The Problem
Intestinal worms, or soil-transmitted helminths (STH), contribute to illness and compromise nutrition in children. STH can negatively affect a child’s vitamin A status by limiting absorption of nutrients by the body. This worsens problems associated with chronic undernutrition. Worms can cause illness, pain, and even death.
Children worldwide are at risk of becoming infected with intestinal worms due to poor sanitation or the presence of worms in the soil. Children under five years are extremely vulnerable to worm infections because they are in a period of intense physical and mental development.(i) Worm-free children have a better nutritional status and grow faster.
Who is at risk?
- Worm infections are widely distributed in tropical and subtropical areas, with the greatest numbers occurring in sub-Saharan Africa, the Americas, China, and East Asia.(ii)
- Worms are prevalent in many of the same countries identified by the WHO as experiencing moderate to severe vitamin A deficiency (VAD).
- Individuals in countries endemic for worms are at risk of STH infection.
Scope of problem:
- About 266 million preschool-age children (children under 5 years) live in areas where worms are intensively transmitted, and are in need of treatment and preventive interventions(iii).
- Government programs often don’t begin treating children until they reach school age.
Causes:
- Worms are transmitted by eggs present in human feces which may contaminate soil in areas that lack adequate sanitation.(iv)
- Children can get worms simply by playing in the dirt then putting unclean hands in their mouths, by consuming vegetables that are not adequately cleaned or cooked, or through contaminated water sources.
How Do Worms Affect the Body?
- Children with worms often experience abdominal pain and distension, increased susceptibility to other serious infections, stunted growth, anemia, and impaired cognitive development.(v)
- Worms also prevent absorption of vitamin A and other nutrients by the body.(vi)
- In addition to worsening the problems associated with chronic undernutrition, worms can cause illness, pain, and even death.
- Other symptoms of intestinal worms include:
- Abdominal pain and distention
- Fatigue or lethargy
- Stunting and impaired cognitive development caused by inadequate absorption of vitamins
- Increased susceptibility to illness and disease
- Children affected by worms often do not exhibit visible signs or symptoms.(vii)
The Solution
Deworming is a simple solution to combat undernutrition.
A single deworming tablet, like albendazole, [provided just twice a year] kills worms living in a child’s system[1]. Deworming also improves the body’s ability to absorb vitamin A.
Why Deworming?
The effects of deworming are almost immediate with the benefits visible as early as the following day.
Deworming & VAS
WHO and UNICEF recommend pairing vitamin A and deworming together wherever possible as the interventions complement each other in the short-term, and increase long-term benefits to physical and cognitive development.
Pairing deworming treatments with vitamin A supplementation means we can eliminate worms and increase absorption of vitamin A at the same time.
Vitamin Angels’ Impact
- In 2016, Vitamin Angels reached 27 million children with deworming tablets.
- Our programs focus on reaching children ages 12-59 months in countries where STH are endemic.
- We’re working to distribute albendazole to those eligible to receive vitamin A supplementation[1] as part of a global STH Coalition.
- Vitamin Angels is partnering with about 50 other organizations on a global deworming strategy to fill critical gaps in combatting intestinal worms.
- Vitamin Angels is co-chair of the STH Coalition Work Group focused on deworming pre-school aged children.
Dosing Schedule: Following recognized guidelines for albendazole, Vitamin Angels calculates that each child 12-23 months of age receive half a tablet (200 mg) twice a year; while each child 24-59 months of age receive a whole tablet (400 mg) twice a year.
[1] Children 12-59 months. Children 6-11 months are not eligible for deworming treatment so while we may say that we are targeting/reaching 100% of eligible beneficiaries with vitamin A and albendazole, the total numbers of beneficiaries reached won’t match (delta being the 6-11 month olds).
Sources:
[i] UNICEF/WHO. How to add deworming to vitamin A distribution. 2004.
[ii] http://www.who.int/mediacentre/factsheets/fs366/en/
[iii] WHO. Weekly epidemiological record. World Health Organization. 6 March 2015, No. 10, 2015, 90, 89-96.
[iv] http://www.who.int/intestinal_worms/more/en/
[v] World Health Organization. Weekly epidemiological record, No. 13, 2014, 89, 133-140.
[vi] World Health Organization. Helminth control in school-age children: A guide for managers of control programmes, 2nd Ed., 2011, pp. 4-6.
[vii] Children without Worms. Retrieved 24 February 2016 from http://www.childrenwithoutworms.org/about-us/why-It-matters