<p>A retrospective cohort study design was used. Cohort, were students who presented with history of fever, headache, diarrhea, and abdominal pain at the time of outbreak. We generated a line list from the school’s sickbay register from 15th May to 7th June 2022. Structured questionnaires were administered to the cohort. We also conducted a desk review of data from the Kenya Health Information System (KHIS) to ascertain the county’s malaria situation. We collected demographic variables (dormitories, classes), and clinical findings (signs and symptoms). Water samples were collected by Kakamega Water and Sewerage Company (KACWASCO) for bacteriological culture. Data obtained were cleaned, analyzed using Epi Info, and presented in proportions.</p>