National Deworming Research Articles

A comprehensive evaluation of an artificial intelligence based digital pathology to monitor large-scale deworming programs against soil-transmitted helminths: A study protocol.

Manual screening of a Kato-Katz (KK) thick stool smear remains the current standard to monitor the impact of large-scale deworming programs against soil-transmitted helminths (STHs). To improve this diagnostic standard, we recently designed an artificial intelligence based digital pathology system (AI-DP) for digital image capture and analysis of KK thick smears. Preliminary results of its diagnostic performance are encouraging, and a comprehensive evaluation of this technology as a cost-efficient end-to-end diagnostic to inform STH control programs against the target product profiles (TPP) of the World Health Organisation (WHO) is the next step for validation. Here, we describe the study protocol for a comprehensive evaluation of the AI-DP based on its (i) diagnostic performance, (ii) repeatability/reproducibility, (iii) time-to-result, (iv) cost-efficiency to inform large-scale deworming programs, and (v) usability in both laboratory and field settings. For each of these five attributes, we designed separate experiments with sufficient power to verify the non-inferiority of the AI-DP (KK2.0) over the manual screening of the KK stool thick smears (KK1.0). These experiments will be conducted in two STH endemic countries with national deworming programs (Ethiopia and Uganda), focussing on school-age children only. This comprehensive study will provide the necessary data to make an evidence-based decision on whether the technology is indeed performant and a cost-efficient end-to-end diagnostic to inform large-scale deworming programs against STHs. Following the protocolized collection of high-quality data we will seek approval by WHO. Through the dissemination of our methodology and statistics, we hope to support additional developments in AI-DP technologies for other neglected tropical diseases in resource-limited settings. The trial was registered on September 29, 2023 Clinicaltrials.gov (ID: NCT06055530).

Low prevalence of soil transmitted helminth infection in Ugandan children hospitalized with severe malaria.

Co-infection by intestinal helminths and Plasmodium spp. may be common in endemic communities. Several studies have identified a relationship between helminth infection, Plasmodium spp. infection and malaria severity. However, the relationship is not well defined, and results are inconclusive. We analyzed 202 stool samples from a cohort of children with severe malaria enrolled in two hospitals in Uganda from 2014-2017 and asymptomatic community children from the same household or neighborhood and enrolled at the same time, all 6 months to 48 months of age. We investigated if intestinal helminth infection modified risk of severe malaria. We extracted nucleic acids from stool and tested them for six helminth species ( Anyclostoma duodenale, Ascaris lumbricoides, Necator americanus, Strongyloides stercolaris, Trichuris trichiura, Shistosoma mansoni ) using highly sensitive quantitative PCR. We found a low prevalence of infection by ≥1 intestinal helminth species in children with severe malaria (5.1%, n=9/177) and community control children (4.0%, n=1/25). Infection by ≥1 of the helminths assessed was not associated with severe malaria (aRR = 1.0, 95% Confidence Interval = 0.82, 1.3, p = 0.78). In 2003 Uganda instituted a national deworming program, with anti-helminth medication provided twice annually to children 6 months to 5 years of age. In these areas of Uganda, the national deworming campaign has been highly successful, as stool-based helminth infection was rare even when using highly sensitive methods of detection and was not a major contributor to risk of severe malaria.

Safety Profile of Mass Administration of Albendazole Among School Children (6-19 Years): A Prospective Active Surveillance Study.

