Prevalence of plasmodium infection and anaemiain primary school children following universal distribution of insecticide treated bed nets inkasipul, Homa-Bay county, Kenya

Malaria is devastating diseases afflicting humans, in Kenya; the disease is endemic in areas around Lake Victoria and along the southern coast. Untreated malaria in school children, result in anaemia, reduced ability to concentrate and learn in school and if fallen sick may lead to school absenteeism. Insecticide treated nets (ITN) have been shown to provide significant protection against Plasmodium infection. Available data show that the overall prevalence of Plasmodium and anaemia among primary school aged children in Kasipul is 25.8 % and 14.1%, respectively. However, there is limited information on the Plasmodium and anaemia prevalence in Kasipul following mass distribution of ITN in 2014. The objective of this study was to assess the prevalence of Plasmodium and anaemia among school children living in Kasipul and their reported use of insecticide treated bed nets, one year after mass distribution of ITN in Kasipul, Homa-Bay County. A descriptive cross-sectional study of 398 primary school pupils was conducted in Kasipul. Pupil’s fingers were pierced using a lancet to obtain blood sample for malaria parasite detection and haemoglobin level determination. Data on insecticide net use was collected using self-administered questionnaire. The overall prevalence of Plasmodium among children was 10.05% and anaemia was 2.3%. The association between net ownership and Plasmodium prevalence among pupils was significant (2= 14.46, df =1, p = 0.000). The difference in malaria prevalence in terms of sex was not statistically significant (2= 0.814, df= 1, p = 0.367). However, anaemia was slightly more prevalent in girls (3.6%) than boys (1.0%) were. Although the difference was not statistically significant (2= 3.217, df= 1, p = 0.073). The study established that only 51.0 % of the study population owned ITN, which is below the 80% target set by the government. A negative correlation of -0.3874 existed between the use of ITN and malaria prevalence. The study observed a significant decline in Plasmodium prevalence from 25.8% in 2011 to 10.05% in 2016, which is evidence that ITN, which was the major control strategy implemented in Kasipul reduced Plasmodium infection in the study population. Decline in Plasmodium infection could also have reduced the prevalence of anaemia in the study area from 14 % in 2010 to 2.3% in 2016. In conclusion, this inquiry revealed that the prevalence of Plasmodium and anaemia has significantly reduced following distribution of free ITN in Kasipul. Plasmodium prevalence was lower in schools, which recorded a large number of pupils using ITN. Prevalence of Plasmodium in Kasipul is still high compared to the national average of 5%; this study recommends that other control measures apart from insecticidal nets should also be introduced in Kasipul, by the Kenya government to eliminate Plasmodium. Ministry of health and other stakeholders should ensure that hang-up’ campaigns to sensitize residence on the relationship between ITN and Plasmodium prevalence, forms an integral part of future treated nets distributions. Further studies using households as sampling units need to be conducted in Kasipul, since this study did not include pupils absent from school on the sampling days.
A thesis submitted in partial fulfilment of the requirements for the award of the Degree of Master of Science (Applied Parasitology) in the School of Pure and Applied sciences of Kenyatta University