Depriving Out-of-School Children of Deworming Tablets for Soil-Transmitted Helminth Infection in Bangladesh: The Irony of a School-Based Deworming Programme.

Avijit Saha,Asadur Rahman,Malabika Sarker,Konica Gop,Srizan Chowdhury,Ariful Alam,Edwin Theophilus Goswami

doi:10.3390/tropicalmed7030035

Abstract

Since 2008, Bangladesh has had a school-based deworming programme to combat soil-transmitted helminth (STH) infection among school-aged children (SACs). Existing programmes have trouble reaching SACs, especially those out-of-school (OSCs). This study evaluated deworming coverage among school going children (SGCs) and OSCs in two Nilphamari sub-districts. It also evaluated community knowledge on STH control and deworming coverage in both areas for all SACs. Saidpur (intervention) and Kishoregonj (control) sub-districts, in Nilphamari, were surveyed in December 2019. The survey included SACs and their parents. Among SGCs, the intervention group (89.0%) had higher deworming coverage than the control group (75.5%). In the intervention group, 59.9% of OSCs received the deworming tablet versus 24.6% in the control group. Community involvement activities including door-to-door visits, courtyard gatherings, and miking benefited both SACs and their primary caregivers. SACs living in the intervention region, awareness of the last pill distribution date, and caregivers observing BRAC workers in action, were linked to SAC deworming coverage. Re-strategizing the deworming programme to include the OSCs is vital and suggests timely action. Building community awareness and periodic epidemiological assessment can further facilitate an improved drug intake.

Highlights

Soil-transmitted helminth (STH) infections affected more than 1.5 billion people worldwide in 2020, most of whom reside in the impoverished parts of Asia and Africa
This was deemed appropriate as the sub-districts are neighbours with a similar population size and the government’s school-based deworming programme was running in both places
Given that SGCs are frequently the primary target of deworming programs, and there is a lack of protocol to integrate the OSCs [9], it is unsurprising that coverage is higher among the SGCs

Summary

Introduction

Soil-transmitted helminth (STH) infections affected more than 1.5 billion people worldwide in 2020, most of whom reside in the impoverished parts of Asia and Africa. STH-related infection was responsible for the loss of approximately 1.9 million disability-adjusted life-years (DALYs) in 2017 [1]. School-aged children (SAC) are among the most vulnerable populations to this group of diseases [2]. In Bangladesh, STH infection is endemic in all 64 districts. About one-third of the general population and two-fifths of SACs are in danger of being infected in rural areas [5]. The Bangladeshi government has been focusing its resources on a biannual school-based deworming pill distribution programme since 2008 [6]. The programme has managed to arrange 23 rounds of deworming sessions up to January 2020 [7]

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Conclusion