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Year : 2012  |  Volume : 136  |  Issue : 5  |  Page : 891-893

Helminth control in school-age children. A guide for managers of control programmes, 2 nd ed.

Department of Pediatrics, King George's Medical University, Lucknow 226 003, India

Date of Web Publication2-Jan-2013

Correspondence Address:
Shally Awasthi
Department of Pediatrics, King George's Medical University, Lucknow 226 003
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
Awasthi S. Helminth control in school-age children. A guide for managers of control programmes, 2 nd ed. Indian J Med Res 2012;136:891-3

How to cite this URL:
Awasthi S. Helminth control in school-age children. A guide for managers of control programmes, 2 nd ed. Indian J Med Res [serial online] 2012 [cited 2020 Oct 22];136:891-3. Available from:

Helminth control in school-age children. A guide for managers of control programmes, 2 nd ed. (World Health Organization, Geneva) 2011. 88 pages. Price US$ 36.00; in developing countries: CHF 21.00 / US $ 25.00

ISBN 978-92-4-154826-7

Soil transmitted helminth (STH) infections and schistosomiasis (SCH) are one of the neglected tropical diseases (NTD) and about 2000 million people worldwide are affected by these, of whom 300 million suffer from associated severe morbidity. Today there are cost-effective anti-helminthics, like praziquantel, albendazole, mebendazole or levamasole, which can be used for large scale deworming programmes to reduce worm load and keep it low and thus avoid disablity in the community. For an effective helminth control programme, targeted drug campaigns need to be combined with improvement in environmental conditions and a change in risk behaviour so that the transmission cycle of helminths is effectively broken.

This book is a comprehensive guide for programme managers of helminth control programmes. The contents are divided into 6 chapters covering areas like background, planning, implementation, monitoring and evaluation, collection of epidemiological data at sentinel sites and opportunities. In the chapter on planning, details are given about situation analysis, estimating the worm burden and thereafter selecting the appropriate control strategy. The suggested indicator for guiding decisions on the control of schistosomiasis and STH infections is the prevalence of infection. In most countries such data are available and it is recommended that data collected during the last 10-15 years be used. If such data are not available, there is need to generate locally. In case of STH, infection has a wide geographical distribution and each zone can cover several districts/States of a country. In case of SCH, the disease is focally transmitted around water bodies with limited ecological zones which may be known. An equation is given for estimating the prevalence of STH. For urinary schistosomiasis, WHO has developed a method for ranking schools in the order for need of intervention relying on reported visible hematuria. If the baseline prevalence of any STH is >20 per cent, and <50 per cent only improvement in sanitation, water supply are needed along with health education, but if prevalence is >50 per cent, additional preventive chemotherapy to all children of school going age is needed twice a year. Likewise, based on the prevalence of SCH, schools have been categorized under high, moderate and low risk categories and for each risk category control strategy has been given. Guidelines are also written about how to estimate the required budget. The budget should include costs of advocacy, and social mobilization, health education, training, data collection at sentinel sites, drug procurement, distribution and administration, supervision, outreach activities and monitoring. Often, only budget of drug interventions is calculated and this leads to deficient financing and inadequate implemention.

In the chapter on implementation, importance of community involvement is highlighted. It has been advised that implementation be divided into pilot and expansion phases. Good quality drugs can be procured locally from reliable pharmaceuticals. There are international donors also and they can be approached through the World Health Organization, weblink for the same is given. Drugs must be stored in cool and dry places centrally and before the campaign moved to the region, district and schools. Storage in the periphery has to be for a short time and the place has to be cool, dry, away from direct sunlight and safe from theft. A cascade type of training of programme managers, health personnel and teachers is recommended. There is also a handy timetable on how to actually implement a school based programme so that a programme manager needs to just plug in date and time for ready use. For ease of calculation of drug dosage for schistosomiasis the use of Tablet Pole has also been demonstrated and a Paper Pole is given with the book for use in the community. Other health interventions can be integrated with deworming programme, like for other NTDs such as active trachoma prevention, global programme for the elimination of lymphatic filariasis; nutritional interventions like iron and vitamin A supplementaion, iodine supplementation, school nutrition programme; and school based immunization activities.

Monitoring and evaluation are an integral part of a campaign. For this process indicators like funding, logistics, policy, guidelines, training, etc, performance indicators like coverage; and impact indicators like prevalence /intensity of infection, morbidity, mortality, incidence, etc. have been identified and given in good visual impact diagram. A case study of monitoring process in Nepal has also been given. Methods of calculating performance indicators have been given in a tabular form. For each indicator, an example of performance monitoring in Cambodia has been included as a case study. For impact indicators, details have been given for each indicator on how to assess, calculate, use and with what goals and expectations, and a case study from Seychelles has been included as an example. Additional indicators like knowledge-attitude-practice, assessment of drug efficacy and safe water supply and sanitation and school effects have been included. Description has been given on when to reduce the distribution and a case study on control of schistosomiasis in Cambodia has been included. This chapter will not only help planning helminth control programme but can be used as a generic guidelines for any community control programme.

Information has also been given on how to establish sentinel sites for the monitoring of parasitological data. Details are given about the number of sites, method of selection of schools and children, personnel needed with their task and responsibilities, collection of biological material and laboratory examination methods, along with useful e-links which give greater methodological details. There is a very informative section as annexes of useful addresses and websites, list of materials for parasitological data collection in sentinel sites, checklists for campaign planning, implementation and monitoring, and forms for data collection from school, child (parasitological and nutritional), tally sheet for drug distribution, drug distribution forms, drug sample collection forms etc. which can be used readily for a helminth control programme.

Overall, this is user friendly book that provides ready to use tables, checklists, which can be used by programme managers in the field. It is written in simple language and can also be used as an academic teaching model on how to model a control programme in the community.


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