Infections with Soil-transmitted Helminths (STHs) impact about 24% of the global population. A disproportionate number of individuals, particularly those from low socioeconomic backgrounds, live in emerging nations. In India, between the ages of one and fourteen, almost 220 million children are susceptible to intestinal worm infestations caused by parasites. The National Deworming Day (NDD) initiative was started by the Indian government in February 2015 as a part of the National Health Mission to address this problem. Though the adverse effects of albendazole in routine therapy are known, the mass administration of the medicine in children as part of a public health program has not been adequately studied. This study aimed to determine the occurrence, type, and severity of adverse drug reactions resulting from mass administration of albendazole in school children aged 6-19 years in a district of northern India. Twenty specified clusters were randomly chosen from a total of 94 clusters in the state to participate in this prospective, descriptive, observational study that was carried out in Karnal, Haryana. Both a passive approach and an active adverse drug reaction reporting system were used in the study. The six-step process known as Deb's Active Surveillance & Assisted Reporting System was employed in our study. Adverse drug reactions were recorded using the suspected Adverse Drug Reaction (ADR) reporting form of the Pharmacovigilance Programme of India (PvPI). Twenty clusters with a combined total of 94 schools and 12,751 students were observed during the study. In this study, there were more female participants (N = 8,060; 63.21%) than male participants (N = 4,691; 36.78%). A total of 29 ADRs were reported. All reported ADRs were mild in nature. It was discovered that there were 1.37 incidences for every 1000 individuals. As illustrated in Fig. (1), the most frequently reported Adverse Drug Reactions (ADRs) were vomiting (N = 10), nausea (N = 4), abdominal pain (N = 2), and headache (N = 1). The majority of ADRs were categorized as probable (N=18; 62.06%), followed by possible (N=11; 37.93%). An active surveillance system alongside voluntary passive reporting during the mass administration of medicines can help evaluate the safety profile of the medicinal products. The occurrence of ADRs following mass administration of albendazole in school children was found to be only 1.37 incidences for every 1000 recipients, being mild in nature, with vomiting being the most common.

Prevalence and intensity of soil-transmitted helminth infections among school-aged children in five districts in Uganda.

Soil-transmitted helminth (STH) infections, commonly caused by roundworms (Ascaris lumbricoides), whipworms (Trichuris trichiura), and hookworms (Necator americanus and Ancylostoma duodenale), were widespread among Ugandan schoolchildren in the late 1990s and early 2000s. Since 2003, the Ugandan Ministry of Health has administered biannual preventive chemotherapy to children aged 1-14 years to control these infections. Twenty years after the program's inception, there is scant data to show the long-term impact of these national deworming efforts. To estimate the prevalence and intensity of STH infections among 10-14-year-old primary school children, school-based, cross-sectional surveys were conducted in November 2023 across five districts (Kamwenge, Sheema, Adjumani, Lamwo, and Zombo). Sixty-five children from five schools per district were selected for inclusion. Fecal egg counts were determined using the Kato-Katz microscopy technique, performed in duplicate by trained laboratory technicians. The survey findings revealed a high prevalence of any STH infection in Kamwenge District (21.2%, 95% confidence limits (CL): 5.7%, 36.6%), while the remaining four districts exhibited lower prevalences, ranging from 0.4% (95% CL: 0.0%, 1.2%) in Adjumani District to 5.6% (95% CL: 0.0%, 11.4%) in Sheema District. The prevalence of moderate-to-heavy-intensity infections was below 1% across all districts. A. lumbricoides was identified infrequently. Hookworm infections were primarily identified in the western districts of Kamwenge and Sheema, while T. trichiura infections were common only in Kamwenge District. Hookworm and T. trichiura infections were uncommon in the northern districts of Adjumani, Lamwo, and Zombo. These surveys suggest that morbidity due to STH infections among schoolchildren may be well controlled in these five districts, as evidenced by low moderate-to-heavy-intensity infection prevalence. However, the prevalence of any intensity infection remains elevated in some districts, indicating the need for continued preventive chemotherapy distribution. A reduction from biannual treatment may be warranted in four districts, per World Health Organization recommendations.

