12]. Most findings were based on cross-sectional or cohort studies of short duration (1–2 years), which only represent the short-term impact of malaria infection on cognitive functions in children [14,15,16,17,18]. There is still a lack of evidence regarding the long-term impact of uncomplicated malaria infection on cognitive function among children in settings of low endemicity where a relatively large atrisk population resides [19]
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