Learner Treatment Kit (school-based malaria diagnosis and treatment in southern Malawi): Study data and support materials

A set of data collection tools, STATA .do processing scripts, and resultant datasets produced as part of the Learner Treatment Kit (LTK) Project, a study funded to evaluate the impact of a school-based programme of malaria diagnosis and treatment (malaria case management) as part of a wider school first-aid kit exploring school attendance, health and education outcomes. The study conducted a cluster randomized controlled trial in 58 primary schools in TA Chikowi, Zomba district of southern Malawi. The intervention, implemented between 2013-2015 in 29 randomly selected schools from the total of 58 schools, comprised providing free-of-charge malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT) to primary schools to be used by trained teachers to diagnose and treat uncomplicated malaria, as part of basic first aid kits known as "Learner Treatment Kits" (LTKs). The primary outcome was school attendance, assessed through teacher-recorded school attendance registers and periodic spot checks. Secondary outcomes included prevalence of Plasmodium spp. infection, anaemia, educational performance, self-reported child wellbeing, and health seeking behaviour. The trial is registered with ClinicalTrials.gov, NCT02213211. Teacher-recorded daily attendance: Full enrolment lists for each school were collected by the study team, compiled as master enrolment lists and used to populate class registers. These were distributed to teachers in five-week periods and were then completed daily for each child. Spotcheck-observed attendance: Unannounced visits to each school was conducted by a study enumerator at least once a term. Using the master enrolment lists, every child’s name in classes 2, 4 and 6 was read out and their presence or absence documented. Child-reported wellbeing: Using the master enrolment lists, charts were prepared listing every child in the class. These were placed on the relevant classroom wall and on set days children were required to draw a happy, neutral or sad face depending on whether they felt well, average or ill on the day. Parent-reported attendance: During interviews at the endline survey, parents were asked how many days of school their child had missed the last time they were ill. Clinical outcomes (malaria parasitameia, anaemia): At baseline and endline, a finger-prick sample of blood was used to assess haemoglobin concentration and to prepare a thin and thick blood film for confirmation and quantification of malaria parasites on the basis of expert microscopy. Education outcomes (literacy, numeracy & sustained attention): Children were assessed using age appropriate tests of literacy and numeracy (baseline and endline) and sustained attention (baseline only). Household & school-level data: Caregivers of study children were interviewed regarding their family size, ownership of possessions, education level, and bed net use by themselves and their children. Interviews were conducted with the head teacher of each school to ascertain school size, enrolment, and school health programmes such as school-feeding or deworming. Health seeking behaviour: Caregivers of study children were interviewed regarding usual and recent health seeking behaviour for their child during questionnaires administered at the endline survey. Treatment consultations: Treatment registers were distributed to all LTK dispensers in the intervention schools. Every child reporting to the dispenser was recorded in the treatment register with details of child seeking care, symptoms reported or observed, and action taken by the LTK dispenser.