Assessment of albendazole efficacy against Ascaris lumbricoides at three sites of Andhra Pradesh, Odisha, and Kerala in India

Objective: To assess efficacy of albendazole against Ascaris (A.) lumbrìcoides among school-children at three sites of Rajahmundry, Sundergarh and Wayanad. Methods: Sites were selected based on soil-transmitted helminths prevalence, different sociocultural-geographical characteristics and operational feasibility. 9-12 Years old children from 14 schools were included. The study was conducted in two rounds: baseline & follow up survey. All eligible children found positive for A. lumbricoides at baseline were administered supervised single tablet albendazole 400 mg under the National Deworming Day Initiative. During post-treatment follow-up survey, eligible children who provided second stool sample were included in the final analysis. Stool samples were examined using WHO recommended Kato-Katz technique. Efficacy was estimated based on cure rate (CR) and Fecal Egg Count Reduction Rate (FECRR) among children found positive in baseline and follow-up surveys. Results: 328 Out of 625 (52.5%) were found positive for A. lumbricoides in the baseline survey and 85 out of 178 samples (47.8%) during post-treatment follow-up survey. Overall, the estimated CR was 52.2%. FECRR (95% CI) for albendazole was 72.6% (79.2%-66.0%). The FECRR was highest in East Godaveri [89.7% (96.8%-82.6%)], followed by Sundergarh [86.4% (95.3%-77.5%)] and Wayanad [69% (81.7%-56.4%)]. Conclusions: Our study confirmed overall reduction in FEC although with varying albendazole efficacy for A. lumbricoides infection at three different locations in India. However, these finding may be assessed in context of ongoing MDA under Filaria control program and further studies by in vivo as well as in vitro methods are required to reach to a conclusion on possible resistance if any.

Adolescents' Perspective Regarding a Community-Wide Mass Drug Administration Program for Soil-Transmitted Helminths in India.

This study was undertaken to understand the perspective of adolescents in endemic communities of India regarding soil-transmitted helminth (STH) infections and community-wide mass drug administration (cMDA). A multicountry community-based cluster-randomized trial, the Deworm3 trial, tested the feasibility of interrupting STH transmission with cMDA, where all individuals aged 1-99 are treated empirically with albendazole. Using a guideline based on the Consolidated Framework for Implementation Research, eight focus group discussions were conducted among 57 adolescents from the trial site in India and analyzed on ATLAS.ti 8.0 software using an a priori thematic codebook. Adolescents believed that adults could be a source of STH infection because they were not routinely dewormed like the children through the national deworming program. Perceived benefits of cMDA for all were better health and increased work efficiency. Perceived barriers to adults' participation in cMDA was their mistrust about the program, fear of side effects, perceived low risk of infection, and absence during drug distribution. To encourage adult participation in cMDAs, adolescents suggested community outreach activities, engaging village influencers and health workers, and tailoring drug distribution to when adults would be available. Adolescents were confident in their ability to be change agents within their households for treatment compliance. Adolescents provided insights into potential barriers and solutions to improve adult participation in cMDA, identified best practices of cMDA delivery, and suggested that they have unique roles as change agents to increase their household participation in cMDA.

Homoeopathy : a Weapon to Children Enemy Ascaris Lumbricoids : a Pilot Study to Study the Effectiveness of Calcarea Carbonica, Cina & Sulphur in Children with Ascariasis

The National Deworming Day is an initiative of Ministry of Health and Family Welfare, Government of India to make every child in the country worm free. This is one of the largest public health programs reaching large number of children during a short period. More than 836 million children are at risk of parasitic worm infections worldwide. According to World Health Organization 241 million children between the ages of 1 and 14 years are at risk of parasitic intestinal worms in India, also known as Soil-Transmitted Helminths (STH). Helminths (worms) which are transmitted through soil contaminated with faecal matter are called soil-transmitted helminths (Intestinal parasitic worms). Roundworm (Ascaris lumbricoides), whipworm (Trichuris trichiura) and hookworms (Necator americanus and Ancylostoma duodenale) are worms that infect people.

