School-based screening and treatment to reduce P. falciparum infection, anemia, and contribute to transmission reduction

In areas highly endemic for malaria, Plasmodium falciparum (Pf) infection prevalence peaks in school-age children, adversely affecting their health and education. Furthermore, school-age children are a key transmission reservoir. School-based intermittent preventive treatment is effective at reducing this burden, however concerns about drug resistance have limited enthusiasm for this approach. School-based screening-and-treatment is an attractive alternative. However, one large-scale trial of this approach showed no benefits. We established school-based cohorts to evaluate the impact of screening-and-treatment on the prevalence of Pf infection, gametocyte carriage and anemia.

A school-based screen-and-treat cohort study was conducted in Malawi concurrent with household-based cross-sectional surveys. Primary school students (n=705) in four schools were screened for infection using a rapid diagnostic test (RDT). If positive, students were treated with artemether-lumefantrine. Subsequent P. falciparum infection and gametocyte carriage in treated and untreated students was assessed after one, two, and six weeks. Anemia was assessed at baseline and after 6 weeks. Gametocyte prevalence and density by age was concomitantly measured in households in each school catchment area.

Drug-based Strategies
Epidemiology
Impact of Interventions
Residual Transmission
Vulnerable Populations

Apr 2015 — Oct 2015

Malawi

Impact of P. falciparum diversity on transmission reducing immunity
Mentoring and patient-oriented research in malaria
Reservoirs of transmission: targets for malaria control interventions

Targeted Test and Treat (TTaT) strategies