Deworming tablets and Vitamin A supplements to the primary school:
Source: WHO-document. Full document HERE
Why treat children for worms?
Worm-free children have a better nutritional status, grow faster and learn better
Treating children of any age for worms is one of simplest and most cost-effective interventions for improving that child’s health. Preschool children are extremely vulnerable to the deficiencies induced by worm infections: they are in a period of intense physical and mental development and particularly need the vitamins and micronutrients that are lost through worm infections.
Why give children vitamin A supplements?
Vitamin A-replete children have an enhanced chance of survival and less severe childhood illnesses
Vitamin A deficiency also does its worst damage during childhood and is a major contributor to childhood mortality and illness. The most commonly known effect of vitamin A deficiency is blindness. Less well known is that vitamin A is also essential for the functioning of the immune system.
Practical reasons for simultaneous delivery of vitamin A supplements and deworming tablets
1. Vitamin A-deficient children usually have worms
Vitamin A deficiency and worms both thrive in communities that are poor and therefore the two problems often coexist. In other words, children living in these environments are invariably vitamin A deficient and infected with worms. Delivering deworming tablets and vitamin A supplements at the same time therefore makes logistical sense, particularly for remote communities that are difficult to reach.
2. Simple delivery – simple training
The drugs used for deworming are regarded as so safe that nonmedical staff, such as village health workers or teachers, can be trained to deliver them. This means that the deworming training is so simple that it can easily be added onto the training sessions for vitamin A distribution programmes. The main difference is the target age group:
• vitamin A supplements are given from the age of 6 months;
• deworming tablets are given from the age of 1 year.
3. Worm-free children have a better vitamin A status
Research has shown that there is a clinical link between worm infection and reduced vitamin A levels. Roundworms live in the gut and need vitamin A to grow. A competition is set up between the parasite and the child, in which it appears that the worms may be more efficient at absorbing vitamin A than their host. Where vitamin A-rich foods are already marginal in the diet, roundworm infections can tip the balance towards vitamin A deficiency
Drug safety
Deworming drugs are extremely safe
Deworming drugs reach and kill the parasites in the digestive tract and, because they are poorly absorbed, cause no significant sideeffects. Minor side-effects such as nausea and abdominal discomfort are rare (occurring in 1–5% of individuals, according to different statistics), transient and well tolerated by children.
Deworming drugs can be given to children from the age of 1 year
According to a recent WHO consultation, it is safe and recommended in highly endemic areas to start deworming children from the age of 1 year
Drug distribution
No special training is needed for distributors
Administering deworming drugs is very simple. With only a few hours of training, non-medical personnel such as village health volunteers or teachers can easily and safely give the drugs and provide clear simple education on the benefits of deworming. Because the drugs are safe, mothers can also take tablets home to deworm children who were unable to attend for treatment.
Deworming drugs
Types of drugs
There are four drugs to treat STHs. Albendazole and mebendazole tablets are chewable and normally fruit flavoured, which means it is not difficult to persuade children to take them. The tablets can be crushed between two spoons and given with a glass of water for children that have difficulties in swallowing the tablets.
