Abstract
BackgroundMalaria among school children is increasingly receiving attention, yet the burden of malaria in this age group is poorly defined. This study presents data on malaria morbidity among school children in Bungoma county, western Kenya.MethodThis study investigated the burden and risk factors of Plasmodium falciparum infection, clinical malaria, and anaemia among 2346 school children aged 5–15 years, who were enrolled in an individually randomized trial evaluating the effect of anthelmintic treatment on the risks of malaria. At baseline, children were assessed for anaemia and nutritional status and information on household characteristics was collected. Children were followed-up for 13 months to assess the incidence of clinical malaria by active detection, and P. falciparum infection and density evaluated using repeated cross-sectional surveys over 15 months.ResultsOn average prevalence of P. falciparum infection was 42 % and ranged between 32 and 48 % during the five cross-sectional surveys. Plasmodium falciparum prevalence was significantly higher among boys than girls. The overall incidence of clinical malaria was 0.26 episodes per person year (95 % confidence interval, 0.24–0.29) and was significantly higher among girls (0.23 versus 0.31, episodes per person years). Both infection prevalence and clinical disease varied by season. In multivariable analysis, P. falciparum infection was associated with being male, lower socioeconomic status and stunting. The risk of clinical malaria was associated with being female.ConclusionThese findings show that the burden of P. falciparum parasitaemia, clinical malaria and anaemia among school children is not insignificant, and suggest that malaria control programmes should be expanded to include this age group.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1176-y) contains supplementary material, which is available to authorized users.
Highlights
Malaria among school children is increasingly receiving attention, yet the burden of malaria in this age group is poorly defined
The risk of clinical malaria was associated with being female. These findings show that the burden of P. falciparum parasitaemia, clinical malaria and anaemia among school children is not insignificant, and suggest that malaria control programmes should be expanded to include this age group
A total of 1853 (79 %) children reported sleeping under a bed net the previous night and the proportion did not vary between boys and girls
Summary
Malaria among school children is increasingly receiving attention, yet the burden of malaria in this age group is poorly defined. Due to a decline in transmission and exposure in some areas, the peak age of clinical attacks of malaria is shifting from very young (under five) to older children [3, 15]. Both asymptomatic and clinical malaria have been shown to have a negative impact on the health and cognitive development of school children [16,17,18,19,20,21,22]. As school children are rarely treated for these asymptomatic infections, they may contribute significantly to the infectious reservoirs of malaria [27, 28]
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