Mass drug administration for control of parasitic infections
- Rojelio Mejia, MD
Rojelio Mejia, MD
- Assistant Professor of Infectious Diseases and Pediatrics
- National School of Tropical Medicine
- Baylor College of Medicine
Population deworming refers to empiric use of anthelmintic drugs to reduce the prevalence of infection due to soil-transmitted helminths in endemic areas. Such reductions in prevalence are generally temporary; mass drug administration interrupts parasite life cycles but does not halt them completely, and the risk for reinfection is high [1,2].
Areas with high prevalence of helminth infection require a number of public health measures beyond preventive treatment, including safe drinking water, basic sanitation, and health education .
Issues related to population deworming are discussed here; issues related to the epidemiology, clinical manifestations, diagnosis, and treatment of individual parasitic infections are discussed separately. (See related topics.)
Infection due to soil-transmitted helminths has been associated with morbidity including delays in growth and cognitive development, particularly among children 2 to 12 years of age [1,4-6]. Population deworming may be effective in reducing the prevalence of infection; the degree of benefit depends on patient characteristics, regional parasite species, and burden of infection. The greatest benefit appears to be among young children who undergo screening prior to treatment .
Studies performed in India during the 1990s suggested that deworming of malnourished children one to five years of age was associated with average weight gain of nearly one kilogram , and targeting worming of this age group has been advocated based on high prevalence of geohelminth infection . Another study among Ugandan children one to seven years of age treated with deworming pills also concluded an association between deworming and weight gain, although the analysis did not reflect that the children were randomized in geographic clusters rather than individually .
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