Prevalence of asymptomatic malaria infection and use of different malaria control measures among primary school children in Morogoro Municipality, Tanzania

Abstract

Background: Malaria is a public health problem in Tanzania affecting all age groups. It is known that school children are the age group most commonly infected with malaria parasites. Their infections are usually asymptomatic, go unnoticed and thus never get treated, result in anaemia, reduced ability to concentrate and learn in school and if fallen sick may lead to school absenteeism. Effective malaria control requires frequent evaluation of effectiveness of different malaria interventions.

Methods: A cross-sectional study design involving 317 out of 350 school children aged 6-13 years from five primary schools within municipality was conducted. Multistage cluster sampling and simple random sampling methods were used to obtain primary school and study participants, respectively. Finger-prick blood samples were collected for Plasmodium parasite detection by malaria rapid diagnostic test (mRDT) and haemoglobin level assessment by Easy Touch(®) GHb system machine. A questionnaire was administered to assess use of insecticide-treated nets (ITNs) and anti-malarial drugs.

Results: The prevalence of asymptomatic malaria was 5.4 % (95 % CI 3.3-8.6 %) and anaemia was 10.1 % (95 % CI 7.2-13.9 %). School children aged 6-9 years were more affected by malaria than those aged 10-13 years. The proportion of ITNs used was 90.6 % (95 % CI 86.3-93.9 %) while that of artemisinin combination therapy (ACT) was 71.9 % (95 % CI 66.2-77.1 %).

Conclusion: Findings show existence of asymptomatic malaria and walking anaemia among primary school children in Morogoro municipality. The majority of school children reported use of ITNs and ACT for malaria control. These findings provide a rationale for using schools and school children to assess effectiveness of malaria interventions.

Fig. 1

Haemoglobin level distribution among primary school children (N = 317). Haemoglobin level was measured in the field using portable Easy Touch^® GHb system machine by examining peripheral blood from finger pricks. It was categorized as follows: haemoglobin level <7 g/dl, severe anaemia, haemoglobin level between 7 and 9.9 g/dl, moderate anaemia, haemoglobin level between 10 and 10.9 g/dl, mild anaemia, haemoglobin level of (11 + g/dl) or ≥11 g/dl, normal haemoglobin level

Fig. 2

Distribution of anti-malarial drugs used among primary school children (N = 281). Common anti-malarial drugs reported to be used in this study by the primary school children were as follows: artemisinin based combination therapy (ACT), sulfadoxine–pyrimethamine (SP), quinine (both tablets and injections), chloroquine tablets, and others (medications such as paracetamol and amoxicillin)