The Burden and Socio-demographic Differentials of Malaria Infection among Asymptomatic School Children in Gombe State, Nigeria

Abstract

Background: As a foremost disease of public health significance, malaria has wrecked untold havoc among children and pregnant women in developing countries with Africa and Nigeria being worst affected. Objective: This study was aimed at documenting the prevalence and socio-demographic differences in the pattern of malaria infection among asymptomatic primary school children in Gombe state, Nigeria. Methodology: Using a cross sectional study design 745 pupils aged 6 to 15 years were assessed from March to June 2019. The subjects were selected from 12 public and 6 private schools in 6 Local Government Areas (LGAs) of the state, using multi-stage sampling technique. Malaria rapid diagnostic test (mRDT) kits were deployed in screening the subjects for malaria parasites positivity or otherwise. Data was analyzed using IBM SPSS version 21 analytical software. And the findings were presented in tables and charts. Proportions were compared using chi square, with alpha significance level set at 0.05. Results: The mean age of the participants was 9.96±2.26 and 379 (50.9%) of them were boys while the rest 366 (49.1%) were girls (about 1:1 male-female sex ratio). A total of 101 (13.6%) of the 745 school children screened yielded positive to malaria rapid diagnostic test (mRDT), with children from the public primary schools being significantly (p=0.000) more affected than their counterparts in the private schools (18.2% vs. 4.1%). Though male children were more affected by malaria, the difference was not statistically significant (15.0% vs. 12.0%, P=0.229). Similarly, significantly higher proportion (p=0.000) of pupils from the rural schools were affected  and were about three times more at risk of malaria (OR=3.362, CI: 2.169-5.212) than their urban counterparts (22.4% vs. 7.9%). Low academic performance was found to be associated with malaria infection (p=0.012). Other socio-demographic factors associated with malaria  infection among the pupils include; senatorial district, family size, source of parental care, tribe etc. However, from the evidence of this study there was no significant association between  the prevalence of malaria infection and birth order, age group and gender of the school children. Conclusion: In view of the high and disproportionate distribution of the burden of malaria among the subjects, it is hereby recommended that concerned authorities should include primary schools in the design and implementation of malaria control/ elimination programmes.