De-Worming of School Children

A study was undertaken to measure the impact of periodic de-worming with albendazole on growth status and incidence of diarrhea in children aged 2–5 years in an urban setting in India and to assess the feasibility of local health workers implementing the procedures involved. This was a double-blind, placebo-controlled, randomized, community-based intervention trial with 702 children randomly allocated to receive either albendazole or placebo. The two study groups received two doses of albendazole (400 mg) or placebo six months apart. Mean weight increased significantly in the albendazole group compared to the control group at three months, six months and nine months following treatment (P < 0.01, P < 0.01 and P < 0.001 respectively). The albendazole group also experienced fewer episodes of diarrhea than their control counterparts (relative risk 1.3, 95% CI 1.07–1.53) with a 28% reduction. The health workers administered the correct dosage satisfactorily and there were no adverse effects. Thus, periodic mass de-worming with albendazole would seem to be a safe and effective method that could be adopted at the community level or as an integral part of school health services and could be expected to improve growth and reduce the incidence of diarrhea in children.

School age children (5-15 years) have not received as much attention from health providers/planners as the under fives. In an international workshop at Kentucky, USA in 1994, it was agreed that there was a dearth of information on the health status of school age children from developing countries particularly at the community level (1). In India, several studies have been carried out on the health status of school age children. These have largely been quantitative and the reported morbidity included malnutrition (10.0-98.0%), dental ailments (4.0-70.0%), worm infestation (2.0-30.0%), skin diseases (5.0-10.0%), eye diseases (4.0-8.0%), and anemia (4.0-15.0%)(2-10), However, data on the community’s perception about these morbidities are inadequate. It is now being increasingly recognized that proper understanding of the community’s view point of any health problem contributes significantly towards formulating and implementing strategies that improve their health. Therefore, qualitative research methods, which bring out the community’s perception of any issue, should form an integral part of investigation of morbidity. With this background, this study was conducted to evaluate the extent and pattern of health status of school age children applying both qualitative and quantitative methods.

Anemia is a serious public health problem in Indian school children. Since 2003, simple health intervention programs such as antihelminthic treatment and vitamin A supplementation have been implemented in primary schools in the Bangalore region, Karnataka, India. This study examines the prevalence of anemia in school children who are beneficiaries of this program. DESIGN: Cross-sectional survey. SETTING: Bangalore district, South India. SUBJECTS: A total of 2,030 boys and girls, aged 5-15 years, attending schools in the Bangalore district. INTERVENTIONS: School-based, twice yearly intervention: de-worming (albendazole 400 mg, single oral dose) and vitamin A supplementation (200,000 IU, single oral dose). MAIN OUTCOME MEASURES: Anemia prevalence based on measure of blood hemoglobin (Hb). RESULTS: Mean age and blood Hb concentration of all children were 9.5+/-2.6 years and 12.6+/-1.1 g/dl (range 5.6-16.7), respectively. The overall anemia prevalence in this group was 13.6%. Anemia prevalence was lower in boys than girls (12.0%; n=1037 vs 15.3%; n=993 respectively, P<0.05). There was no significant difference in anemia prevalence between children in urban and rural locations (14.6 and 12.3%, respectively). CONCLUSIONS: The current low anemia prevalence in Bangalore could be due to the impact of school-based intervention programs that have been in place since 2003. The beneficial interactions of de-worming and vitamin A supplementation could have widespread implications for current preventive public health initiatives. There is now need for the development of clear policy guidelines based on these simple and integrated interventions

July 25, 2008 Post Under - Read More

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