Measuring the impact of improved malaria control in school-age children on education outcomes

This PhD opportunity is being offered as part of the LSTM and Lancaster University Doctoral Training Partnership. Find out more about the studentships and how to apply. 

Abstract Malaria remains a leading global health threat. School-age children suffer an underappreciated burden of malaria which manifests as both acute clinical disease and chronic, “sub-clinical” infections associated with anaemia and inflammation. Malaria can undermine school-age children’s educational outcomes through multiple pathways, e.g. clinical disease causes school absences and chronic infections limit cognitive function, ultimately limiting learning, achievement, and attainment. Seminal studies from Sri Lanka showed malaria chemoprevention (drugs taken regularly to both clear existing infections and provide a period of prevention) among primary school students reduced both absenteeism and improved test scores in both reading and math. While subsequent studies in sub-Saharan Africa have shown mixed results, a recent trial from our group showed improvement in literacy among participants who received chemoprevention. This PhD will support further investigation into the mechanisms and magnitude of malaria’s impact on education in school-age children. Exact scope is adaptable to candidate’s interests and may be tailored based on success of current grant proposals. However, could include a scoping review, detailed secondary analysis of existing data (assessments of attention, literacy, and math and many co-variates) from prior clinical trials, prospective data collection and analysis in the context of funded trials, and more mechanistic evaluations, if funded. Relevant analytic techniques include psychometric analysis, regression analysis, and causal inference methods. Results will have implications for policy and prioritization of malaria control interventions targeting school-age children as well as for broader dialogue on the measurement of education outcomes in the context of health interventions.
Where does this project lie in the translational pathway? T2 - Human /Clinical Research
Methodological Aspects
  • Scoping review and evidence synthesis
  • Analysis of the psychometric properties of learning and potentially cognitive function data
  • Statistical analysis (multi-level regression modeling) of educational outcomes based on intervention arms.
  • Additional analysis evaluating impact of co-variates on education outcomes
  • Potential to use causal inference methods
Expected Outputs
  • 2-3 peer reviewed manuscripts
  • Inform approaches to measure the education outcomes of school health interventions beyond malaria
  • Outcomes that are translatable to economic terms and therefore may influence policy and resource allocation
  • Results to support future grant submissions in multiple areas
Training Opportunities =- Coursework _xludf.and mentorship in analytic techniques
  • Participation in multi-sectoral network focused on malaria in school-age children
  • Possibility to be involved in prospective data collection
Skills Required
  • Background in psychology, clinical medicine, or education
  • Strong quantitative skills - basic statistics, at least one coding langage (R, Stata...)
Subject Areas Malaria & other Vector Borne Diseases; Maternal, Neonatal, and Child Health
Key Publications associated with this project

Cohee LM, Opondo C, Clarke SE, Halliday KE, Cano J, Shipper AG, et al. Preventive malaria treatment among school-aged children in sub-Saharan Africa: a systematic review and meta-analyses. Lancet Glob Heal. 2020 Oct;8(12):e1499–511.

Cohee LM, Nankabirwa JI, Greenwood B, Djimde A, Mathanga DP. Time for malaria control in school-age children. Vol. 5, The Lancet Child Adolesc Health; 2021. p. 537–8.

Sixpence A, Vokhiwa M, Kumalakwaanthu W, Pitchford NJ, Seydel KB, Magder LS, et al. Comparing approaches for chemoprevention for school-based malaria control in Malawi: an open label, randomized, controlled clinical trial. eClinicalMedicine. 2024 Oct 1;76:102832

Cohee LM, Halliday KE, Gelli A, Mwenyango I, Lavadenz F, Burbano C, et al. The Role of Health in Education and Human Capital: Why an Integrated Approach to School Health Could Make a Difference in the Futures of Schoolchildren in Low-Income Countries. Am J Trop Med Hyg. 2020; doi: 10.4269/ajtmh.20-0779

Fernando D, De Silva D, Carter R, Mendis KN, Wickremasinghe R. A randomized, double-blind, placebo-controlled, clinical trial of the impact of malaria prevention on the educational attainment of school children. Am J Trop Med Hyg. 2006;74(3):386–93.