Nationwide school malaria parasitaemia survey in public primary schools, the United Republic of Tanzania

Abstract

BackgroundA nationwide, school, malaria survey was implemented to assess the risk factors of malaria prevalence and bed net use among primary school children in mainland Tanzania. This allowed the mapping of malaria prevalence at council level and assessment of malaria risk factors among school children.MethodsA cross-sectional, school, malaria parasitaemia survey was conducted in 25 regions, 166 councils and 357 schools in three phases: (1) August to September 2014; (2) May 2015; and, (3) October 2015. Children were tested for malaria parasites using rapid diagnostic tests and were interviewed about household information, parents’ education, bed net indicators as well as recent history of fever. Multilevel mixed effects logistic regression models were fitted to estimate odds ratios of risk factors for malaria infection and for bed net use while adjusting for school effect.ResultsIn total, 49,113 children were interviewed and tested for malaria infection. The overall prevalence of malaria was 21.6%, ranging from < 0.1 to 53% among regions and from 0 to 76.4% among councils. The malaria prevalence was below 5% in 62 of the 166 councils and above 50% in 18 councils and between 5 and 50% in the other councils. The variation of malaria prevalence between schools was greatest in regions with a high mean prevalence, while the variation was marked by a few outlying schools in regions with a low mean prevalence. Overall, 70% of the children reported using mosquito nets, with the highest percentage observed among educated parents (80.7%), low land areas (82.7%) and those living in urban areas (82.2%).ConclusionsThe observed prevalence among school children showed marked variation at regional and sub-regional levels across the country. Findings of this survey are useful for updating the malaria epidemiological profile and for stratification of malaria transmission by region, council and age groups, which is essential for guiding resource allocation, evaluation and prioritization of malaria interventions.Electronic supplementary materialThe online version of this article (10.1186/s12936-018-2601-1) contains supplementary material, which is available to authorized users.

Uncomplicated falciparum malaria among schoolchildren in Bajil district of Hodeidah governorate, west of Yemen: Association with anaemia and underweight

“…The gender, age and residence of schoolchildren were not signi cant predictors of falciparum malaria in the present study. The lack of signi cant association between the age and malaria is consistent with that found among Tanzanian schoolchildren in a nationwide survey [39]. In contrast, the male gender and age younger than 10 years were signi cantly associated with asymptomatic malaria among Ugandan and Kenyan schoolchildren [34,38].…”

“…It is also lower than the household-based malaria prevalence of 18.8% (136/735) reported from the south-eastern governorate of Hadhramout [32], where over 99.0% of infections being caused by P. falciparum. However, it is substantially lower than those reported for schoolchildren from several African countries, including Malawi (60.0%), Kenya (42.0%), Uganda (27.6%), Cameroon (22.8-33.8%) and Tanzania (21.6-38.1%; 93/244) [33][34][35][36][37][38][39]. In contrast, it is higher than the rates reported among Kenyan children (4.3%) in a nationwide survey and asymptomatic schoolchildren from northwest Ethiopia (6.8%;…”

Applied mathematical modelling to inform national malaria policies, strategies and operations in Tanzania

“…Strategic planning in Tanzania is based on a strong malaria monitoring and surveillance system, including high-quality district health information system (DHIS2) data [48], entomological surveillance [49], resistance monitoring [50], demographic and health surveys, and malaria indicator surveys [51][52][53][54][55]. Since 2014, nationwide annual school malaria parasitaemia surveys also bring high-quality and high-resolution cross-sectional data to the NMCP database [56]. The Tanzanian epidemiological data show nowadays a highly heterogeneous malaria transmission and burden throughout the country [51][52][53][54][55][56].…”

“…Since 2014, nationwide annual school malaria parasitaemia surveys also bring high-quality and high-resolution cross-sectional data to the NMCP database [56]. The Tanzanian epidemiological data show nowadays a highly heterogeneous malaria transmission and burden throughout the country [51][52][53][54][55][56]. The National Malaria Strategic Plan (NMSP) for 2015-2020 acknowledged that diversity of malaria transmission and disease burden within the borders of Mainland Tanzania, but largely adopted a uniform approach to disease management and prevention nationwide [57].…”

Describing the current status of Plasmodium falciparum population structure and drug resistance within mainland Tanzania using molecular inversion probes

“…Sample collection: 1,232 samples from 13 districts in 7 regions of Tanzania ( Figure 1 ) were available from previously conducted cross-sectional surveys and drug efficacy studies. For the former, 552 samples were collected between July and November 2017 from districts with historically high transmission (22,26) . All individuals in 120 households from two villages selected from each district were tested for malaria, representing both symptomatic and asymptomatic malaria cases in adults and children (27) .…”