School-age children found to be least protected from malaria

5 October 2009

The research, funded by the Wellcome Trust and published in the open access journal BMC Public Health, has found that parents and their young children under the age of five were much more likely to have access to protection from nets than older children in the same house.

Malaria is transmitted by mosquitoes and kills nearly a million people in Africa every year. Control measures such as the use of ITNs have been targeted towards those most vulnerable: pregnant women and children under the age of five. However, the findings of the recent study show that school-age children are now the group most vulnerable to infection as they are the least well protected by ITNs compared to their mothers and younger siblings. Data computed from eighteen African countries from 2005-2009 found that the trend was generally the same across countries

"Five to nineteen year olds are a particularly important group for two reasons," said lead researcher Dr Abdisalan Noor, from the Kenyan Medical Research Institute-Wellcome Trust Research Programme and the University of Oxford. "Firstly, they represent a large fraction of the population in most developing African communities. Secondly, while they may have developed immunity against clinical disease, they will not have developed immunity to the malaria parasite and will therefore continue to contribute transmission in the community."

Dr Noor and his colleagues report that as an unintended consequence of attempting to achieve the targets of the Abuja declaration and Millennium Development Goals, children and adolescents over five are being put at risk. An estimated eighty per cent of human to mosquito transmission comes from over-fives, with young adolescents and older children the peak age group. They argue that measures to ensure this group is protected from malaria should be viewed as important.

"Where school attendance is high, the delivery of nets through schools should be considered as a quick and cost-effective approach to reach universal coverage and improve the likelihood of impacting upon parasite transmission," concludes Dr Noor.

Reference

Noor AM, Kirui VC, Brooker SJ, and Snow RW. (2009). The use of insecticide treated net by age: implications for universal coverage Africa. BMC Public Health .