Plasmodium infection, anaemia and mosquito net use among school children across different settings in Kenya

Objective  To investigate risk factors, including reported net use, for Plasmodium infection and anaemia among school children and to explore variations in effects across different malaria ecologies occurring in Kenya. Methods  This study analysed data for 49 975 school children in 480 schools surve...

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Bibliographic Details
Published in:Tropical medicine & international health 2012-07, Vol.17 (7), p.858-870
Main Authors: Gitonga, Caroline W., Edwards, Tansy, Karanja, Peris N., Noor, Abdisalan M., Snow, Robert W., Brooker, Simon J.
Format: Article
Language:English
Subjects:
Adolescent
Age Factors
anaemia
anemia
Anemia - epidemiology
Anemia - prevention & control
Anemias. Hemoglobinopathies
anémie
Biological and medical sciences
Child
Child, Preschool
Culicidae
Diseases of red blood cells
facteurs de risque
factores de riesgo
Female
General aspects
Hematologic and hematopoietic diseases
Human protozoal diseases
Humans
Infectious diseases
Insecticide-Treated Bednets - adverse effects
Insecticide-Treated Bednets - statistics & numerical data
insecticide‐treated nets
Kenia
Kenya
Kenya - epidemiology
Logistic Models
Malaria
Malaria - epidemiology
Malaria - prevention & control
Male
Medical sciences
mosquiteras impregnadas con insecticida
Mosquito Control - methods
moustiquaires imprégnées d’insecticide
niños escolares
paludisme
Parasitic diseases
Plasmodium
Protozoal diseases
Risk Factors
school children
Sex Factors
écoliers
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Summary:Objective  To investigate risk factors, including reported net use, for Plasmodium infection and anaemia among school children and to explore variations in effects across different malaria ecologies occurring in Kenya. Methods  This study analysed data for 49 975 school children in 480 schools surveyed during a national school malaria survey, 2008–2010. Mixed effects logistic regression was used to investigate factors associated with Plasmodium infection and anaemia within different malaria transmission zones. Results  Insecticide‐treated net (ITN) use was associated with reduction in the odds of Plasmodium infection in coastal and western highlands epidemic zones and among boys in the lakeside high transmission zone. Other risk factors for Plasmodium infection and for anaemia also varied by zone. Plasmodium infection was negatively associated with increasing socio‐economic status in all transmission settings, except in the semi‐arid north‐east zone. Plasmodium infection was a risk factor for anaemia in lakeside high transmission, western highlands epidemic and central low‐risk zones, whereas ITN use was only associated with lower levels of anaemia in coastal and central zones and among boys in the lakeside high transmission zone. Conclusions  The risk factors for Plasmodium infection and anaemia, including the protective associations with ITN use, vary according to malaria transmission settings in Kenya, and future efforts to control malaria and anaemia should take into account such heterogeneities among school children. Objectif:  Etudier les facteurs de risque, y compris l’utilisation rapportée des moustiquaires, pour l’infection à Plasmodium et l’anémie chez les écoliers et explorer les variations dans les effets à travers différentes écologies du paludisme au Kenya. Méthodes:  Cette étude a analysé les données de 49.975 écoliers dans 480 écoles surveillées lors d’une enquête nationale sur le paludisme dans les écoles de 2008 à 2010. La régression logistique à effets mixtes a été utilisée pour étudier les facteurs associés à l’infection à Plasmodium et à l’anémie dans les différentes zones de transmission du paludisme. Résultats:  L’utilisation des moustiquaires imprégnées d’insecticide (MII) a été associée à une réduction de la probabilité d’infection à Plasmodium dans les zones montagneuses côtières et de l’ouest et chez les garçons dans la zone de transmission élevée. D’autres facteurs de risque pour l’infection à Plasmodium et l’anémie varient auss
ISSN:1360-2276
1365-3156
DOI:10.1111/j.1365-3156.2012.03001.x