Deworming in children
This topic covers the importance of deworming in children.
World Health Organization estimates that 241 million children between the ages of 1 and 14 are at risk of parasitic intestinal worms in India, known as Soil-Transmitted Helminths (STH). These children represent approximately 68% of children in this age-group and approximately 28% of the number of children estimated to be at-risk of STH infections globally.
- There are three main types of STH that infect people: roundworm (Ascaris lumbricoides), whipworm (Trichuris trichiura) and hookworms (Necator americanus and Ancylostoma duodenale).
- Adult worms live in human intestines for food and survival where they produce thousands of eggs each day.
- Infected people who defecate outdoors spread worm eggs in their feces.
- Subsequently, the eggs contaminate the soil which can spread infection in several ways:
- Attached to vegetables that are ingested when the vegetables are not carefully cooked, washed or peeled;
- Ingested from contaminated water sources;
- Ingested by children who play in soil and then put their hands in their mouths without washing them.
Symptoms of infection
- Regular treatment of at-risk populations will reduce the intensity of infection and protect infected individuals from morbidity.
- The greater the amount of worms in an individual (intensity), the more symptoms the infected individual will have.
- People with light infections usually have no symptoms.
- Heavier infections can cause a range of symptoms including diarrhea, abdominal pain, and weakness.
- Loss of appetite.
Harms associated with having worms
Effect of STH on the nutritional status of children
Worms impair the nutritional status of people they infect in multiple ways:
- Worms feed on host tissues, including blood, which leads to a loss of iron and protein and often contributes to anaemia.
- Worms can increase the malabsorption of nutrients; roundworm may compete for Vitamin A in the intestine.
- Some worms can cause a loss of appetite, reducing nutritional intake and physical fitness.
- Some worms can cause diarrhea and dysentery.
Development and educational consequences of worms in children
Worms have negative effects on the mental and physical development of children. Children with worms are often underweight and have stunted growth. Heavy infections often make children too sick or too tired to concentrate at or even attend school. Long term, children not treated for worms are shown to earn less as adults.
Effect of worms on child mortality
Intestinal worm infections affect child morbidity, not mortality. There is not rigorous evidence that suggests that worms affect child mortality but there is ample evidence that worms fundamentally affect the quality of children’s lives and negatively impact their access to health, education and livelihoods.
Prevention of infection
Infections can be prevented by taking precautions, including:
- Using sanitary toilets, not defecating outside.
- Hand-washing, particularly before eating and after using toilets.
- Wearing slippers and shoes.
- Washing fruits and vegetables in safe and clean water.
- Properly cooking food.
Deworming treatment given to children
Albendazole and Mebendazole are the names of the deworming drugs used by the Government of India and is a safe treatment for intestinal worms. The recommended dosage is as follows
- For children of 2 years and upwards - : 1 tablet Albendazole (400 mg) or 1 tablet Mebendazole (500 mg)
- For children of age 1 – 2 years - ½ tablet of Albendazole (400 mg) or 1 tablet of Mebendazole (500 mg)
Appropriate administration of tablets to children between the ages of 1 and 3 years is important. The tablet should be broken and crushed between 2 spoons, then safe water added to help administer the drug. The older children should chew the tablet and if required should consume some water.
Side effects of deworming treatment
The deworming treatment has very few side effects. There may be some mild side effects like dizziness, nausea, headache, and vomiting, all likely due to the worms being passed through the child’s body. These side effects disappear after some time. Side effects are usually experienced by children with high infections. If symptoms do not go away within 24 hours, or if they are very severe, the child is probably experiencing something unrelated to the treatment and should be taken to the nearest health facility.
Benefits of treatment
Rigorous studies have shown that deworming has a significant impact on the health, education and livelihoods of treated children. Outcomes of deworming can include:
- Decreases anaemia and improves nutrition
- Increases growth and weight gain
- Improves cognition and mental and physical development
- Increases resistance to other infections
- Supports more frequent school attendance
- Improves children’s ability to learn better and be more active in school
- Increase hours worked and wages earned in the long-run in adulthood
Deworming also has important spillover effects, meaning that other members of the community who do not receive treatment benefit, as there are fewer worms in the environment. This is especially important for children who are too young to be treated but for whom worms can greatly impair cognitive development.
National Deworming Day 2017
With an aim to intensify efforts towards STH control among children in India, the Ministry of Health & Family Welfare, Government of India (GoI) observes the National Deworming Day (NDD) on 10th February every year. The third annual National Deworming Day (NDD) was held on 10 February 2017.
Currently largest single day public health program in the world, the National Deworming Day this year is set to reach approximately 34 crore children in the age group of 1-19 years in 34 states and union territories in government and government-aided schools, anganwadis, and private schools.
The National Deworming Day will be followed by a Mop-Up Day (MUD) on 15th February 2017 with the intent of deworming children who missed the dose on February 10th. All Government and Government aided schools and anganwadi centers will be the sites for implementation of National Deworming Day across the country.
Target audience - All children (both boys and girls) in the age group of 1-19 years.
Second round of National Deworming Day 2017
Ministry of Health and Family Welfare observes the 2nd round of National Deworming Day (NDD) 2017 on 10th August in 33 States/UTs followed by mop-up activities on 17th August targeting 31 crore children. A total of 7.8 crore children are targeted in private schools and 3.5 crore out of school children will be covered in this program through Anganwadi workers and ASHAs.
In an effort to improve child health scenario of the country, National Deworming Day aims to reach every child, regardless of their socio-economic circumstance. Schools and anganwadis are ideal platforms for such a program, reaching children in their natural environment in a coordinated, cost-effective, and systematic way. In addition, through extensive awareness generation and community mobilization efforts at state, district, and community levels, children who are out of school, live in hard-to-reach areas, and are from vulnerable populations are also mobilized to be dewormed at anganwadis on National Deworming Day.
The NDD is being implemented through the combined efforts of Department of School Education and Literacy under Ministry of Human Resource and Development, Ministry of Women and Child Development and Ministry of Drinking Water and Sanitation.