Efficacy and safety of praziquantel treatment against Schistosoma mansoni infection among pre-school age children in southern Ethiopia

BackgroundPreventive chemotherapy with a single dose of praziquantel given to an all-at-risk population through mass drug administration is the cornerstone intervention to control and eliminate schistosomiasis as a public health problem. This intervention mainly targets school age children, and pre-school age children (pre-SAC) are excluded from receiving preventive chemotherapy, partly due to scarcity of data on praziquantel treatment outcomes.MethodsWe conducted active efficacy and safety surveillance of praziquantel treatment among 240 Schistosoma mansoni-infected pre-SAC who received a single dose of praziquantel (40 mg/kg) in southern Ethiopia. The study outcomes were egg reduction rates (ERR) and cure rates (CRs) four weeks after treatment using the Kato–Katz technique and treatment-associated adverse events (AEs) that occurred within 8 days post-treatment.ResultsThe overall ERR was 93.3% (WHO reference threshold ≥ 90%), while the CR was 85.2% (95% CI = 80.0–89.5%). Baseline S. mansoni infection intensity was significantly associated with CRs, 100% among light infected than moderate (83.4%) or heavy (29.4%) infected children. An increase of 100 in baseline S. mansoni egg count per gram of stool resulted in a 26% (95% CI: 17%, 34%) reduction in the odds of cure. The incidence of experiencing at least one type of AE was 23.1% (95% CI: 18.0%, 29.0%). Stomachache, diarrhea, and nausea were the most common AEs. AEs were mild-to-moderate grade and transient. Pre-treatment moderate (ARR = 3.2, 95% CI: 1.69, 6.14) or heavy infection intensity (ARR = 6.5, 95% CI: 3.62, 11.52) was a significant predictor of AEs (p < 0.001). Sex, age, or soil-transmitted helminth coinfections were not significant predictors of CR or AEs.ConclusionsSingle-dose praziquantel is tolerable and effective against S. mansoni infection among pre-SAC, and associated AEs are mostly mild-to-moderate and transient. However, the reduced CR in heavily infected and AEs in one-fourth of S. mansoni-infected pre-SAC underscores the need for safety and efficacy monitoring, especially in moderate-to-high infection settings. Integrating pre-SACs in the national deworming programs is recommended to accelerate the elimination of schistosomiasis as a public health problem.

Prevalence and intensity of soil-transmitted helminth infections in Uganda: Results from population-based prevalence surveys in five districts.

Soil-transmitted helminth (STH) infections are caused by roundworms (Ascaris lumbricoides), whipworms (Trichuris trichiura), and hookworms (Necator americanus and Ancylostoma duodenale). In Uganda, baseline surveys conducted during the late 1990s and early 2000s suggested STH infections were common, with prevalence >50% among surveyed schoolchildren. In 2003, a national program was launched with mass preventative chemotherapy (PC) and health education for children 1-14 years old. Little evidence is available to show the impact of national deworming. We conducted population-based, cross-sectional household surveys in five districts (Buikwe, Kassanda, Kiryandongo, Kisoro, and Rubanda) in March and May 2022. Our primary objective was to estimate STH prevalence by species due to infections of any intensity and infections of moderate-to-heavy intensity among preschool-aged children (PSAC, 1-4 years old), school-aged children (SAC, 5-14 years old), and women of reproductive age (WRA, 15-49 years old). Laboratory technicians used duplicate Kato-Katz microscopy to determine fecal egg count. Overall, 3,352 PSAC; 3,884 SAC; and 1,226 WRA provided stool samples. The prevalence of any infection remained high in Kisoro at or above ~50% within all risk groups. In other districts, the prevalence of any infection ranged from approximately 5 to 16% among PSAC, 6 to 23% among SAC, and 12 to 19% among WRA. Moderate-to-heavy intensity infection prevalence was highest in Kisoro (~15-26%), followed by Rubanda (<5%), and was ≤1% in other districts. A. lumbricoides and T. trichiura infections were largely confined to Kisoro and Rubanda, whereas hookworm was most common in other districts. The STH prevalence has decreased markedly in three districts in Uganda. Based on our findings, the national deworming program should consider decreasing PC distribution frequency in these districts per the World Health Organization guidelines. Efforts are needed to understand why the Kisoro and Rubanda districts did not demonstrate similar gains.

