Intended for healthcare professionals


Mass deworming in Ugandan children

BMJ 2006; 333 doi: (Published 13 July 2006) Cite this as: BMJ 2006;333:105

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


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.

Competing interests:
None declared

Competing interests: No competing interests

26 September 2006
Parvaiz A Koul
Additional Professor of Internal and Pulmonary Medicine,
A Qayoom, Directorate of Health services, Srinagar
SKIMS, Srinagar 190011, Kashmir (India)