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EDITORIALS: Mickey Chopra Mass deworming in Ugandan children BMJ 2006; 333: 105 [Full text]

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Mass deworming in Kashmir- A case for a Mass deworming day

Parvaiz A Koul, A Qayoom, Directorate of Health services, Srinagar   (26 September 2006)

Mass deworming in Kashmir- A case for a Mass deworming day 26 September 2006
Parvaiz A Koul, Additional Professor of Internal and Pulmonary Medicine, SKIMS, Srinagar 190011, Kashmir (India), A Qayoom, Directorate of Health services, Srinagar Send response to journal: Re: Mass deworming in Kashmir- A case for a Mass deworming day	Worm infestations by the intestinal nematode, Ascaris lumbricoides is endemic to the northern Indian state of Jammu & Kashmir, and is seen in all age groups, especially the children. The manifestations of the infestation are varied, from mild gut symptoms to potentially life threatening consequences of pancreatic and biliary Ascariasis (1). The infestation has thus been associated with considerable morbidity and even mortality. Worm induced acute emergencies like biliary colics,cholecystitis, cholangitis, pancreatitis, appendicular emergencies and intestinal obstructions are all too frequent and long term consequences of oriental cholangiohepatitis have been documented(3). Nutritional status of the affected children has been documented in many countries to be rather poor, and mass deworming has been shown to result in weight gain(4). Poliomyeilitis has been a parallel scourge which used to very frequent in the Indian subcontinent. The disease has cripplig consequences and a strategy by the WHO (World Health Organization) to eradicate the disease from various areas of the world by way of mass immunization has resulted in a tremendous drop in its incidence (5). In fact it has largely been eradicated from the industrialized world by aggressive oral polio vaccination programmes. Mass polio immunization days to children under 5 years of age are being observed in the Indian subontinent and the same gets publicized widely through popular print and electronic media.The strategy has been largely successful with a documented decrease in the incidence of poliomyelitis (5), and we are hoping a total eradication of the disease. The morbidity and mortality with Ascariasis is so enormous that it might be pertinent to borrow a leaf from the mass polio vaccination programme and ensure mass deworming of all people living in endemic areas on the patterns of Oral Polio vaccine days. A MASS DEWORMING DAY could be observed wherein all the population, especially the children could be dewormed. This could be based in schools or even through health care institutions at the primary level. Inexpensive drugs like levamisole or albendazole could be employed after careful consideration of the benfits of the strategy. Observing of such a day would certainly result in reduction in the prevalence of Ascariasis and its potential attendant consequences. REFERENCES: 1. Khuroo MS. Hepatobiliary and pancreatic ascariasis. Indian J Gastroenterol. 2001 Mar;20 Suppl 1:C28-32. 2. : Khuroo MS, Zargar SA, Yattoo GN, Koul P, Khan BA, Dar MY, Alai MS. Ascaris-induced acute pancreatitis. Br J Surg. 1992 Dec;79(12):1335-8. 3. Bhushan B, Watal G, Mahajan R, Khuroo MS. Endoscopic retrograde cholangiopancreaticographic features of pancreaticobiliary ascariasis. Gastrointest Radiol. 1988 Oct;13(4):327-30. 3. Alderman H, Konde-Lule J, Sebuliba I, Bundy D. Hall A. Effect on weight gain of routinely giving albendazole to preschool children during child health days in Uganda: cluster randomised controlled trial. Br Med J 2006;333: 122-4. 5.Sutter RW, Maher C. Mass vaccination campaigns for polio eradication: an essential strategy for success.Curr Top Microbiol Immunol. 2006;304:195-220. Competing interests: None declared