The cognitive burden of severe malaria in the Ugandan classroom and the effects of a computerized intervention

Abstract

IntroductionDue to the increased availability of anti-malarial treatments and the prevalence of malarial infection among vulnerable populations leading to cognitive impairment, malaria has become a leading cause of pediatric cognitive impairment in sub-Saharan Africa. ObjectivesTo examine the effects of malaria-induced cognitive impairment on school performance as an indicator of health and effects of a computerized intervention on school performance over time. DesignSecondary analysis. Sample216 school reports were collected from three hundred Ugandan children, aged five to twelve, enrolled in a randomized controlled trial. MeasurementsAcademic subjects (English, reading, writing, arithmetic, and Luganda); scores were standardized on an ordinal scale from one to five. ResultsAt baseline, malaria had no effect on academic performance, but age and socio-economic status had some effect. At one-year, there was no effect of the intervention on academic change over time; however, factors such as sex and home environment did demonstrate some effect on performance. ConclusionsThe results were unable to support the hypotheses that survivors of SM would demonstrate lower school performance than healthy comparisons and that the cognitive intervention would improve the performance of survivors. This suggests that future interventions ought to consider the influence of age, sex, and socio-economic status when caring for the cognitive needs of children in order to facilitate their ability to achieve academic success and, thus, improved quality of life.