Background: A study among primary school children in Kisarawe district by Otito in 1994
showed that the prevalence of malaria parasitemia and anemia was 24.3% and was 86.1%
respectively. The use of Insecticides Treated Nets (ITNs) and Artemisinin-based Combination
Therapies (ACTs) has the potential of interrupting malaria transmission thus changing the
epidemiology of malaria in endemic areas such as Kisarawe. Following scaling up of these
interventions, it is not known how much they have changed the epidemiology of malaria in the
Kisarawe district, in particular among primary school children.
Objective: This study aimed to determine the malaria parasite rate and hemoglobin level among
primary school children in Kisarawe district after wide scale use of ITNs and ACTs.
Methodology: A descriptive cross sectional study of 300 school children was carried out in
Kisarawe district, a holoendemic area for malaria. A random cluster sampling and simple
random sampling methods were used to obtain schools and participants. Finger prick blood
samples were collected for malaria parasite detection and hemoglobin level. ITNs and ACTs use
were also assessed. The main outcome was proportion of school-aged children with
asymptomatic malaria parasite infection and anemia as well as ITNs and ACTs use.
Results: A total of 300 pupils in standard four to seven with mean age 12.4 years, range 8 – 17
years participated in the survey in both steps. The prevalence of asymptomatic malaria was very
low, only 9 (3.0%) [95% CI (1.38, 5.20)] had malaria parasites and anemia was 10.3% [95% CI
(7.1, 14.0)]. The overall use of ITNs is 83.7% [95% CI (79.0, 87.6)] but 75.9% [95% CI (70.3,
81.2)] were reported to use ITNs last night and the proportion of ACTs use for treatment of
malaria was 86% [95% CI (81.6, 89.7)]. There was no association between anemia and history of
malaria, use of ITNs, use of ACTs, age groups and sex.
Conclusion: There is a significant decline in asymptomatic malaria from 24.3% in 1994 to 3% in
2012 which is the evidence of wide scaled up of ITNs and ACTs use as intervention of malaria.
Decline in malaria could have also reduced the prevalence of anemia since it is the one among
major cause of anemia. More effort on scaling up ITNs and ACTs intervention and sustainability
are needed for elimination of the disease. However further studies with large sample size are
needed to explore the prevalence of asymptomatic malaria as well as possible causes of existing
anemia.