The High Burden of Malaria in Primary School Children in Southern Malawi

Don P Mathanga, Katherine E Halliday, Mpumulo Jawati, Allison Verney, Andrew Bauleni, John Sande, Doreen Ali, Rebecca Jones, Stefan Witek-McManus, Natalie Roschnik, Simon J Brooker, Don P Mathanga, Katherine E Halliday, Mpumulo Jawati, Allison Verney, Andrew Bauleni, John Sande, Doreen Ali, Rebecca Jones, Stefan Witek-McManus, Natalie Roschnik, Simon J Brooker

Abstract

Malaria among school children has received increased attention recently, yet there remain few detailed data on the health and educational burden of malaria, especially in southern Africa. This paper reports a survey among school children in 50 schools in Zomba District, Malawi. Children were assessed for Plasmodium infection, anemia, and nutritional status and took a battery of age-appropriate tests of attention, literacy, and numeracy. Overall, 60.0% of children were infected with Plasmodium falciparum, 32.4% were anemic and 32.4% reported sleeping under a mosquito net the previous night. Patterns of P. falciparum infection and anemia varied markedly by school. In multivariable analysis, higher odds of P. falciparum infection were associated with younger age and being stunted, whereas lower odds were associated with reported net use, higher parental education, and socioeconomic status. The odds of anemia were significantly associated with P. falciparum infection, with a dose-response relationship between density of infection and odds of anemia. No clear relationship was observed between health status and cognitive and educational outcomes. The high burden of malaria highlights the need to tackle malaria among school children.

© The American Society of Tropical Medicine and Hygiene.

Figures

Figure 1.
Figure 1.
The location of TA Chikowi, Zomba District, in Malawi (A) and the geographical distribution of (B) Plasmodium falciparum infection, (C) anemia, and (D) reported mosquito net use (adjusted for age and sex) in 50 schools in TA Chikowi, Zomba District, southern Malawi, 2011.
Figure 2.
Figure 2.
Data flow diagram for the education and health surveys conducted in 50 schools in TA Chikowi, Zomba District, southern Malawi, 2011.

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