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THE IMPACT OF REPEATED MALARIA ATTACKS ON THE SCHOOL PERFORMANCE OF CHILDREN

The impact of repeated malarial infections on the school performance of children was investigated in 571 school children 6–14 years of age in a malaria-endemic area in southern Sri Lanka where both Plasmodium falciparum and P. vivax infections are prevalent. Malaria infections confirmed by microscopy were monitored over a six-year period. School performance was assessed by two specially designed, school grade-specific, test papers for Sinhala language and mathematics. The scores for Sinhala language and mathematics for each school term test for the year 1997 were obtained. Malarial infections were a major predictor of children’s performance in language and mathematics after controlling for parent’s education, monthly family income, and house type. The education of the father predicted language scores but not mathematics scores. A child who experienced more than five attacks of malaria scored approximately 15% less than a child who experienced less than three attacks of malaria. The data suggest that repeated attacks of malaria have an adverse impact on the school performance of children.

Received July 16, 2003. Accepted for publication August 26, 2003.

Acknowledgments: We acknowledge the technical assistance provided by Anusha Gallewate, Jagath Rajakaruna, and Sudath Weerasinghe. Our thanks are also given to the Head and staff of the Malaria Research Unit and the Head and staff of the Department of Parasitology, University of Colombo for their support.

Financial support: This study was supported by the UNDP/World Bank/World Health Organization Special Program for Research and Training in Tropical Diseases (grant number 970315).

Authors’ addresses: S. D. Fernando, Department of Parasitology, Faculty of Medicine, University of Colombo, PO Box 271, Kynsey Road, Colombo 8, Sri Lanka, Telephone: 94-1-2688-660, Fax: 94-1-269-9284. E-mail: deepfern{at}slt.lk. D. M. Gunawardena, Regional Malaria Officer, Badulla, Sri Lanka, Telephone: 94-1-0552-29560. M. R. S. S. Bandara, Kurunegala, Sri Lanka, Telephone: 94-1-0372-22193. D. de Silva, Department of Psychiatry, Faculty of Medicine, University of Colombo, PO Box 271, Kynsey Road, Colombo 8, Sri Lanka, Telephone: 94-1-695-300. R. Carter, Institute of Cell, Animal and Population Biology, Division of Biologic Sciences, University of Edinburgh, Kings Building, West Mains Road, Edinburgh EH9 3JT, United Kingdom, Telephone: 44-122-740-0764, Fax: 44-131-668-3861. K. N. Mendis, Roll Back Malaria Project, World Health Organization, CH-1211, Geneva 27, Switzerland, Telephone: 41-22-740-0764, Fax: 41-22-791-4854. A. R. Wickremasinghe, Department of Community Medicine and Family Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka, Telephone: 94-1-598-014, Fax: 94-1-598014.

Reprint requests: S. D. Fernando, Department of Parasitology, Faculty of Medicine, University of Colombo, PO Box 271, Kynsey Road, Colombo 8, Sri Lanka.

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