Assessing the knowledge, attitudes, practices, and perspectives of stakeholders of the deworming program in rural Rwanda.

Worm infections are among the most prevalent neglected tropical diseases worldwide. Schistosomiasis and soil-transmitted helminths infections, most common worm infections affecting Rwandan school-aged children, are addressed by the national deworming program since 2014. To date, no published studies have assessed the knowledge, attitudes, and practices of the key implementers of the national deworming program conducted at village and school level in Rwanda. This study aimed to assess key stakeholders' knowledge, attitudes, practices, and perspectives about the decentralized national deworming program. We carried out a quantitative, cross-sectional study with complementary in-depth interviews in two districts of Rwanda in June 2021. From the 852 surveyed community health workers and teachers, 54.1% had a knowledge score considered good (≥80%). The mean knowledge score was 78.04%. From the multivariate analysis, lack of training was shown to increase the odds of having poor knowledge (OR 0.487, 95% CI: 0.328-0.722, p <0.001). The in-depths interviews revealed poor water access and hesitance from caregivers as perceived challenges to the success of the deworming program. Our findings demonstrate the importance of training community health workers and schoolteachers on worm infections as they are the key implementers of the deworming program. This would enhance their capacity to provide health education and sensitization on misconceptions and misinformation towards deworming. Moreover, research is needed to assess the impact of poor access to water, sanitation and hygiene facilities on the prevalence of worm infections in Rwanda.

Effect of educational intervention on knowledge, attitude and practice about deworming and its association with anaemia among medical undergraduates in a medical college in dakshina Kannada

The WHO considered soil-transmitted helminthiasis and schistosomiasis among neglected tropical diseases. It has affected more than a third of the world’s population. National Deworming Day (NDD) will be conducted yearly on February 10, followed by a mop-up day on February 15 in the country.According to WHO, across the world, about 24% of the population is infected with soil-transmitted helminthic infections.We used a validated questionnaire, and it included questions to evaluate the participant’sknowledge, attitude, and practice of deworming and anemia. Data was collected by giving 20 minutes to students to answer the questions. After that, a 30-minute lecture was given on anaemia and deworming using PPT. Students were again told to fill in the questionnaire immediately after the lecture. Pre-test and post-test scores were compared, and a chi-square test was used to test the association of knowledge, attitude, and practice. It was observed that knowledge, attitude, and practice among medical students increasedsignificantly after educational intervention.From the above study, we conclude that there is a significant impact on knowledge, attitude, andpractice. As a result, medical student training and healthcare professionals can effectively prevent worm infestation and thus anaemia in the population, which is a major burden in a developing country like India.

Mental health and coping strategies of caregivers of people with intellectual and developmental disabilities: the initial impact of the COVID-19 pandemic in Brazil

Studies on the COVID-19 pandemic highlight detrimental effects of social distancing on mental health. These effects were also observed among caregivers of people with intellectual and developmental disabilities (IDD), who undergo particular challenges in this context. This study aimed to identify the coping strategies adopted by caregivers of people with IDD in the period of social isolation during the COVID-19 pandemic and their relationship to signs of mental illness. Forty-eight caregivers of people with IDD who were users of a non-governmental organization for the assistance of people with IDD and their families in southeastern Brazil undertook an on-line survey. Data analysis included descriptive statistics, Pearson’s correlation, multiple regression, and the word cloud technique. Results indicate that most caregivers employed healthy coping strategies and used negative words to describe their feelings towards the pandemic. Confrontation, withdrawal, self-control, social support, acceptance, and escape correlated with psychological symptoms (stress, depression, or loneliness). Those symptoms were more prevalent among participants using escape as a coping strategy. These findings indicate that caregivers of people with National Deworming Day (NDD) used mostly positive coping strategies to face the COVID-19 pandemic, which may have contributed to the low prevalence of psychological burden in this population.

