The relationship between Schistosoma haematobium infection and school performance and attendance in Bamako, Mali.

Schistosomiasis due to Schistosoma haematobium was the most common helminth infection in school-age children from a poor area in Bamako, Mali. Almost half (47%) of the boys and 40% of the girls were infected, 18% of the children being heavily infected. There was a significant decline in academic performance and in school attendance with increasing intensity of infection. When all sources of variation were taken into consideration, absenteeism was the main factor explaining the variation in academic performance, although a significant effect of infection remained. School-based delivery of chemotherapeutic interventions is currently promoted by several international organizations. However, rates of school attendance are low in some areas and it is the absentees who appear to be at relatively high risk of ill health. Novel ways of reaching this elusive subset of the population are required.