Halliday K.E., Karanja P., Turner E.L., Okello G., Njagi K., Dubeck M.M., Allen E., Jukes M.C.H., Brooker S.J.
Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom; Malaria Public Health and Epidemiology Group, Kenya Medical Research Institute-Wellcome Trust Collaborative Programme, Nairobi, Kenya; Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, United Kingdom; Division of Malaria Control, Ministry of Public Health and Sanitation, Nairobi, Kenya; Department of Teacher Education, College of Charleston, SC, United States; Graduate School of Education, Harvard University, Cambridge, MA, United States
Halliday, K.E., Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom; Karanja, P., Malaria Public Health and Epidemiology Group, Kenya Medical Research Institute-Wellcome Trust Collaborative Programme, Nairobi, Kenya; Turner, E.L., Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, United Kingdom; Okello, G., Malaria Public Health and Epidemiology Group, Kenya Medical Research Institute-Wellcome Trust Collaborative Programme, Nairobi, Kenya; Njagi, K., Division of Malaria Control, Ministry of Public Health and Sanitation, Nairobi, Kenya; Dubeck, M.M., Department of Teacher Education, College of Charleston, SC, United States; Allen, E., Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, United Kingdom; Jukes, M.C.H., Graduate School of Education, Harvard University, Cambridge, MA, United States; Brooker, S.J., Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom, Malaria Public Health and Epidemiology Group, Kenya Medical Research Institute-Wellcome Trust Collaborative Programme, Nairobi, Kenya
Objectives Studies have typically investigated health and educational consequences of malaria among school-aged children in areas of high malaria transmission, but few have investigated these issues in moderate transmission settings. This study investigates the patterns of and risks for Plasmodium falciparum and anaemia and their association with cognitive and education outcomes on the Kenyan coast, an area of moderate malaria transmission. Methods As part of a cluster randomised trial, a baseline cross-sectional survey assessed the prevalence of and risk factors for P. falciparum infection and anaemia and the associations between health status and measures of cognition and educational achievement. Results are presented for 2400 randomly selected children who were enrolled in the 51 intervention schools. Results The overall prevalence of P. falciparum infection and anaemia was 13.0% and 45.5%, respectively. There was marked heterogeneity in the prevalence of P. falciparum infection by school. In multivariable analysis, being male, younger age, not sleeping under a mosquito net and household crowding were adjusted risk factors for P. falciparum infection, whilst P. falciparum infection, being male and indicators of poor nutritional intake were risk factors for anaemia. No association was observed between either P. falciparum or anaemia and performance on tests of sustained attention, cognition, literacy or numeracy. Conclusion The results indicate that in this moderate malaria transmission setting, P. falciparum is strongly associated with anaemia, but there is no clear association between health status and education. Intervention studies are underway to investigate whether removing the burden of chronic asymptomatic P. falciparum and related anaemia can improve education outcomes. © 2012 Blackwell Publishing Ltd.
anemia; baseline conditions; baseline survey; child health; coastal zone; cognition; disease prevalence; disease transmission; educational attainment; health risk; health status; heterogeneity; infectivity; literacy; malaria; multivariate analysis; primary education; protozoan; risk factor; adolescent; adult; anemia; article; cancer risk; child; cognition; controlled study; dietary intake; female; health status; human; infection risk; Kenya; major clinical study; malaria; male; medical education; Plasmodium falciparum; preschool child; prevalence; school child; sex difference; Adolescent; Age Distribution; Anemia; Attention; Causality; Child; Child, Preschool; Cluster Analysis; Cognition Disorders; Comorbidity; Cross-Sectional Studies; Educational Status; Family Characteristics; Female; Health Status; Humans; Kenya; Malaria, Falciparum; Male; Mosquito Nets; Plasmodium falciparum; Prevalence; Risk Factors; Sex Distribution; Kenya