Short-Term Impact of Acute Uncomplicated Malaria on The Cognitive Performance of School Children Living in an Endemic Area
Lubis, Iskandar Z.
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Background In Indonesia, malaria remains a public health problem. In North Sumatra between 2000 and 2004, an estimated 50,670 clinical cases occurred every year, leading to the deaths of 9-10 people per year. Objectives To determine the short-term impact of acute uncomplicated malaria on the cognitive performance of school children. Methods A prospective study was conducted on students at four elementary schools in Madina, North Sumatra, Indonesia, from August 15 to September 3, 2006. Subjects were classified into malaria and non-malaria groups based on microscopically confirmed blood smears; they were selected by means of random sampling. Cognitive performance was measured with two examination papers on mathematics and Indonesian language before and two weeks after artesunate and amodiaquin treatment for three days in the malaria group. Independent or paired t-tests were used to analyze differences in mean scores of cognitive performance. Results From 925 children examined, 384 suffered from malaria. One-hundred and thirty three children were recruited from the malaria group and 132 children were recruited from the nonmalaria group. There was no difference in the distribution of general characteristics of the subjects. There was a significant difference in cognitive performance between the malaria and non-malaria groups (P<O.OOOl) before and after treatments. In the malaria group, there was a significant difference in cognitive performance before (mean 38.9; SD 15 .19) and after treatment (mean 72.9; SD 10.41) with P<0.000l. Conclusion Acute uncomplicated malaria significantly affects the cognitive performance of school children living in a malariaendemic area