INTRODUCTION

Malaria is a major public health problem and cause of much suffering and premature death in the poorer areas of tropical Africa, Asia and Latin America particularly among young children (Cheesbrough, 2010). Children under five years of age are one of the most vulnerable groups affected by malaria. There was an estimated 438,000 malaria deaths around the world in 2015 of which approximately 69% were in children under five years of age. In high transmission areas, partial immunity to the disease is acquired during childhood. In such settings, the majority of malarial disease and particularly severe disease with rapid progression to death occurs in young children without acquired immunity. Severe anaemia, hypoglycaemia and cerebral malaria are features of malaria more commonly seen in children than in adults (WHO 2016). Malaria is an infection caused by parasites of the Plasmodium species. There are four major species of the parasite that infect man. These are P. falciparum, P. vivax, P. ovale and P. malariae. P. Knowlesi is rare. The age distribution of cases of malaria is influenced strongly by the intensity of malaria transmission. In areas where the population is exposed only occasionally to an infectious bite, malaria occurs in subjects of all ages, often most frequently in adults who have occupational risk. In contrast, in areas of high transmission, the main burden of malaria including all malarial deaths is in young children. Until recently, malaria transmission in most endemic areas of sub Saharan Africa was moderate or high and control measure consequently focused on the protection of young children and pregnant women. However, enhanced control efforts have recently reduced the level of malaria transmission in many areas where transmission was previously hyper or holo endemic, it has become mesoendemic. As a consequence, children are acquiring immunity to malaria more gradually than in the past and clinical attacks, sometimes severe, are occurring in school age children more frequently. However, the epidemiology and management of malaria has until recently received little attention (Brooker et al., 2008, Brooker, 2009). In this review, information on the current burden of malaria in African school age children is presented and novel approaches that are being explored to control malaria in this increasingly important groups are reviewed (Nankabirwa et al., 2014).