Helminth Infection among Children Living in an Urban Area in Tropical Countries: A Systematic Review

Background&#x0D; &#x0D; Neglected tropical diseases (NTDs) are a group of preventable and treatable diseases, in which soil-transmitted helminth (STH) infections are among the most common infections worldwide. Most affected are the children and this review aims to identify the prevalence, risk factors and impact of STH in an urban area. &#x0D; &#x0D; Methodology&#x0D; &#x0D; This review was guiding using PRISMA review protocol incorporating the research question of “What is the prevalence, risk factors and impact of helminth infection among urban children in tropical countries?". The databases used in this review include SCOPUS, WEB OF SCIENCE, OVID MEDLINE and PUBMED. The articles used include observational and interventional studies conducted among children aged 18 years and less from 2010 to 2020. The main outcome measure was risk factors of STH infection seen in urban children includes social backgrounds, sanitation and policy.&#x0D; &#x0D; &#x0D; Results&#x0D; &#x0D; From the initial 973 articles found in the database searching, only 13 articles selected for qualitative synthesis after exclusion and screening for eligibility done. The overall prevalence of helminth infection among urban children ranges from 4.8-48.9%. The associated factor that influences helminth infection among children living in an urban area are age, male more common than female, low socioeconomic status, low parents’ education level, living in an urban slum or crowded area, low water quality and sanitation practice and poor hygiene practice. The deworming tablets consumption acts as protective factors for helminth infections. The medium haemoglobin value was significantly lower in helminth-infected children compared to uninfected children and the stunting, underweight as well as moderate acute malnutrition were attributable to helminth infections.&#x0D; &#x0D; &#x0D; Conclusion&#x0D; &#x0D; The prevalence and intensity of helminthiasis were heterogeneous among urban areas of developing countries, however, the endemicity is still high. Further efforts including healthy policies, continuous national deworming programmes and multi-sectoral partnership are required to reduce the prevalence of helminthiasis in the urban area.

Strategies to Decrease the Prevalence of Soil-Transmitted Helminths in Central India.

Background Intestinal parasites are a major public health problem in tropical countries. Over 1.5 billion people are infected with soil-transmitted helminths (STH), of which 225 million are in India. Parasitic infections are associated with poor sanitation, lack of safe potable water, and improper hygiene. Materials and Methods The study was undertaken to ascertain the impact of control strategies, namely open-defecation free drive and mass drug administration of single dose albendazole. Stool samples received at AIIMS Bhopal Microbiology laboratory, across all age groups, were studied for protozoan trophozoites/cysts and helminthic ova. Results Out of 4,620 stool samples, 389 (8.41%) were positive either for protozoal or helminthic infections. Protozoan infections were more common than helminthic infections with Giardia duodenalis infection being the most common, 201 (51.67%), followed by Entamoeba histolytica , 174 (44.73%). The helminthic infections constituted 14 (3.5%) of the positive stool samples with Hookworm ova in 6 (1.5%) cases. Conclusion This study proves that strategies, namely "Swachh Bharat Abhiyan" and "National Deworming Day" started in 2014 and 2015 led to significant reduction of intestinal parasite infections in Central India, with a higher reduction of STH compared with protozoan parasite infection being ascribed to the activity spectrum of albendazole.

Epidemiology of Soil-Transmitted Helminth Infections among Primary School Children in the States of Chhattisgarh, Telangana, and Tripura, India, 2015-2016.

