Controlling soil-transmitted helminthiasis in pre-school-age children through preventive chemotherapy.
Pre-school age children account for 10%-20% of the 2 billion people worldwide who are infected with soil-transmitted helminths (STHs): Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm), and Ancylostoma duodenale/Necator americanus (hookworms). Through a systematic review of the published literature and using information collated at World Health Organization headquarters, this paper summarizes the available evidence to support the recommendation that pre-school children should be included in regular deworming programmes. The first section describes the burden of STH disease in this age group, followed by a summary of how infection impacts iron status, growth, vitamin A status, and cognitive development and how STHs may exacerbate other high mortality infections. The second section explores the safety of the drugs themselves, given alone or co-administered, drug efficacy, and the importance of safe administration. The third section provides country-based evidence to demonstrate improved health outcomes after STH treatment. The final section provides country experiences in scaling up coverage of pre-school children by using other large scale public health interventions, including vitamin A programmes, immunization campaigns, and Child Health days. The paper concludes with a number of open research questions and a summary of some of the operational challenges that still need to be addressed.
Albonico
Marco
M
Ivo de Carneri Foundation (IdCF), Milano, Italy. albonico@tin.it
Allen
Henrietta
H
Chitsulo
Lester
L
Engels
Dirk
D
Gabrielli
Albis-Francesco
AF
Savioli
Lorenzo
L
D000722:Ancylostoma / Q000187:drug effects / Q000502:physiology; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D017164:Ascaris lumbricoides / Q000187:drug effects / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006373:Helminthiasis / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007223:Infant; D008297:Male; D017221:Necator americanus / Q000187:drug effects / Q000502:physiology; D011315:Preventive Medicine / Q000379:methods; D012987:Soil / Q000469:parasitology*; D014258:Trichuris / Q000187:drug effects / Q000502:physiology
D000871:Anthelmintics; D012987:Soil