Experience with school-based interventions against soil-transmitted helminths and extension of coverage to non-enrolled children

Abstract

This paper reviews the experience with school-based interventions against soil-transmitted helminths with regard to reduction in prevalence, intensity of infection and morbidity. It also examines the existing experience with coverage of school-based programmes to non-enrolled children. However, as this experience is limited, the paper also seeks to give an overview of the need for school control programmes to include other segments of the community. The experiences from the programmes indicate that treatment should be performed twice or thrice yearly without prior diagnosis, should be school-based and involving schoolteachers assisted by health staff, if possible. The drugs of choice are a single dose of 400 mg albendazole or 500 mg mebendazole. If intensities of Trichuris trichiura or hookworm infections are high, a double or triple dose of one of these drugs could be considered to maximise reduction in intensities. For the benefit of growth and iron status, it should be considered to supplement with iron and other micronutrients. School-based programmes should include non-enrolled school age children and pre-school children, and the system of having 'treatment days' at school, where these groups are invited for treatment, seems to be a promising strategy. While antenatal clinics have been involved in the anthelminthic treatment of pregnant women, they have not covered non-pregnant adolescent girls and women. These could be offered treatment through the 'treatment days' at school mentioned earlier.