ABSTRACT.Soil-transmitted helminth (STH) infections are highly prevalent in many developing countries, affecting the poorest and most deprived communities. We conducted school-based surveys among children studying in first to fifth standard in government schools in the Indian States of Chhattisgarh, Telangana, and Tripura to estimate the prevalence and intensity of STH infections during November 2015 and January 2016. We adopted a two-stage cluster sampling design, with a random selection of districts within each agro-climatic zone in the first stage. In the second stage, government primary schools were selected by probability proportional to size method from the selected districts. We collected information about demographic details, water, sanitation, and hygiene (WASH) characteristics and stool samples from the school children. Stool samples were tested using Kato-Katz method. Stool samples from 3,313 school children (Chhattisgarh: 1,442, Telangana: 1,443, and Tripura: 428) were examined. The overall prevalence of any STH infection was 80.2% (95% confidence interval [CI]: 73.3–85.7) in Chhattisgarh, 60.7% (95% CI: 53.8–67.2) in Telangana, and 59.8% (95% CI: 49.0–69.7) in Tripura. Ascaris lumbricoides was the most prevalent STH infection in all three states. Most of the STH infections were of light intensity. Our study findings indicate that STH infections were highly prevalent among the school children in Chhattisgarh, Telangana, and Tripura, indicating the need for strengthening STH control program in these states. The prevalence estimates from the survey would serve as a baseline for documenting the impact of the National Deworming Day programs in these states.

Perspective: Opportunities and Scope for Expanded Deworming Programs for Soil-Transmitted Helminths in India

The current deworming strategy for soil-transmitted helminthiases (STH) focuses on pre-school and school-aged children and women in the reproductive age to eliminate morbidity. However, mathematical modeling and meta-analysis show that STH could be eliminated if the entire population, including adults, were treated. The Government of India (GOI) has been deworming children through various maternal and child health programs and school health programs. One of the largest initiatives is the school-based biannual deworming program for children aged 1-19 years in the ‘National Deworming Day’ since 2015. Women of the reproductive age have the opportunity to get dewormed under the Anemia Free India program. Adult men and women have the opportunity to receive Albendazole in the lymphatic filariasis (LF) endemic districts. The gaps in deworming are women above the age of 49 and adult men above 19 years, living in non-LF endemic areas. Understanding gaps in deworming will help plan policy changes and program strategies for STH elimination in India, which has 21% of the global STH burden, as well as in other STH endemic countries.

Statistical Regression Model of Water, Sanitation, and Hygiene; Treatment Coverage; and Environmental Influences on School-Level Soil-Transmitted Helminths and Schistosome Prevalence in Kenya: Secondary Analysis of the National Deworming Program Data.

.According to the Kenya National School-Based Deworming program launched in 2012 and implemented for the first 5 years (2012–2017), the prevalence of soil-transmitted helminths (STH) and schistosomiasis substantially reduced over the mentioned period among the surveyed schools. However, this reduction is heterogeneous. In this study, we aimed to determine the factors associated with the 5-year school-level infection prevalence and relative reduction (RR) in prevalence in Kenya following the implementation of the program. Multiple variables related to treatment, water, sanitation, and hygiene (WASH) and environmental factors were assembled and included in mixed-effects linear regression models to identify key determinants of the school location STH and schistosomiasis prevalence and RR. Reduced prevalence of Ascaris lumbricoides was associated with low (< 1%) baseline prevalence, seven rounds of treatment, high (50–75%) self-reported coverage of household handwashing facility equipped with water and soap, high (20–25°C) land surface temperature, and community population density of 5–10 people per 100 m2. Reduced hookworm prevalence was associated with low (< 1%) baseline prevalence and the presence of a school feeding program. Reduced Trichuris trichiura prevalence was associated with low (< 1%) baseline prevalence. Reduced Schistosoma mansoni prevalence was associated with low (< 1%) baseline prevalence, three treatment rounds, and high (> 75%) reported coverage of a household improved water source. Reduced Schistosoma haematobium was associated with high aridity index. Analysis indicated that a combination of factors, including the number of treatment rounds, multiple related program interventions, community- and school-level WASH, and several environmental factors had a major influence on the school-level infection transmission and reduction.

