Second Round of National Deworming initiative

•  Ministry of Health and Family Welfare has launched its 2nd round of National Deworming Day (NDD) 2017 in 33 States/UTs targeting.
• 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.
• The NDD program has been launched in 2015 as WHO estimates that 220 million children below 14 years of age are at risk of STH infections in India.
• National Deworming Day is organised twice in a year covering all the children from 1-19 years of age except the States of Rajasthan and Madhya Pradesh where deworming is carried out once in a year. The Soil Transmitted Helminths (STH) prevalence in these two States is less than 20%.
• All the children are provided deworming tablet in schools and anganwadis. The deworming has the potential to improve nutritional status of children. The deworming tablet called ‘Albendazole’ is a safe and efficacious drug for controlling worm infestation.
• During NDD, besides the deworming tablet, various health promotion activities related to Water, Sanitation and Hygiene (WASH) are also being organised in schools and anganwadis. This program is being implemented in close collaboration with Ministry of Human Resource & Development and Ministry of Women & Child Development.
• This is one of the largest public health programs reaching large number of children during a short period. The first NDD round of 2017 implemented in February covered 26 crore children with a coverage of 89%.

Analysis:

• WHO indicates that India has the highest burden of soil-transmitted helminths (STH) in the world, with 220 million children aged 1-14 estimated to be at risk of worm infections. Almost 7 in 10 children between 6 month and 5 years are anaemic, with even higher rates of anaemia in rural areas, according to the 2006 National Family Health Survey.
• There are at least two randomized trials in India in the last decade that demonstrate the positive impact of deworming in the country. A health intervention that provided iron, Vitamin A, and deworming drugs to Indian preschool children in the slums of Delhi found a significant gain in children’s weight and school participation compared to intervention with Vitamin A alone. Absenteeism was reduced by one-fifth in the treatment group (Bobonis et al, 2006). A cluster-randomized controlled trial found children aged 1-5 that were treated with five rounds of the deworming drug, resulted in a greater weight gain compared to non-treated groups (Awasthi S. et al 2008).
• Soil-transmitted helminth (STH) infections are among the most common infections worldwide and a¬ct the poorest and most deprived communities. They are transmitted by eggs present in human faeces, which in turn contaminate soil in areas where sanitation is poor. Several studies show the detrimental e¬ects of STH on children’s educational performance and school attendance. Children with the highest intensity of STH infestation are often too sick or too tired to concentrate at school or attend school at all. STHs interfere with nutrient uptake in children; can lead to anaemia, malnourishment and impaired mental and physical development. Rigorous research has shown that they also pose a serious threat to children’s education and productivity later in life.Mass deworming leads to significant improvement in outcomes related to education, earnings, and long-term well-being
• School-based mass deworming program is safe, cost-effective, and can reach millions of children quickly.
• Deworming has also been shown to reduce absenteeism in schools; improve health, nutritional, and learning outcomes; and increase the likelihood of higher-wage jobs later in life

By: Vishal