• 1

    Snow R, Marsh K, 2002. The consequences of reducing transmission of Plasmodium falciparum infection in Africa. Adv Parasitol 52 :235–264.

    • Search Google Scholar
    • Export Citation
  • 2

    Holding PA, Snow RW, 2001. Impact of Plasmodium falciparum malaria on performance and learning: review of the evidence. Am J Trop Med Hyg 64 (Suppl):68–75.

    • Search Google Scholar
    • Export Citation
  • 3

    Fernando SD, Gunawardena DM, Bandara MR, de Silva D, Carter R, Mendis KM, Wickremasinghe AR, 2003. The impact of repeated malaria attacks on the school performance of children. Am J Trop Med Hyg 69 :582–588.

    • Search Google Scholar
    • Export Citation
  • 4

    Bundy DAP, Lwin S, Osika JS, McLaughlin J, Pannenborg CO, 2000. What should schools do about malaria? Parasitol Today 16 :181–182.

  • 5

    Trape JF, Rogier C, 1996. Combating malaria morbidity and mortality by reducing transmission. Parasitol Today 12 :236–240.

  • 6

    Minakawa N, Sonye G, Mogi M, Githeko A, Yan G, 2002. The effects of climatic factors on the distribution and abundance of malaria vectors in Kenya. J Med Entomol 39 :833–841.

    • Search Google Scholar
    • Export Citation
  • 7

    Beier JC, Oster CN, Onyango FK, Bales JD, Sherwood JA, Perkins PV, Chumo DK, Koech DV, Whitmire RE, Roberts CR, Diggs CL, Hoffman SL, 1994. Plasmodium falciparum incidence relative to entomologic inoculation rates at a site proposed for testing malaria vaccines in western Kenya. Am J Trop Med Hyg 50 :529–536.

    • Search Google Scholar
    • Export Citation
  • 8

    Malakooti MA, Biomndo K, Shanks GD, 1998. Reemergence of epidemic malaria in the highlands of western Kenya. Emerg Infect Dis 4 :671–676.

    • Search Google Scholar
    • Export Citation
  • 9

    Hay SI, Were EC, Renshaw M, Noor AM, Ochola SA, Olusanmi I, Alipui N, Snow RW, 2003. Forecasting, warning, and detection of malaria epidemics: a case study. Lancet 361 :1705–1706.

    • Search Google Scholar
    • Export Citation
  • 10

    World Health Organization, 1983. Measuring Change in Nutritional Status. Geneva: World Health Organization.

  • 11

    Brooker S, Clarke SE, Njagi JK, Polack S, Mugo B, Estambale B, Muchiri E, Magnussen P, Cox J, 2004. Spatial clustering of malaria and associated risk factors during an epidemic in a highland area of western Kenya. Trop Med Int Health 9 :757–766.

    • Search Google Scholar
    • Export Citation
  • 12

    Bloland PB, Boriga DA, Ruebush TK, McCormick JB, Roberts JM, Oloo AJ, Hawley W, Lal A, Nahlen B, Campbell CC, 1999. Longitudinal cohort study of the epidemiology of malaria infections in an area of intense malaria transmission. II. Descriptive epidemiology of malaria infection and disease among children. Am J Trop Med Hyg 60 :641–648.

    • Search Google Scholar
    • Export Citation
  • 13

    World Health Organization, 2001. Iron Deficiency Anaemia: Assessment, Prevention and Control. Geneva: World Health Organization.

  • 14

    Smith PG, Morrow RH, eds, 1996. Field Trials of Health Interventions in Developing Countries: A Toolbox. Second edition. Oxford, United Kingdom: Macmillan Education, 306–311.

  • 15

    Some ES, 1994. Effects and control of highland malaria epidemic in Uasin Gishu District, Kenya. East Afr Med J 71 :2–8.

  • 16

    Hay S, Renshaw M, Ochola SA, Noor AM, Snow RW, 2003. Performance of forecasting, warning and detection of malaria epidemics in the highlands of western Kenya. Trends Parasitol 19 :394–399.

    • Search Google Scholar
    • Export Citation
  • 17

    Abdalla S, Weatherall DJ, Wickramasinghe SN, Hughes M, 1980. The anaemia of P. falciparum malaria. Br J Haematol 46 :171–183.

  • 18

    Philips RE, Pasvol G, 1992. Anaemia of Plasmodium falciparum malaria. Baillieres Clin Haematol 5 :315–330.

  • 19

    Geissler PW, Meinert L, Brooker S, Njagi JK, 2002. School Children, Medicines and Malaria. Findings of the Social Science Component of the Pre-Study on Medicines and Malaria in School-Age Children in a Highland and a Lowland Area of Western Kenya. Report commissioned by the Roll Back Malaria team. Washington, DC: World Bank.

  • 20

    Trape JF, Lefebre-Zante E, Legros F, Druilhe P, Rogier C, Bouganali H, Salem G, 1993. Malaria morbidity among children exposed to low seasonal transmission in Dakar, Senegal and its implications for malaria control in tropical Africa. Am J Trop Med Hyg 48 :748–756.

    • Search Google Scholar
    • Export Citation
  • 21

    Thompson R, Begtrup K, Cuamba N, Dgedge M, Mendis C, Gamage-Mendis A, Enosse S, Barreto J, Sinden RE, Hogh B, 1997. The Matola malaria project: a temporal and spatial study of malaria transmission and disease in a suburban area of Maputo, Mozambique. Am J Trop Med Hyg 57 :550–559.

