Impact of Intermittent Screening and Treatment for Malaria among School Children in Kenya : A Cluster Randomized Trial
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World Bank, Washington, DC
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This paper investigates the effects of
intermittent screening and treatment of malaria on the
health and education of school children in an area of
low-to-moderate malaria transmission. A cluster randomized
trial was implemented with 5,233 children in 101 government
primary schools on the south coast of Kenya in 2010-12. The
intervention was delivered to children randomly selected
from classes 1 and 5 who were followed up twice across 24
months. Once during each school term, public health workers
used malaria rapid diagnostic tests to screen the children.
Children who tested positive were treated with a six-dose
regimen of artemether-lumefantrine. Given the nature of the
intervention, the trial was not blinded. The primary
outcomes were anemia and sustained attention and the
secondary outcomes were malaria parasitaemia and educational
achievement. The data were analyzed on an intention-to-treat
basis. Anemia in this setting in Kenya, intermittent
screening and treatment, as implemented in this study, is
not effective in improving the health or education of school
children. Possible reasons for the absence of an impact are
the marked geographical heterogeneity in transmission, the
rapid rate of reinfection following artemether-lumefantrine
treatment, the variable reliability of malaria rapid
diagnostic tests, and the relative contribution of malaria
to the etiology of anemia in this setting.
Palabras clave
ACADEMIC ACHIEVEMENT, ACCESS TO FOOD, ACCESS TO TREATMENT, ACHIEVEMENT, ACHIEVEMENT TESTS, ADJUSTMENT, ADOLESCENTS, AGED, AMODIAQUINE, ANEMIA, ANEMIA CONTROL, ANOPHELES MOSQUITOES, ANTENATAL CARE, ARITHMETIC, ATTENTION, BASIC EDUCATION, BASIC EDUCATION SECTOR, BLIND, BLOOD SAMPLES, BURDEN OF MALARIA, CERVICAL CANCER, CHILD DEVELOPMENT, CHILDHOOD, CLASSROOM, COGNITION, COGNITIVE DEVELOPMENT, COGNITIVE IMPAIRMENT, COGNITIVE PERFORMANCE, COMPARATIVE EDUCATION, DEWORMING, DIAGNOSIS, DIAGNOSTIC TESTS, DISEASE, DISEASE BURDEN, DROWNING, DRUG ADMINISTRATION, DRUG RESISTANCE, DRUG TREATMENT, DRUGS, EDUCATIONAL ATTAINMENT, EDUCATIONAL OUTCOMES, EDUCATIONAL PERFORMANCE, EFFECTIVE EDUCATION, EFFECTIVE TEACHING, ENROLLMENT, EPIDEMIOLOGY, ETHICS, EXAM, FEMALE ADOLESCENTS, FEMALES, FREE SCHOOLS, GAMETOCYTE CARRIAGE, GOVERNMENT PRIMARY SCHOOLS, HEADACHE, HEALTH FACILITY, HEALTH INTERVENTIONS, HEALTH OUTCOMES, HEALTH SURVEYS, HEALTH WORKERS, HEMOGLOBIN CONCENTRATION, HIGH MALARIA TRANSMISSION, HIGH RISK OF INFECTION, HIV, HUMAN BIOLOGY, HYGIENE, IMPACT OF MALARIA, INFANTS, INFECTION, INFECTION RATES, INFECTIONS, INFORMED CONSENT, INTERVENTION, IRON, LEARNING, LEUKEMIA, LITERACY, LITERACY INSTRUCTION, LYMPHATIC FILARIASIS, MALARIA, MALARIA CONTROL, MALARIA DIAGNOSIS, MALARIA ENDEMIC COUNTRIES, MALARIA IN PREGNANCY, MALARIA INFECTION, MALARIA INFECTIONS, MALARIA INTERVENTIONS, MALARIA MORBIDITY, MALARIA PARASITES, MALARIA PREVENTION, MALARIA SYMPTOMS, MALARIA TRANSMISSION, MALARIA TREATMENTS, MALARIA-ENDEMIC AREAS, MASS SCREENING, MEDICAL RESEARCH, MENTAL DEVELOPMENT, MIGRATION, MODELING, MORBIDITY, MORBIDITY AND MORTALITY, MORTALITY, MOSQUITO NET, NATIONAL SURVEILLANCE, NEGATIVE EFFECTS, NUMERACY, NURSES, NUTRITION, NUTRITIONAL STATUS, OLDER CHILDREN, PARASITIC INFECTIONS, PARASITOLOGY, PARENTAL EDUCATION, PNEUMONIA, POLYMERASE CHAIN REACTION, PREGNANCY, PREGNANT WOMEN, PREVALENCE, PREVENTION OF MALARIA, PREVENTIVE TREATMENT, PRIMARY SCHOOL, PRIMARY SCHOOL ACCESS, PRIMARY SCHOOLING, PRIMARY SCHOOLS, PROPHYLAXIS, PUBLIC HEALTH, SCHOOL HEALTH, SCHOOL QUALITY, SCHOOLING, SCREENING, SEX, SIBLINGS, SOCIAL SCIENCE RESEARCH, STOMACH, TEACHER EDUCATION, TEACHERS, TEACHING METHODS, THERAPY, TRAUMA, TREATMENT, TREATMENT OF MALARIA, TROPICAL DISEASES, TROPICAL MEDICINE, VECTORS, VOMITING, WORKERS, YELLOW FEVER, Microdata Set