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This Week In The Bmj

Worm treatment improves weight gain in Ugandan preschool children

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.333.7559.0-b (Published 13 July 2006) Cite this as: BMJ 2006;333:0-b

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Consider routine deworming of all anaemic pregnant women in developing countries.

The article on role of 400 mg oral albendazole in significantly
increasing weight in Ugandan children is very important but not
surprising. The prevalence of worm infestations and amoebiasis and
giardiasis is very high in developing world especially in rural areas due
to toilet habits in open fields and walking barefooted which make them
more prone to get hook worm infestation which is an important cause of
anaemia in most developing countries and has to be treated along with the
treatment of anaemia and malnutrition as in this Ugandan study if the
optimum results are to be expected. In fact the deworming should start in
pregnant women as the prevalence of anaemia and worm infestation is
extremely high in the making them more vulnerable for anaemia in pregnancy
with all its morbidity and mortality. We found the prevalence of worm
infestation ,amoebiasis and giardiasis to be up to 40% in pregnant anaemic
women of Delhi, India(1). The prevalence is bound to be higher in rural
areas.Hence it is of vital importance to treat all pregnant women with
anaemia with regular deworming with broad spectrum antihelminthic drugs
like mebendazole or albendazole in second and third trimester of pregnancy
along with regular iron supplementation for optimum results.

The
antihelminthic mebendazole or albendazole are safe in pregnancy and can
easily be given to all pregnant women with anaemia in later half of
pregnancy as confirmed by various studies (2). Some areas with high
prevalence of malaria need tretment of malaria too for optimum results.

Hence the obstetricians working in developing countries should consider
deworming therapy with iron supplementation and proper diet in pregnant
anaemic mothers for better maternal and perinatal outcome(3).

References;

1.Sharma JB,Arora BS, Kumar S, Goel S, Dhamija A. Helminth and
protozoan infestation: an important cause for anaemia in pregnant women in
Delhi, India.

J Obstet Gynaecol Ind 2001; 51: 58-61.

2. Atukola T, deSilva ID, Dechering WH, Dassenaeike TS, Parera RS.
Evaluation of effectiveness of iron folate supplementation and
antihelminthic therapy against anemia in pregnancy study in the plantation
sector of Sri Lanka.
Am J Clin Nutr 1994; 60: 286-292.

3. Sharma JB. Nutritional anaemia during pregnancy in
nonindustrialised countries. In Studd J (eds) Progress in Obsterics and
Gynaecology, Edinburgh, Churchill Livingstone. 2003;15:103-122.

Competing interests:
None declared

Competing interests: No competing interests

21 July 2006
Jai B Sharma
Assistant Professor of Obstetrics & Gynaecology
Professor Suneeta Mittal , Professor Sunesh Kumar
All India Institute of Medical Sciences, New Delhi, India