Should you routinely deworm children if working in a region with a high rate of parasite infection

jpegThe debate as to whether or not we should be devoting time and resources towards routine deworming is still out. However, a recent cochrane review (systematic review of the medical literature) would suggest that it has little benefit in terms of overall nutrition, hemoglobin level, and missed school days.

So what should where should we be focusing our resources if we want to improve overall pediatric health and reduce the worm burden. Just like with most interventions, primary prevention is the cheapest. Since this is primarily a sanitation issue, it makes sense to focus our efforts on the following:

1. Improved sanitation through building toilets and encouraging their use to decrease the spread of worms. This also has the benefit of reducing other fecal-oral transmitted illnesses.

2. Spend money on clothing, specifically soled shoes/slippers. Also, provides additional safety/podiatric injury prevention. You can even consider empowering a community by helping locals build an industry around this. Check out the link to follow a discussion on the pros and cons of microlending.

3. If you are concerned about anemia in pediatric populations, consider iron supplementation. This systematic review suggests that mass iron supplementation is cheaper and more effective than routine deworming.

Well that is my tip for today. What are your experiences with deworming and will these reviews change your practice plan? Let me know in the comments section.