Prevalence Of Plasmodium Infection And Anaemia In Primary School Children Following Universal Distribution Of Insecticide Treated Bed Nets In Kasipul, Homa-Bay County, Kenya

ABSTRACT

Malaria is devastating diseases afflicting humans, in Kenya; the disease is endemic in

areas around Lake Victoria and along the southern coast. Untreated malaria in school

children, result in anaemia, reduced ability to concentrate and learn in school and if

fallen sick may lead to school absenteeism. Insecticide treated nets (ITN) have been

shown to provide significant protection against Plasmodium infection. Available data

show that the overall prevalence of Plasmodium and anaemia among primary school

aged children in Kasipul is 25.8 % and 14.1%, respectively. However, there is limited

information on the Plasmodium and anaemia prevalence in Kasipul following mass

distribution of ITN in 2014. The objective of this study was to assess the prevalence

of Plasmodium and anaemia among school children living in Kasipul and their

reported use of insecticide treated bed nets, one year after mass distribution of ITN in

Kasipul, Homa-Bay County. A descriptive cross-sectional study of 398 primary

school pupils was conducted in Kasipul. Pupil’s fingers were pierced using a lancet to

obtain blood sample for malaria parasite detection and haemoglobin level

determination. Data on insecticide net use was collected using self-administered

questionnaire. The overall prevalence of Plasmodium among children was 10.05%

and anaemia was 2.3%. The association between net ownership and Plasmodium

prevalence among pupils was significant (2= 14.46, df =1, p = 0.000). The difference

in malaria prevalence in terms of sex was not statistically significant (2= 0.814, df=

1, p = 0.367). However, anaemia was slightly more prevalent in girls (3.6%) than

boys (1.0%) were. Although the difference was not statistically significant (2=

3.217, df= 1, p = 0.073). The study established that only 51.0 % of the study

population owned ITN, which is below the 80% target set by the government. A

negative correlation of -0.3874 existed between the use of ITN and malaria

prevalence. The study observed a significant decline in Plasmodium prevalence from

25.8% in 2011 to 10.05% in 2016, which is evidence that ITN, which was the major

control strategy implemented in Kasipul reduced Plasmodium infection in the study

population. Decline in Plasmodium infection could also have reduced the prevalence

of anaemia in the study area from 14 % in 2010 to 2.3% in 2016. In conclusion, this

inquiry revealed that the prevalence of Plasmodium and anaemia has significantly

reduced following distribution of free ITN in Kasipul. Plasmodium prevalence was

lower in schools, which recorded a large number of pupils using ITN. Prevalence of

Plasmodium in Kasipul is still high compared to the national average of 5%; this

study recommends that other control measures apart from insecticidal nets should also

be introduced in Kasipul, by the Kenya government to eliminate Plasmodium.

Ministry of health and other stakeholders should ensure that hang-up’ campaigns to

sensitize residence on the relationship between ITN and Plasmodium prevalence,

forms an integral part of future treated nets distributions. Further studies using

households as sampling units need to be conducted in Kasipul, since this study did not include pupils absent from school on the sampling days.