Should deworming be included in antenatal packages in hookworm-endemic areas of developing countries?
BACKGROUND
WHO recommends antenatal (after the first trimester) deworming for pregnant women who live in areas where the prevalence of hookworm infection exceeds 20-30%. However, deworming has not been included in antenatal care packages in most developing countries.


METHODS
A review of articles publishing original data identified primarily through Medline was conducted using subject heading terms and text words for "deworming", "pregnant women", "hookworm", "anthelminthic", "anthelmintic", "albendazole", "mebendazole", "pregnancy" and their combinations. Bibliographies of retrieved articles were scanned to identify any additional relevant documents.


RESULTS
Five articles examined the benefits of antenatal deworming. All provided evidence favourable to deworming, in terms of both maternal and infant outcomes. Comparison of outcome measures could be improved with a more standardized approach to outcome ascertainment and reporting.


CONCLUSIONS
The evidence base for the inclusion of deworming in antenatal care packages in hookworm-endemic areas is mostly observational in nature. Future research should be directed towards 1) strengthening the evidence base with empirical data from randomized controlled trials, and 2) furthering our understanding related to government uptake of the WHO policy on deworming.
Larocque
Renée
R
Department of Epidemiology and Biostatistics, McGill University, Montreal, QC. renee.larocque@mail.mcgill.ca
Gyorkos
Theresa W
TW
D015766:Albendazole / Q000627:therapeutic use; D000871:Anthelmintics / Q000627:therapeutic use*; D003906:Developing Countries; D019353:Endemic Diseases / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D005260:Female; D006302:Health Services Research; D006725:Hookworm Infections / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D008463:Mebendazole / Q000627:therapeutic use; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D014944:World Health Organization
D000871:Anthelmintics; D008463:Mebendazole; D015766:Albendazole