Malaria Infection and Bednet Efficacy Among Ghanaian High Schools Students

Introduction: Malaria is a major cause of morbidity and mortality in sub-Saharan Africa, where an estimated 90% of the world's malaria-credited deaths occur. Bed net use is considered a cost-effective method of prevention in malaria endemic areas. This study examined the relationship between bed net uses and self-reports of malaria infection as told by medical doctor or nurse among high school students in Ghana.

Methods: We utilized data from the 2008 Ghana Global School-based Student Health Survey (GSHS). Using complex samples analysis, prevalence estimates (95% CI) and odds ratios were calculated.

Results: Overall, 38.0% of students reported being sick with malaria during previous school term. Girls were 1.56 times more likely to report malaria infection. Boarding students were 1.43 times more likely to report malaria than day students. Female students (43.8%; CI: 41.1-46.4) were significantly more likely to report malaria infection compared to male students (33.6%; CI: 31.8-35.3). Interestingly, there is no association between general bed net use (37.5%) and malaria when considering gender and grade level. However, among bed net users, Insecticide treated bed nets (ITN's) users (36.7%; CI: 34.5-38.9) were less likely to report getting malaria compared to non-ITN (43.8%; CI: 41.0-46.7) users.

Conclusion: Existing literature indicates the effectiveness of bed nets in preventing malaria infection. However, there is a lack of association between infection and general bed net use among high school students in Ghana. We recommend further investigation to explore why bed net use does not have an impact on malaria prevalence among this population.