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Malaria is associated with poor school performance in an endemic area of the Brazilian Amazon
Sheila Vitor-Silva1, Roberto C Reyes-Lecca, Tamam R A Pinheiro
1Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, 69065-001 Manaus, Brazil. vitorsheila@hotmail.com
Insights
Malaria negatively impacts children's school performance, even non-severe cases. This study in Brazil highlights the link between malaria and poor academic outcomes in endemic regions.
Area of Science:
- Global Health
- Pediatrics
- Infectious Diseases
Background:
- Malaria affects 40% of the global population, posing significant risks to children in endemic tropical areas.
- Malaria, malnutrition, and intestinal helminths can interact, potentially hindering cognitive development in children.
- Plasmodium vivax is the primary malaria species in the study region, necessitating research into its specific impacts.
Purpose of the Study:
- To investigate the relationship between malaria infection and school performance in children.
- To assess the impact of Plasmodium vivax malaria on academic outcomes in an endemic Brazilian Amazon region.
Main Methods:
- A nine-month follow-up study in Careiro, Amazonas, Brazil, involving 198 children aged 5-14.
- Malaria diagnosis via thick blood smear for febrile children; school performance assessed by final grades in Mathematics and Portuguese.
- Poor performance defined as grades below the 50th percentile in either subject.
Main Results:
- 70 (35.4%) students experienced malaria, predominantly Plasmodium vivax (69.2%), with no severe cases.
- Multivariate analysis revealed that at least one malaria episode independently predicted poor school performance (OR = 1.91, p = 0.039), adjusting for covariates.
- Age, mother's education, study area duration, and school absenteeism were considered in the analysis.
Conclusions:
- Non-severe malaria significantly compromises children's school performance over a nine-month period.
- This study provides the first evidence in Latin America of malaria's negative impact on school performance, particularly with Plasmodium vivax.
- Findings suggest malaria contributes to underdevelopment in endemic countries, underscoring the need for effective control strategies.
Background:
Approximately 40% of the world's population is at risk for malaria. In highly endemic tropical areas, malaria is a major cause of morbidity and mortality during infancy. There is a complex interrelationship between malaria, malnutrition and intestinal helminths, and this may impair cognitive development in children. The aim of this study was to determine the relationship between malaria and school performance in children living in an endemic area where Plasmodium vivax is the species responsible for most of the cases.
Methods:
The study was conducted in the Municipality of Careiro, Amazonas, Brazil, with five to 14 year-old children, studying the first eight grades of public school, during the year 2008. After an initial active case detection, during nine months of follow-up, passive malaria cases detection was instituted, through a thick blood smear performed in every child with fever. School performance was evaluated by the final notes in Mathematics and Portuguese Language. Performance was considered poor when either of the final notes in these disciplines was below the 50th percentile for the respective class and grade.
Results:
The total number of students followed-up in the cohort was 198. Malarial attacks were reported in 70 (35.4%) of these students, with no cases of severe disease. Plasmodium vivax was detected in 69.2% of the attacks, Plasmodium falciparum in 25.5% and both species in 5.3%. In the multivariate analysis, adjusting for age, mother's education, time living in the study area and school absenteeism, presenting with at least one episode of malaria independently predicted a poor performance at school [OR = 1.91 (1.04-3.54); p = 0.039].
Conclusion:
Non-severe malaria compromises the school performance of children even during a nine-month follow-up, potentially contributing to the maintenance of underdevelopment in countries endemic for malaria. This is the first evidence of such impact in Latin America, where P. vivax is responsible for the majority of the cases.
