Prevalence of malaria parasitaemia in school children from two districts of Ghana earmarked for indoor residual spraying: a cross-sectional study

Nimako Sarpong, Ellis Owusu-Dabo, Benno Kreuels, Julius N Fobil, Sylvester Segbaya, Frank Amoyaw, Andreas Hahn, Thomas Kruppa, Jürgen May, Nimako Sarpong, Ellis Owusu-Dabo, Benno Kreuels, Julius N Fobil, Sylvester Segbaya, Frank Amoyaw, Andreas Hahn, Thomas Kruppa, Jürgen May

Abstract

Background: Indoor residual spraying (IRS) is considered a valuable transmission control measure against malaria but exact efficacy data are not available for many epidemiological settings. This study was conducted to determine indicators for malaria epidemiology and transmission among school children as baseline assessment before IRS implementation in Ghana.

Methods: A cross-sectional study was conducted in Adansi South District of the Ashanti Region and Wa West District of the Upper West Region of Ghana. Malarial parasitaemia and anaemia were determined in pupils between the ages of 2 and 14 years from Early Childhood Development Centres and primary schools. Plasmodium falciparum parasitaemia was detected by light microscopy.

Results: Out of 1,649 pupils who were enrolled at participating schools, 684 were positive for plasmodia resulting in a baseline parasitaemia prevalence of 41.5%. Parasite rate was similar in the two districts (42.0% in Adansi South and 40.7% in Wa West), but differed across the nine sentinel schools ranging from 21 to 63% (p < 0.001). The mean haemoglobin concentration was 11.3 g/dl [standard deviation (SD) ±2.1]. Pupils who had moderate to mild anaemia (7.0-10.9 g/dl) constituted 41.7% of the study sample.

Conclusion: The burden of parasitaemia, malaria and anaemia is a major public health problem among school children in rural Ghana with extensive heterogeneity between schools and warrants further investment in intervention measures.

References

    1. WHO (2014) World Malaria Report 2014. World Health Organization, Geneva. (Available: )
    1. WHO (2011) World Malaria Report 2011. World Health Organization, Geneva. (Available: )
    1. Ronald LA, Kenny SL, Klinkenberg E, Akoto AO, Boakye I, Barnish G, et al. Malaria and anaemia among children in two communities of Kumasi, Ghana: a cross-sectional survey. Malar J. 2006;5:105. doi: 10.1186/1475-2875-5-105.
    1. Murphy SC, Breman JG. Gaps in the childhood malaria burden in Africa: cerebral malaria, neurological sequelae, anaemia, respiratory distress, hypoglycemia, and complications of pregnancy. Am J Trop Med Hyg. 2001;64:57–67.
    1. Greenwood BM. Asymptomatic malaria infections: do they matter? Parasitol Today. 1987;3:206–214. doi: 10.1016/0169-4758(87)90061-5.
    1. Kobbe R, Neuhoff R, Marks F, Adjei S, Langefeld I, von Reden C, et al. Seasonal variation and high multiplicity of first Plasmodium falciparum infections in children from a holoendemic area in Ghana, West Africa. Trop Med Int Health. 2006;11:613–619. doi: 10.1111/j.1365-3156.2006.01618.x.
    1. Abonuusum A, Owusus-Daako K, Tannich E, May J, Garms R, Kruppa T. Malaria transmission in two rural communities in the forest zone of Ghana. Parasitol Res. 2011;108:1465–1471. doi: 10.1007/s00436-010-2195-1.
    1. Appawu M, Owusu-Agyei S, Dadzie S, Asoala V, Anto F, Koram K, et al. Malaria transmission dynamics at a site in northern Ghana proposed for testing malaria vaccines. Trop Med Int Health. 2004;9:164–170. doi: 10.1046/j.1365-3156.2003.01162.x.
    1. Kobbe R, Adjei S, Kreuzberg C, Kreuels B, Thompson B, Thompson PA, et al. Malaria incidence and efficacy of intermittent preventive in infants (IPTi) Malar J. 2007;6:163. doi: 10.1186/1475-2875-6-163.
    1. Bierrenbach A (2008) Steps in applying probability proportional to size (PPS) and calculating basic probability weights. In: Training workshops on TB prevalence surveys. World Health Organization. . Accessed 12 June 2015
    1. Greenwood BM, Armstrong JR. Comparison of two simple methods for determining malaria parasite density. Trans R Soc Trop Med Hyg. 1991;85:186–188. doi: 10.1016/0035-9203(91)90015-Q.
    1. Kreuels B, Kobbe R, Adjei S, Kreuzberg C, von Reden C, Bäter K, et al. Spatial variation of malaria incidence in young children from a geographically homogeneous area with high endemicity. J Infect Dis. 2008;197:85–93. doi: 10.1086/524066.
    1. May J, Mockenhaupt FP, Ademowo OG, Falusi AG, Olumese PE, Bienzle U, et al. High rate of mixed and subpatent malarial infections in southwest Nigeria. Am J Trop Med Hyg. 1999;61:339–343.
    1. Brooker S, Guyatt H, Omumbo J, Shretta R, Drake L, Ouma J. Situation analysis of malaria in school-aged children in Kenya—what can be done? Parasitol Today. 2000;16:183–186. doi: 10.1016/S0169-4758(00)01663-X.
    1. Colbourne MJ. The effect of malaria suppression in a group of Accra school children. Trans R Soc Trop Med Hyg. 1955;49:556–569.
    1. Kimbi HK, Nformi D, Ndamukong KJ. Prevalence of asymptomatic malaria among school children in an urban and rural area in the Mount Cameroon region. Cent Afr J Med. 2005;51:5–10.
    1. Bejon P, Mwangi T, Lowe B, Peshu N, Hill AV, Marsh K. Clearing asymptomatic parasitaemia increases the specificity of the definition of mild febrile malaria. Vaccine. 2007;25:8198–8202. doi: 10.1016/j.vaccine.2007.07.057.
    1. Kreuels B, Kreuzberg C, Kobbe R, Ayim-Akonor M, Apiah-Thompson P, Thompson B, et al. Differing effects of HbS and HbC traits on uncomplicated falciparum malaria, anemia, and child growth. Blood. 2010;115:4551–4558. doi: 10.1182/blood-2009-09-241844.
    1. Clarke SE, Brooker S, Njagi JK, Njau E, Estambale B, Muchiri E, et al. Malaria morbidity among school children living in two areas of contrasting transmission in Western Kenya. Am J Trop Med Hyg. 2004;71:732–738.
    1. Kreuels B, Kobbe R, Adjei S, Kreuzberg C, von Reden C, Bäter K, et al. Spatial variation of malaria incidence in young children from a geographically homogeneous area with high endemicity. J Infect Dis. 2008;197:85–93. doi: 10.1086/524066.
    1. Sarpong N, Loag W, Fobil J, Meyer CG, Adu-Sarkodie Y, May J, et al. National health insurance coverage and socio-economic status in a rural district of Ghana. Trop Med Int Health. 2010;15:191–197. doi: 10.1111/j.1365-3156.2009.02439.x.

Source: PubMed

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