Views from the London School of Hygiene & Tropical Medicine

Anopheles gambiae

School-based malaria screening and treatment not effective in improving health or educational achievement

A school-based malaria screening and treatment program in rural coastal Kenya had no benefits on the health and education of school children, according to a study in PLOS Medicine.

The study, led by the London School of Hygiene & Tropical Medicine, included 5,233 children from 101 government schools.

Half of the schools received malaria parasite screening once a school term using a rapid diagnostic test, followed by treatment with the anti-malarial drug artemether-lumefantrine for all children who tested positive. 17.5% of the children screened in these schools tested positive for malaria.

The pupils’ health and educational achievement in these schools was then compared to that of pupils in schools that did not receive the intermittent screening and treatment programme.

Researchers followed up pupils at 12 and 24 months after the intervention and found no difference between the proportion of children with anaemia and the proportion of children who tested positive for malaria parasites between the two groups. At nine and 24 months, there was also no benefit to class attention or achievement scores for the pupils who were screened and treated.

Lead author, Katherine Halliday of the London School of Hygiene & Tropical Medicine, said: “In contrast to the beneficial impact of previous school-based malaria control our findings show there are no health or education benefits of implementing school-based intermittent screening and treatment programs with artemether-lumefantrine in a low to moderate transmission setting such as this study site.

“Nevertheless, our results do highlight a potential role for schools as screening platforms whereby pockets of high transmission can be identified for targeted malaria control.”

Halliday KE, Okello G, Turner EL, Njagi K, Mcharo C, et al. Impact of Intermittent Screening and Treatment for Malaria among School Children in Kenya: A Cluster Randomised Trial. PLOS Medicine. DOI:10.1371/journal.pmed.1001594

(Image: Malaria-transmitting Anopheles gambiae mosquito. Credit: LSHTM)

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