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Medientyp:
E-Artikel
Titel:
School-Based Malaria Screening and Treatment Reduces Plasmodium falciparum Infection and Anemia Prevalence in Two Transmission Settings in Malawi
Beteiligte:
Cohee, Lauren M;
Peterson, Ingrid;
Buchwald, Andrea G;
Coalson, Jenna E;
Valim, Clarissa;
Chilombe, Moses;
Ngwira, Andrew;
Bauleni, Andy;
Schaffer-DeRoo, Sarah;
Seydel, Karl B;
Wilson, Mark L;
Taylor, Terrie E;
Mathanga, Don P;
Laufer, Miriam K
Beschreibung:
<jats:title>Abstract</jats:title>
<jats:sec>
<jats:title>Background</jats:title>
<jats:p>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.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>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.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>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%; P &lt; .0001) and qPCR (aRR, 24.5%; P &lt; .0001), and in anemia prevalence (aRR, 30.8%; P = .003). Intervention impact was reduced by infections not detected by RDT and new infections following treatment.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>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.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Clinical Trials Registration</jats:title>
<jats:p>NCT04858087.</jats:p>
</jats:sec>