Impact of a malaria intervention package in schools on infection, anaemia and cognitive function in schoolchildren in Mali: a pragmatic cluster-randomised trial.

Background: School-aged children are rarely targeted by malaria control programmes, yet the prevalence of infection in primary school children often exceeds that seen in younger children and could affect haemoglobin concentration and school performance.

Methods: A cluster-randomised trial was carried out in 80 primary schools in southern Mali to evaluate the impact of a school-based malaria intervention package. Intervention schools received two interventions sequentially: (1) teacher-led participatory malaria prevention education, combined with distribution of long-lasting insecticidal nets (LLINs), followed 7 months later at the end of the transmission season by (2) mass delivery of artesunate and sulfadoxine-pyrimethamine administered by teachers, termed intermittent parasite clearance in schools (IPCs).

Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali.

Background: The expansion of malaria prevention and control to school-aged children is receiving increasing attention, but there are still limited data on the costs of intervention. This paper analyses the costs of a comprehensive school-based intervention strategy, delivered by teachers, that included participatory malaria educational activities, distribution of long lasting insecticide-treated nets (LLIN), and Intermittent Parasite Clearance in schools (IPCs) in southern Mali.

Methods: Costs were collected alongside a randomised controlled trial conducted in 80 primary schools in Sikasso Region in Mali in 2010-2012.

Beyond distance: an approach to measure effective access to case management for sick children in Africa.

Health planners commonly use geographic proximity to define access to health services. However, effective access to case management requires reliable access to a trained, supplied provider. We defined effective access as the proportion of the study population with geographic access, corrected for other barriers, staffing patterns, and medicine availability.