Deworming to combat the health and nutritional impact of helminth infections
Helminths are a group of parasites commonly referred to as worms and include schistosomes and soil-transmitted helminths. Schistosome and soil-transmitted helminth infections are among the most common infections in developing countries and can impair nutritional status by causing:
- internal bleeding which can lead to loss of iron and aenemia;
- malabsorption of nutrients;
- diarrhoea; and
- loss of appetite which can lead to a reduction in energy intake.
Infections can also cause cognitive impairment as well as tissue damage that may require corrective surgery.
The nutritional impairment caused by schistosome and soil-transmitted helminth infections during childhood has been shown to have a significant impact on growth and development of children. Periodic treatment (deworming) of children together with improvement of water and sanitation, and health education can reduce the transmission of schistosome and soil-transmitted helminth infections.
WHO recommendations
WHO recommends periodic treatment with anthelminthic (deworming) medicines, without previous individual diagnosis to all at-risk people living in endemic areas.
People at risk are:
- preschool-aged children
- school-aged children
- women of childbearing age (including pregnant women in the second and third trimesters and breastfeeding women)
Treatment should be given once a year when the prevalence of soil-transmitted helminth infections in the community is over 20%, and twice a year when the prevalence of soil-transmitted helminth infections in the community exceeds 50%. This intervention reduces morbidity by reducing the worm burden.
In addition:
- education on health and hygiene reduces transmission and reinfection by encouraging healthy behaviours;
- provision of adequate sanitation is also important but not always possible in resource-constrained settings.
Additional information can be found in the guidance documents under 'WHO documents' below.
WHO documents
GRC-approved guidelines
Status: not currently available
Other guidance documents
-
Helminth control in school-age children. A guide for managers of control programmes
Publication date: 2011 -
Preventive chemotherapy in human helminthiasis. Coordinated use of anthelminthic drugs in control interventions: a manual for health professionals and programme managers [pdf 1.58Mb]
Publication date: 2006 -
How to add deworming to vitamin A distribution [pdf 651kb]
Publication date: 2004 -
Strengthening interventions to reduce helminth infections as an entry point for the development of health promoting schools [pdf 2.89Mb]
Publication date: 1996
Evidence
Related Cochrane reviews
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Deworming drugs for soil-transmitted intestinal worms in children: effects on nutritional indicators, haemoglobin and school performance
Taylor-Robinson DC, Maayan N, Soares-Weiser K, Donegan S, Garner P.
Cochrane Database of Systematic Reviews. 2015; Issue 7. Art. No.: CD000371. -
Podcast (Cochrane)
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Effect of administration of antihelminthics for soil-transmitted helminths during pregnancy
Salam RA, Haider BA, Humayun Q, Bhutta ZA.
Cochrane Database of Systematic Reviews. 2015; Issue 6. Art. No.: CD005547.
Other related systematic reviews
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Impact of hookworm infection and deworming on anaemia in non-pregnant populations: a systematic review.
Smith JL, Brooker S.
Tropical Medicine & International Health. 2010; 15:776–795. -
A review and meta-analysis of the impact of intestinal worms on child growth and nutrition.
Hall A, Hewitt G, Tuffrey V, De Silva N.
Maternal and Child Nutrition. 2008, 4:118–236.
