Malaria control in school children

The risks and severity of clinical outcomes following exposure to P. falciparum increase among older children as transmission intensity declines. Malaria control in Africa has focused on pre-school children and pregnant women over the last decade, but as transmission intensity declines school aged children will become an important clinical risk group. As a result of a historical pre-school prevention focus, we have shown that children aged 5-19 years have the lowest ITN use in any community and thus pose a threat to universal coverage targets and abilities to reduce local transmission. Our group have undertaken randomized-controlled and plausibility trials of malaria prevention among school children, notably IPTsc and the delivery of ITN to school children in hard-to-reach areas. The revised Kenyan national malaria control strategy now includes a Malaria Free Schools Initiative and the MPHEG have been asked by the Ministries of Health and Education to define and undertake a research agenda aimed at defining tailored intervention suites based upon transmission risks, formative research on delivery modalities and impact monitoring to support this new initiative over the next five years.