Status: Funded - Open
Malaria in school-age children: Defining new interventions to improve health and reduce transmission
Lauren Cohee, M.D.
BACKGROUND: Malaria remains a leading cause of death and illness among children in sub-Saharan Africa. In community-based surveys in Malawi, the prevalence of malaria in school-age children is 25%, which is 2.5 times higher than the prevalence in younger children and adults. School-age children also have the highest rates of infections containing gametocytes, the stage of the parasite that transmits malaria to mosquitoes and perpetuates infection to the next human host.
GAP: School-based malaria interventions have been shown to improve health and educational outcomes, however the optimal type of intervention has not been established and the possibility that school-based interventions can reduce malaria transmission has never been evaluated.
HYPOTHESIS: We postulate that prevalence of malaria infection among children attending school may be slightly less than school-age children in the community, but will still represent the largest portion of infection and the largest reservoir of gametocytes in the community. Rapid diagnostic tests will fail to detect a significant portion of these infections including infections that contain gametocytes.
METHODS: Cross-sectional school-based surveys of malaria will be conducted simultaneously with household surveys in the surrounding communities. Primary school students will be tested for malaria infection using rapid diagnostic tests as well as molecular methods to detect all malaria infections and infections containing gametocytes.
IMPACT: Results from this study will provide the evidence to design a clinical trial of a school-based malaria control intervention to improve the health and educational outcomes of the students as well as decrease malaria transmission in the community.
University of Maryland, Baltimore
United States, Malawi