Research Article: The Role of Child Health Days in the Attainment of Global Deworming Coverage Targets among Preschool-Age Children

Date Published: November 6, 2015

Publisher: Public Library of Science

Author(s): Richard Senam Kumapley, Roland Kupka, Nita Dalmiya, Kerry Gallo.

Abstract: BackgroundGlobal deworming programs aim to reach 75% of at-risk preschool-age children (pre-SAC) by 2020. The 2013 global pre-SAC deworming coverage initially published by the World Health Organization (WHO) was 23.9%, but this estimate inadequately captured deworming delivered through Child Health Day (CHD) platforms.ObjectiveTo update global and regional coverage estimates of pre-SAC deworming in 2013 by supplementing data from the WHO Preventive Chemotherapy and Transmission Control (PCT) databank with national CHD data.MethodsUNICEF country offices (n = 82) were mailed a questionnaire in July 2014 to report on official national biannual CHD deworming coverage as part of the global vitamin A supplementation coverage reporting mechanism. Coverage data obtained were validated and considered for inclusion in the PCT databank in a collaboration between UNICEF and WHO. Descriptive statistical analyses were conducted to update the number of pre-SAC reached and the number of treatments delivered.ResultsOf the 47 countries that responded to the UNICEF pre-SAC deworming questionnaire, 73 data points from 39 countries were considered for inclusion into the WHO PCT databank. Of these, 21 new data points were from 12 countries were newly integrated into the WHO database. With this integration, deworming coverage among pre-SAC increased to 49.1%, representing an increase in the number of children reached and treatments administered from 63.7 million to 130.7 million and 94.7 million to 234.8 million, respectively. The updated databank comprised 98 mass deworming activities conducted in 55 countries, in which 80.4% of the global pre-SAC population requiring deworming reside. In all, 57 countries requiring deworming were not yet represented in the database.ConclusionsWith the inclusion of CHD data, global deworming programs are on track to achieving global pre-SAC coverage targets. However, further efforts are needed to improve pre-SAC coverage reporting as well as to sustain and expand deworming delivery through CHDs and other platforms.

Partial Text: Soil-transmitted helminthiases (STH) are a group of parasitic diseases caused by intestinal worms that are transmitted to humans through fecally-contaminated soil [1]. Although STH is classified as a neglected tropical disease (NTD), it is estimated that over 3.5 billion people are at risk of infection, 10%-15% of whom are children of preschool age (pre-SAC) [2]. STH-related morbidity increases with higher worm load and includes iron deficiency, protein malnutrition and poor cognitive development [3, 4]. The regular deworming of pre-SAC with anthelminthic agents is an efficient and effective method of keeping STH worm loads below the levels associated with morbidity [1, 5].

Of the 82 UNICEF offices contacted, 47 (57%) submitted responses (Fig 1). Of these, a total of 39 countries had valid and nationally endorsed data points. In all, 27 (73%) were from Africa, 6 (16%) from South-East Asia, 3 (8%) from the Western Pacific region, 2 (5%) from East Mediterranean Region, and 1 (3%) from the Americas. The nationally validated datasets covered 74.9% of the global pre-SAC population requiring deworming. In total, the database contained 73 data points from the 39 respondent countries.

With the current CHD deworming coverage assessment, a total of 35 new data points were added to the WHO PCT databank. These new data points captured an additional 140.1 million deworming dosages, thus increasing the global number of pre-SAC deworming dosages administered in 2013 to 234.8 million. With this inclusion, the global 2013 pre-SAC deworming coverage increased from 23.9% to 49.1%.



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