    • Search Google Scholar
    • Export Citation
  • 22

    Clarke SE, Bøgh C, Brown RC, Walraven GEL, Thomas CJ, Lindsay SW, 2002. Risk of malaria attacks in Gambian children is greater away from malaria vector breeding sites. Trans R Soc Trop Med Hyg 96 :499–506.

    • Search Google Scholar
    • Export Citation
  • 23

    Brooker S, Guyatt H, Omumbo J, Shretta R, Drake L, Ouma J, 2000. Situation analysis of malaria in school-aged children in Kenya–what can be done? Parasitol Today 16 :183–186.

    • Search Google Scholar
    • Export Citation
  • 24

    Imbert P, Sartelet I, Rogier C, Ka S, Baujat G, Candito D, 1997. Severe malaria among children in a low seasonal transmission area, Dakar, Senegal: influence of age on clinical presentation. Trans R Soc Trop Med Hyg 91 :22–24.

    • Search Google Scholar
    • Export Citation
  • 25

    Snow RW, Omumbo JA, Lowe B, Molyneaux CS, Obiero JO, Palmer A, Weber MW, Pinder M, Nahlen B, Obonyo C, New-bold C, Gupta S, Marsh K, 1997. Relation between severe malaria morbidity in children and level of Plasmodium falciparum transmission in Africa. Lancet 349 :1650–1654.

    • Search Google Scholar
    • Export Citation
  • 26

    Snow RW, Craig M, Deichmann U, Marsh K, 1999. Estimating mortality, morbidity and disability due to malaria among Africa’s non-pregnant population. Bull World Health Organ 77 :624–640.

    • Search Google Scholar
    • Export Citation
  • 27

    Sachs J, Malaney P, 2002. The economic and social burden of malaria. Nature 415 :680–685.

  • 28

    Magnussen P, Ndawi B, Sheshe AK, Byskov J, Mbwana K, 2001. Malaria diagnosis and treatment administered by teachers in primary schools in Tanzania. Trop Med Int Health 6 :1–7.

    • Search Google Scholar
    • Export Citation
  • 29

    Trape JF, Zoulani A, Quinet MC, 1987. Assessment of the incidence and prevalence of clinical malaria in semi-immune children exposed to intense and perennial transmission. Am J Epidemiol 126 :193–201.

    • Search Google Scholar
    • Export Citation
  • 30

    Rogier C, Trape JF, 1993. Malaria attacks in children exposed to high transmission: who is protected? Trans R Soc Trop Med Hyg 87 :245–246.

    • Search Google Scholar
    • Export Citation
  • 31

    Deleron P, Ringwald P, Luty AJ, Renaut A, Minh TG, Mbessy JR, Millet P, 1999. Relationships between malaria prevalence and malaria-related morbidity in school children from two villages in central Africa. Am J Trop Med Hyg 61 :99–102.

    • Search Google Scholar
    • Export Citation
  • 32

    Marsh K, Hayes RH, Carson DC, Otoo L, Shenton F, Byass P, Zavala F, Greenwood BM, 1988. Anti-sporozoite antibodies and immunity to malaria in a rural Gambian population. Trans R Soc Trop Med Hyg 82 :532–537.

    • Search Google Scholar
    • Export Citation
  • 33

    Colbourne MJ, 1955. The effect of malaria suppression in a group of Accra school children. Trans R Soc Trop Med Hyg 49 :356–369.

  • 34

    Lepers JP, Deloron P, Andriamagatiana-Rason MD, Raman-amirija JA, Coulanges P, 1990. Newly transmitted Plasmodium falciparum malaria in the central highland plateaux of Madagasgar: assessment of clinical impact in a rural community. Bull World Health Organ 68 :217–222.

    • Search Google Scholar
    • Export Citation
 
 
 

 

 
 
 

 

 

 

 

 

 

MALARIA MORBIDITY AMONG SCHOOL CHILDREN LIVING IN TWO AREAS OF CONTRASTING TRANSMISSION IN WESTERN KENYA

View More View Less
  • 1 Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; Malaria Control Division, and Division of Vector Borne Disease, Ministry of Health, Nairobi, Kenya; Institute for Infectious and Tropical Diseases, University Of Nairobi, Nairobi, Kenya; Danish Bilharziasis Laboratory, Charlottenlund, Denmark

Research in malaria-endemic areas is usually focused on malaria during early childhood. Less is known about malaria among older school age children. The incidence of clinical attacks of malaria was monitored, using active case detection in primary schools, in two areas of western Kenya that differ in the intensity of transmission. Clinical malaria was more common in schools in the Nandi highlands, with a six-fold higher incidence of malaria attacks during the malaria epidemic in 2002, compared with school children living in a holoendemic area with intense perennial transmission during the same period. The high incidence coupled with the high parasite densities among cases is compatible with a low level of protective immunity in the highlands. The malaria incidence among school children exposed to intense year-round transmission (26 per 100 school children per year) was consistent with reports from other holoendemic areas. Taken together with other published studies, the data suggest that malaria morbidity among school age children increases as transmission intensity decreases. The implications for malaria control are discussed.

Save