الفهرس 
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Abstract
Malaria is the most prevalent mosquito-borne disease throughout tropical and subtropical regions of the world with huge medical, economic, and social impact. According to the WHO report (2016), about 3.2 billion people remain at risk of malaria, and there were 212 million malaria cases worldwide, accounting for nearly 429,000 deaths, of which 92% were in African region, 6% were in South-East Asian region, and 2% were in Eastern Mediterranean region.
Child undernutrition in all its forms is a global health concern. Underweight, stunting and wasting are reported to be serious problems affecting developing countries. Child undernutrition has short and long term effects. The short term effects include morbidity and mortality. The long-term effects include preventing children from reaching their full developmental potential and poor cognitive performance, which in turn has consequences for the country‘s productivity. A variety of haematological alterations have been reported in Plasmodium falciparum malaria.
In the light of the above, in order to enrich the research, the current study aimed to determine the prevalence of Falciparum malaria and its relation to nutritional status and haematological parameters among schoolchildren in Hodeidah Governorate, Yemen.
This study was conducted on 400 randomly selected children from four schools in Hodeidah Governorate, after obtaining their parent’s consent and obtaining moral and signed approval from the concerned authorities. Their data were taken using a pre-prepared questionnaire. Data were collected on gender, age, place of residence, where any antimalarial drugs used during the year prior to the research, and were asked about the risk factors that would help spread the malaria parasite. Malaria was investigated using rapid diagnostic tests to detect the presence of malaria parasites by taking blood by finger prick and rapid examination. A few drops of blood were taken on two glass slides for the purpose of making thick and thin blood film to detect Plasmodium falciparum or not. After the staining of these blood smears with the giemsa stain according to the standard methods, and counting the non-sexual stages to determine the density of the parasite on the thick blood smear against white blood cells, was also detected the presence of sexual phases of the parasite, and also collection three ml of venous blood in the EDTA tubes to examine the haematological parameters. Weight, height and temperature were measured for all children enrolled in the current study.
After obtaining the results, questionnaire data and laboratory data were entered and analyzed statistically using the appropriate statistical tests by SPSS version 20.0. Differences and relationships were considered statistically significant when the probability values were less than or equal to 0.05.
After conducting the laboratory methods, and the appropriate statistical processing of the data obtained, the following results were revealed:
The current study illustrated that the prevalence of Falciparum malaria was 8.0% and 0.25% P. vivax as diagnosed by microscopy and RDT antigen which gives similar prevalence results. Falciparum malaria infected cases were asymptomatic except 6.25% who had fever Regarding the relationship between malaria parasite and demographic variables including gender, age and residence, the prevalence of Falciparum malaria is higher in males (59.4%) than in females (40.6%). So, Male students are more likely to have malaria parasites than females. Malaria was higher among the age group of 10 – 12 years (59.4%), as compared to other groups. It was higher among rural children (53.1%) as compared to those in urban areas (46.9%) but there was no significant difference.
Concerning the risk factors; sleep under bed net, use wire screening of windows and living near water stream, the results revealed that there was statistical significant association between malaria parasite and students living near water stream, while there is no statistical significance between malaria parasites and other risk factors. They may be didn’t care to sleep under bed net or use of screening windows.
As regarding the nutritional status including stunting, wasting, underweight and malnutrition, it was higher in male than female, in students of 10-12 years than other age group , in family size 7-10 members than other group and higher in rural area than urban area with no significant difference as compared to other groups of both malaria cases and non-malaria infected cases except underweight. BMIZ among the Plasmodium falciparum positive children showed a statistically significant decrease as compared to those non-infected participants.
Concerning the haematological parameters, the current study showed a statistically significant relationship between malaria parasite and haemoglobin, red blood cells, total white blood cells, monocytes and platelets, as well as a statistically significant relationship between malaria parasite and anaemia was observed. The occurrence of anaemia among students with malaria parasites is higher (53.1%) than the rate of anaemia among non-infected children (17.9%). Although there is lower platelet counts among positive cases and significantly decreased as compared to non-malaria cases, it is in the normal range this may be due to low parasitemia.
As for nutritional status and haematological parameters, the current study showed statistically significant relationship between stunting and haemoglobin, red blood cells and platelets, between wasting and haemoglobin, total white blood cells and platelets, between underweight, haemoglobin and platelets and between malnutrition, haemoglobin and platelets. This reflect the morbidity of the community.
Collectively, the results of this study revealed that demographic data particularly gender (male), age (10-12), family size (7-10) and residence (rural) are associated with malaria infection. Stream water was the highest risk factor among infected patients. Considering, malnutrition, underweight, BMIZ predominantly was significantly associated with P. falciparum. Anemia, low platelets and monocytes’ counts are the most haematological parameters significantly associated with P. falciparum.