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School-Based Deworming Program in Pakistan

Challenge

835 million children infected with soil transmitted helminths (STH) require immediate treatment around the globe1. STH infections are found mainly in geographic areas with warm and moist climates where sanitation and hygiene are poor2.

The prevalence of worm infections affects child’s nutrient uptake and leads to anemia and malnourishment. It also impairs mental and physical development and puts child’s health at risk. Moreover, these infections disrupt child’s productivity since they feel too tired to focus on their studies or perform any other physical task.

The World Health Organization (WHO) classifies Pakistan as a high burden country for STH with the available data. In order to understand the burden of STH in Pakistan there is a need of a baseline survey to gauge prevalence of STH followed by a policy on nationwide deworming campaign.

Our Approach

IRD collaborated with Evidence Action’s Deworm the World Initiative, the Indus Hospital, and Institute of Development and Economic Alternatives (IDEAS) to conduct the first nationwide STH prevalence survey in Pakistan between August and December, 2016.

The survey was conducted by utilizing a WHO recommended microscope-based technique called ‘Kato-Katz’ to collect stool samples and analyze type of worm infection. The technicians were provided a comprehensive training on the Kato-Katz technique at the Indus Hospital beforehand in order to ensure quality data collection.

In 5 months, IRD teams visited 77 schools across four provinces and one territory to collect samples from over 4,000 students. The selection of schools followed WHO’s recommended ecological methodology to gather epidemiological data, which were located in different ecological zones.

Moreover, at every school children were given awareness about worm infections, hygiene and sanitation. The survey teams also provided deworming medication to every consented school with the help of WHO global drug donation program.

Impact

Survey results indicate that STH is not widespread throughout the country, but confined to northern areas, with the highest prevalence focused in the areas around Rawalpindi and Islamabad. Much of the southern region of Pakistan has very low levels of infection, with the notable exception of the vicinity of Karachi.

Since now the baseline has been established, IRD and Evidence Action is proposing a nationwide program to adapt the school-based deworming approach recommended by Jameel Poverty Action Lab (J-Pal).

This approach is designed to utilize already existing educational infrastructure to deworm school age children with a pill in which school teachers will be conducting drug administration. Mass deworming with pills has proven to be a low cost and impactful method in under-developed communities.

 

 

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