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Impact of intermittent screening and treatment for malaria among school children in Kenya : a cluster randomized trial

Author

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  • Halliday, Katherine E.
  • Okello, George
  • Turner, Elizabeth L.
  • Njagi, Kiambo
  • Mcharo, Carlos
  • Kengo, Juddy
  • Allen, Elizabeth
  • Dubeck, Margaret M.
  • Jukes, Matthew C.H.
  • Brooker, Simon J.

Abstract

This paper investigates the effects of intermittent screening and treatment of malaria on the health and education of school children in an area of low-to-moderate malaria transmission. A cluster randomized trial was implemented with 5,233 children in 101 government primary schools on the south coast of Kenya in 2010-12. The intervention was delivered to children randomly selected from classes 1 and 5 who were followed up twice across 24 months. Once during each school term, public health workers used malaria rapid diagnostic tests to screen the children. Children who tested positive were treated with a six-dose regimen of artemether-lumefantrine. Given the nature of the intervention, the trial was not blinded. The primary outcomes were anemia and sustained attention and the secondary outcomes were malaria parasitaemia and educational achievement. The data were analyzed on an intention-to-treat basis. Anemia in this setting in Kenya, intermittent screening and treatment, as implemented in this study, is not effective in improving the health or education of school children. Possible reasons for the absence of an impact are the marked geographical heterogeneity in transmission, the rapid rate of reinfection following artemether-lumefantrine treatment, the variable reliability of malaria rapid diagnostic tests, and the relative contribution of malaria to the etiology of anemia in this setting.

Suggested Citation

  • Halliday, Katherine E. & Okello, George & Turner, Elizabeth L. & Njagi, Kiambo & Mcharo, Carlos & Kengo, Juddy & Allen, Elizabeth & Dubeck, Margaret M. & Jukes, Matthew C.H. & Brooker, Simon J., 2014. "Impact of intermittent screening and treatment for malaria among school children in Kenya : a cluster randomized trial," Policy Research Working Paper Series 6791, The World Bank.
    • Handle: RePEc:wbk:wbrwps:6791
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    1. Emmanuel Jimenez & Harry Anthony Patrinos, 2009. "Can Cost–Benefit Analysis Guide Education Policy in Developing Countries?," Chapters, in: Robert J. Brent (ed.), Handbook of Research on Cost–Benefit Analysis, chapter 4, Edward Elgar Publishing.
    2. Glewwe, Paul & Kremer, Michael, 2006. "Schools, Teachers, and Education Outcomes in Developing Countries," Handbook of the Economics of Education, in: Erik Hanushek & F. Welch (ed.), Handbook of the Economics of Education, edition 1, volume 2, chapter 16, pages 945-1017, Elsevier.
    3. Edward Miguel & Michael Kremer, 2004. "Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities," Econometrica, Econometric Society, vol. 72(1), pages 159-217, January.
    4. Jones, Caroline & Abeku, Tarekegn A. & Rapuoda, Beth & Okia, Michael & Cox, Jonathan, 2008. "District-based malaria epidemic early warning systems in East Africa: Perceptions of acceptability and usefulness among key staff at health facility, district and central levels," Social Science & Medicine, Elsevier, vol. 67(2), pages 292-300, July.
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    Cited by:

    1. Wolf, Sharon & Turner, Elizabeth L. & Jukes, Matthew C.H. & Dubeck, Margaret M., 2018. "Changing literacy instruction in Kenyan classrooms: Assessing pathways of influence to improved early literacy outcomes in the HALI intervention," International Journal of Educational Development, Elsevier, vol. 62(C), pages 27-34.
    2. Nia King & Cate Dewey & David Borish, 2015. "Determinants of Primary School Non-Enrollment and Absenteeism: Results from a Retrospective, Convergent Mixed Methods, Cohort Study in Rural Western Kenya," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-17, September.
    3. Erin M Stuckey & Jennifer Stevenson & Katya Galactionova & Amrish Y Baidjoe & Teun Bousema & Wycliffe Odongo & Simon Kariuki & Chris Drakeley & Thomas A Smith & Jonathan Cox & Nakul Chitnis, 2014. "Modeling the Cost Effectiveness of Malaria Control Interventions in the Highlands of Western Kenya," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-11, October.
    4. Dubeck, Margaret M. & Gove, Amber, 2015. "The early grade reading assessment (EGRA): Its theoretical foundation, purpose, and limitations," International Journal of Educational Development, Elsevier, vol. 40(C), pages 315-322.
    5. Tom L. Drake & Yoel Lubell, 2017. "Malaria and Economic Evaluation Methods: Challenges and Opportunities," Applied Health Economics and Health Policy, Springer, vol. 15(3), pages 291-297, June.

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