School-Based Malaria Screening and Treatment Reduces Plasmodium falciparum Infection and Anemia Prevalence in Two Transmission Settings in Malawi.
J Infect Dis
; 226(1): 138-146, 2022 08 12.
Article
de En
| MEDLINE
| ID: mdl-35290461
ABSTRACT
BACKGROUND:
In areas highly endemic for malaria, Plasmodium falciparum infection prevalence peaks in school-age children, adversely affecting health and education. School-based intermittent preventive treatment reduces this burden but concerns about cost and widespread use of antimalarial drugs limit enthusiasm for this approach. School-based screening and treatment is an attractive alternative. In a prospective cohort study, we evaluated the impact of school-based screening and treatment on the prevalence of P. falciparum infection and anemia in 2 transmission settings.METHODS:
We screened 704 students in 4 Malawian primary schools for P. falciparum infection using rapid diagnostic tests (RDTs), and treated students who tested positive with artemether-lumefantrine. We determined P. falciparum infection by microscopy and quantitative polymerase chain reaction (qPCR), and hemoglobin concentrations over 6 weeks in all students.RESULTS:
Prevalence of infection by RDT screening was 37% (9%-64% among schools). An additional 9% of students had infections detected by qPCR. Following the intervention, significant reductions in infections were detected by microscopy (adjusted relative reduction [aRR], 48.8%; Pâ <â .0001) and qPCR (aRR, 24.5%; Pâ <â .0001), and in anemia prevalence (aRR, 30.8%; Pâ =â .003). Intervention impact was reduced by infections not detected by RDT and new infections following treatment.CONCLUSIONS:
School-based screening and treatment reduced P. falciparum infection and anemia. This approach could be enhanced by repeating screening, using more-sensitive screening tests, and providing longer-acting drugs. CLINICAL TRIALS REGISTRATION NCT04858087.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Paludisme à Plasmodium falciparum
/
Anémie
/
Paludisme
/
Antipaludiques
Type d'étude:
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
/
Screening_studies
Limites:
Child
/
Humans
Pays/Région comme sujet:
Africa
Langue:
En
Journal:
J Infect Dis
Année:
2022
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique