Sociodemographic and clinical determinants of asymptomatic Plasmodium falciparum infection among School Children in Low Transmission Season in The Kassena Nankana West District of Ghana

Abstract

Abstract Background: Asymptomatic malaria remains a diagnostic challenge and serves as a reservoir forinfection transmission and leads to malaria in children. This study was therefore conducted to assess the sociodemographic and clinical determinants of asymptomatic Plasmodium falciparum (Pf) infection among school children in low transmission season. Methods:In a cross-sectional study, 328 school children ages 6-14 years were recruited in the study. Asymptomatic malaria status was determined using three laboratory diagnostic method: Rapid Diagnostic Test (RDT), Microscopy and Polymerase Chain Reaction (PCR) analysis. Anaemia as one of the clinical determinants of asymptomatic Plasmodium falciparum infection was diagnosed as low haemoglobin concentration using a haemoglobinometer. Results: The prevalence of asymptomatic Plasmodium falciparum infection was 13.4%. The mean age was (10.6 ± 2.4) years with majority (52.7%) being in the age category ≥11 years. Most of the participants were females (59.8%). Mean haemoglobin concentration was (10.4 ± 1.8) g/dl. Anaemia was recorded in 91 out of the 328 children, accounting for 27.7% of the studied subjects and was significantly associated with P. falciparum infection [OR = 19.9, 95%CI = (2.7 – 147.2), p = 0.003]. Of the 91 asymptomatic subjects who had anemia, 59 (64.8%) were anaemic with falciparum infection with 29 (31.9%) and 13 (14.3%) having moderate (8-10.9g/dl) and severe (<8g/dl) anaemia with P. falciparum infection respectively. Though statistically insignificant, males were associated with increased odds of malaria infection [OR = 1.8, 95%CI = 0.9 – 3.3), p = 0.083], and the use of mosquito nets as one of the interventive measures against the malaria vector were statistically not significant (p = 0.960) despite low 24.7% of the participants’ patronage. Conclusion: Prevalence of asymptomatic malaria P. falciparum infection was relatively high and was associated with moderate anaemia in the cohort suggesting that they may be a target of control interventions.