title: School-based participatory health education for malaria control in Ghana: engaging children as health messengers.
abstract: BACKGROUND
  School children have been increasingly recognized as health messengers for malaria control. However, little evidence is available. The objective of this study was to determine the impact of school-based malaria education intervention on school children and community adults.
  
  
  METHODS
  This study was conducted in the Dangme-East district of the Greater Accra Region, Ghana, between 2007 and 2008. Trained schoolteachers designed participatory health education activities and led school children to disseminate messages related to malaria control to their communities. Three schools and their respective communities were chosen for the study and assigned to an intervention group (one school) and a control group (two schools). Questionnaire-based interviews and parasitological surveys were conducted before and after the intervention, with the intervention group (105 children, 250 community adults) and the control group (81 children, 133 community adults). Chi-square and Fisher's Exact tests were used to analyse differences in knowledge, practices, and parasite prevalence between pre- and post-intervention.
  
  
  RESULTS
  After the intervention, the misperception that malaria has multiple causes was significantly improved, both among children and community adults. Moreover, the community adults who treated a bed net with insecticide in the past six months, increased from 21.5% to 50.0% (p < 0.001). Parasite prevalence in school children decreased from 30.9% to 10.3% (p = 0.003). These positive changes were observed only in the intervention group.
  
  
  CONCLUSIONS
  This study suggests that the participatory health education intervention contributed to the decreased malaria prevalence among children. It had a positive impact not only on school children, but also on community adults, through the improvement of knowledge and practices. This strategy can be applied as a complementary approach to existing malaria control strategies in West African countries where school health management systems have been strengthened.
authors.affiliation: Bureau of International Medical Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, Japan.
authors.forename: Irene
authors.initials: I
authors.lastname: Ayi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nonaka
authors.forename: Josiah K
authors.initials: JK
authors.lastname: Adjovu
authors.forename: Shigeki
authors.initials: S
authors.lastname: Hanafusa
authors.forename: Masamine
authors.initials: M
authors.lastname: Jimba
authors.forename: Kwabena M
authors.initials: KM
authors.lastname: Bosompem
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mizoue
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Boakye
authors.forename: Jun
authors.initials: J
authors.lastname: Kobayashi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004522:Educational Status; D005260:Female; D005869:Ghana; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016778:Malaria, Falciparum / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control / Q000379:methods; D015995:Prevalence; D015397:Program Evaluation; D012572:School Health Services / Q000458:organization & administration; D012574:Schools; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
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