Impact of Intermittent Screening and Treatment for Malaria Among School Children in Kenya: A Cluster Randomized Trial

69 Pages Posted: 20 Apr 2016

See all articles by Katherine Halliday

Katherine Halliday

London School of Hygiene and Tropical Medicine - Faculty of Infectious and Tropical Diseases

George Okello

KEMRI-Wellcome Trust - Health Systems and Social Science Research Group

Elizabeth Turner

Duke University - Department of Biostatistics and Bioinformatics

Kiambo Njagi

Ministry of Public Health & Sanitation - Division of Malaria Control

Carlos Mcharo

Health and Literacy Intervention Project

Juddy Kengo

Health and Literacy Intervention Project

Elizabeth Allen

London School of Hygiene and Tropical Medicine - Faculty of Epidemiology and Population Health

Margaret Dubeck

College of Charleston

Matthew Jukes

Harvard University - Harvard Graduate School of Education

Simon Brooker

London School of Hygiene and Tropical Medicine - Faculty of Infectious and Tropical Diseases

Date Written: February 1, 2014

Abstract

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.

Keywords: Health Monitoring & Evaluation, Disease Control & Prevention, Primary Education, Adolescent Health, Educational Sciences

Suggested Citation

Halliday, Katherine and Okello, George and Turner, Elizabeth and Njagi, Kiambo and Mcharo, Carlos and Kengo, Juddy and Allen, Elizabeth and Dubeck, Margaret and Jukes, Matthew and Brooker, Simon, Impact of Intermittent Screening and Treatment for Malaria Among School Children in Kenya: A Cluster Randomized Trial (February 1, 2014). World Bank Policy Research Working Paper No. 6791, Available at SSRN: https://ssrn.com/abstract=2404641

Katherine Halliday

London School of Hygiene and Tropical Medicine - Faculty of Infectious and Tropical Diseases ( email )

Keppel St.
Bloomsbury, London, WC1E 7HT
United Kingdom

George Okello (Contact Author)

KEMRI-Wellcome Trust - Health Systems and Social Science Research Group

Kilifi
Kenya

Elizabeth Turner

Duke University - Department of Biostatistics and Bioinformatics

Durham, NC 27708
United States

Kiambo Njagi

Ministry of Public Health & Sanitation - Division of Malaria Control

Nairobi
Kenya

Carlos Mcharo

Health and Literacy Intervention Project

Ukunda
Kenya

Juddy Kengo

Health and Literacy Intervention Project

Ukunda
Kenya

Elizabeth Allen

London School of Hygiene and Tropical Medicine - Faculty of Epidemiology and Population Health

London, WC1E 7HT
United Kingdom

Margaret Dubeck

College of Charleston

66 George Street
Charleston, SC 29424
United States

Matthew Jukes

Harvard University - Harvard Graduate School of Education

6 Appian Way
Cambridge, MA 02138
United States

Simon Brooker

London School of Hygiene and Tropical Medicine - Faculty of Infectious and Tropical Diseases

Keppel St.
Bloomsbury, London, WC1E 7HT
United Kingdom

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