The Impact on Absence from School of Rapid Diagnostic Testing and Treatment for Malaria by Teachers.
Abstract
Malaria is the principal preventable reason a child misses school in sub-Saharan Africa and the leading cause of death in school-aged children We describe a model for teachers to use rapid diagnostic testing (RDT) for malaria and treatment with Artemisinin-based combination therapy (ACT) to enhance education by reducing school absence due to malaria. Conduct: A 2 year pilot program in 4 primary schools in rural Uganda. Year 1, Pre-intervention baseline evaluation (malaria knowledge; school practices when  pupils become sick; monitoring of days absent as a surrogate for morbidity and teachers trained to administer RDT/ACT as the Year 2 intervention. Findings: Teachers identified malaria as a barrier to education, contributed to logistic design, participated willingly, collected accurate data, and readily implemented/sustained RDT/ACT program. Pre-intervention: 953/1764 pupils were sent home due to presumed infectious illness; mean duration of absence was 6.5 days (SD: 3.17). With school-based teacher-administered RDT/ACT 1066/1774 pupils were identified as sick, 765/1066 (67.5%) tested RDT positive for malaria and received ACT; their duration of absence fell to 0.59 days (SD: 0.64) (p<0.001) and overall absenteeism to 2.55 (SD: 3.35). This RDT/ACT program empowered teachers, significantly reduced days of education lost due to malaria and is applicable to other schools.
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