STRUCTURED ASSESSMENT, EVALUATION AND MONITORING PARAMETERS: CRITICAL CORRELATES TO THE PERCEIVED EFFECTIVENESS OF SCHOOL-BASED DEWORMING PROGRAMS

Background: Soil-transmitted helminths are the most common cause of childhood parasitic infection particularly in developing countries. Government efforts are geared towards addressing this health concern especially among school-aged children who are most vulnerable to intestinal infections secondary to environmental exposure from play and recreation. This study examines the determinants of effectiveness of the national deworming program initiated by the Department of Health in Marawi City, Philippines. Methods: The study used descriptive-correlational research design involving 50 parents/guardians of children who were recipients of the national deworming program. Validity and reliability-tested questionnaires were used as instrument. The data obtained was analyzed using frequency and percentage distribution, weighted mean and Chi-square correlation technique. Results: When tested at 0.05 level of significance, the chi-square values obtained were (=108.494) and (=42.957) at p-value=0.000, revealing that assessment, evaluation and monitoring of the recipients before and after deworming interventions have a significant association to the perceived effectiveness of the program. Conclusion: The present national school deworming drive can be improved further by creating clear-cut protocols and procedures to assess parameters that would measure assessment findings, evaluation and monitoring of children vis-à-vis effects of anti-helminthic drugs taken.

Adverse Events Management During Albendazole Mass Drug Administration: A Pilot Study Experiences from A District of Andhra Pradesh, India

Focussed Surveillance of Albendazole Mass Drug Administration This pilot study describes the field experiences of integrated approach of regional Adverse Drug Reactions monitoring centre (AMC) under Pharmacovigilance Programme of India (PvPI) and National de worming program in Nandyal district of Andhra Pradesh, India in adverse events monitoring associated with albendazole mass drug administration in school children. Though 2% of adverse events (AE) reported as non - serious in nature, found few gap areas in management of children those encountered with such adverse events. Therefore, necessary Standard Operating Procedures and risk management plan to be developed and healthcare workers trained accordingly to minimize the risk

Development of a Decision-Making Approach for Mass Deworming Campaigns on Intestinal Parasites among Primary School Children in Egypt

Intestinal parasitic infections are widespread and cause considerable morbidity. Although mortality from such infections is low, most intestinal parasitic infections interfere with nutrition, growth, development and cognitive progress of children, in addition to interference with productivity and quality of life of adults.&#x0D; &#x0D; Study Aim: Reduction of intestinal parasites prevalence among primary school children.&#x0D; &#x0D; Methods: this is a three-phased study;&#x0D; &#x0D; Desk review on current prevention and control methods including mass deworming in the light of global guidelines.&#x0D; Cross-sectional field study on 522 school children from 8 Governorates, and interviews with 168 members of the health team running the deworming campaign at these Governorates in 2017.&#x0D; Development of decision making approach to guide future consideration of mass deworming campaigns&#x0D; &#x0D; &#x0D; Results:&#x0D; National mass deworming campaigns were effective in reducing prevalence of intestinal worms among primary school children in Egypt, and provided a nationwide awareness on the issue. However, unless these campaigns are combined with sustainable measures of clean drinking water, sewage disposal in schools and households the success of these campaigns in reducing intestinal worms' prevalence will be transient.&#x0D; &#x0D; Conclusion and Recommendations:&#x0D; The national mass deworming campaigns ranged an alarm bell in the community about dangers of intestinal parasites. However, it's recommended to include other susceptible groups like preschool children, adolescent girls and women of childbearing age while focusing the deworming only on infected individuals. It's also recommended to convert the deworming campaigns into a program to ensure sustainability of resources and continuous monitoring and evaluation of intestinal parasitic burden among populations at risk.&#x0D; &#x0D; Key Words:&#x0D; Intestinal Parasites – Primary School Children – Mass Deworming Campaigns – Egypt