The Impact on Absence from School of Rapid Diagnostic Testing and Treatment for Malaria by Teachers.

Andrew Macnab, Sharif Mutabazi, Ronald Mukisa, Atukwatse Eliab, Hassan Kigozi, Rachel Steed


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.


Absenteeism, Community-based education, Health promoting schools, Malaria.

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