Controlling disease due to helminth infections Controlling disease due to helminth infections

268 Pages·2003·0.97 MB·English

During the past decade there have been major efforts to plan, C CCoonnttrroolllliinngg ddiisseeaassee
o
implement, and sustain measures for reducing the burden of human
n
disease that accompanies helminth infections. Further impetus was t dduuee ttoo
provided at the Fifty-fourth World Health Assembly, when WHO r
o
Member States were urged to ensure access to essential anthelminthic
l
l hheellmmiinntthh iinnffeeccttiioonnss
drugs in health services located where the parasites – schistosomes, i
n
roundworms, hookworms, and whipworms – are endemic. The g
Assembly stressed that provision should be made for the regular d
anthelminthic treatment of school-age children living wherever i
s
schistosomes and soil-transmitted nematodes are entrenched. e
a
s
This book emerged from a conference held in Bali under the auspices e

of the Government of Indonesia and WHO. It reviews the science d
that underpins the practical approach to helminth control based on u
e
deworming. There are articles dealing with the public health

t
significance of helminth infections, with strategies for disease control,
o
and with aspects of anthelminthic chemotherapy using high-quality
h
recommended drugs. Other articles summarize the experience gained e
in national and local control programmes in countries around the l
m
world. Deworming is an affordable, cost-effective public health
i
n
measure that can be readily integrated with existing health care
t
programmes; as such, it deserves high priority. Sustaining the benefits h
of deworming depends on having dedicated health professionals,
i
n
combined with political commitment, community involvement,
f
health education, and investment in sanitation. e
c
t
i
o
n edited by
"Let it be remembered how many lives and what
s
a fearful amount of suffering have been saved by D.W.T. Crompton
the knowledge gained of parasitic worms through A. Montresor
the experiments of Virchow and others…" M.C. Nesheim
L. Savioli
Charles Darwin
The Times (London)
18 April 1881
World Health Organization
WHO Geneva
Additional reading
The attention of readers is drawn to the following recent
publications, which are closely concerned with the control of disease
due to helminth infections:
Crompton DWT et al., eds (2003) Preparing to control schistosomiasis
and soil-transmitted helminthiasis in the twenty-first century. Acta
Tropica, 86(2–3):121–347.
Drake L et al. (2002) School-age children: their nutrition and health.
SCN News, 25:4–30.
Montresor A et al. (2002). Helminth control in school-age children:
a guide for managers of control programmes. Geneva, World Health
Organization.
Stephenson LS, Holland CV, Otteson EA, eds. (2000) Controlling
intestinal helminths while eliminating lymphatic filariasis. Cambridge,
Cambridge University Press (supplement to Parasitology, 121).
WHO (2002) Prevention and control of schistosomiasis and soil-
transmitted helminthiasis. Report of a WHO Expert Committee.
Geneva, World Health Organization (WHO Technical Report Series,
No. 912).
WHO (2002) Success in Africa: the Onchocerciasis Control Programme
in West Africa, 1974–2002. Geneva, World Health Organization.
Front cover: original painting by D.W.T. Crompton
Controlling disease
due to
helminth infections
edited by
D.W.T. Crompton
A. Montresor
M.C. Nesheim
L. Savioli
WORLD HEALTH ORGANIZATION
GENEVA
Controlling disease
due to helminth infections
edited by
D.W.T. Crompton
WHO Collaborating Centre for Soil-transmitted Helminthiases
Institute of Biomedical and Life Sciences
University of Glasgow, Glasgow, Scotland
A. Montresor
Strategy Development and Monitoring for Parasitic Diseases and Vector Control
Control, Prevention and Eradication
World Health Organization, Geneva, Switzerland
M.C. Nesheim
Division of Nutritional Sciences
Cornell University, Ithaca, NY, USA
L. Savioli
Strategy Development and Monitoring for Parasitic Diseases and Vector Control
Control, Prevention and Eradication
World Health Organization, Geneva, Switzerland
WORLD HEALTH ORGANIZATION
GENEVA
2003
WHO Library Cataloguing-in-Publication data
Controlling disease due to helminth infections / edited by
D. W. T. Crompton...[et al.].
1.Helminthiasis—prevention and control 2.Helminthiasis—drug therapy 3.Anthelmintics—
pharmacology 4.National health programs 5.Epidemiologic studies 6.Evaluation studies
I.Crompton, David W. T. II.Controlling Disease due to Helminth Infections (2000 : Bali,
Indonesia)
ISBN 92 4 156239 0 (NLM classification: WC 800)
© World Health Organization 2003
All rights reserved. Publications of the World Health Organization can be obtained from Marketing
and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel:
[phone]; fax: [phone]; e-mail: [email protected]). Requests for permission to
reproduce or translate WHO publications—whether for sale or for noncommercial distribution—
should be addressed to Publications, at the above address (fax: [phone]; e-mail:
[email protected]).
The designations employed and the presentation of the material in this publication do not imply the
expression of any opinion whatsoever on the part of the World Health Organization concerning the
legal status of any country, territory, city or area or of its authorities, or concerning the delimitation
of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there
may not yet be full agreement.
The mention of specific companies or of certain manufacturers’ products does not imply that they are
endorsed or recommended by the World Health Organization in preference to others of a similar
nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are
distinguished by initial capital letters.
The World Health Organization does not warrant that the information contained in this publication
is complete and correct and shall not be liable for any damages incurred as a result of its use.
The named authors and editors alone are responsible for the views expressed in this publication.
Designed by minimum graphics New Zealand
Typeset by SNP Best-set Typesetter Ltd., Hong Kong
Printed by Interpint, Malta
When Carlo Urbani took it upon himself to investi-
gate the new and deadly disease we now know as
SARS (severe acute respiratory syndrome) and so alert
the world to this emerging danger, he did so without the
slightest regard for his own health and safety. He died of
SARS in Bangkok on 29 March 2003 aged 46, at the
pinnacle of his career – first and foremost as a physician
but also as an authority on the prevention and control of
parasitic disease.
Carlo Urbani now stands shoulder to shoulder with
Edward Jenner, Ignaz Semmelweis, Louis Pasteur, Robert
Koch, Rudolph Virchow, Matthew Lukwiya and other
giants of public health whose efforts have relieved us from
the burden of infectious disease.
Carlo contributed to this volume, which is dedicated to
his memory with affection and admiration.

Contents
Preface vii
Opening address ix
The Bali Declaration xi
List of participants and contributors xii
Part I Public health significance 1
Important human helminthiasis in Indonesia Sri S. Margono 3
Schistosomiasis D. Engels, L. Chitsulo 15
Hookworm infection and iron status D.W.T. Crompton, H. Torlesse,
M.E. Hodges 23
Helminth infections, growth, and anaemia: lessons from Zanzibar
Hababu M. Chwaya, Rebecca J. Stoltzfus 33
Impact of deworming on the growth of schoolchildren in Yangon
Thein Hlaing, Win Win Khine, Tin Tin Than, Myo Khin, Than Saw,
San Shwe, Ma Ma Gyi, Aung Tun, Hkwar Nyo Zin, Phyu Phyu Aye 43
Parasites, nutrition, child development, and public policy J.D. Kvalsvig 55
The effect of soil-transmitted helminth infection on the cognitive
function of schoolchildren S.A.N. Abidin, P. Hadidjaja 67
Part II Strategies and major programmes for the control of disease due
to helminth infections 73
Strategies for the control of intestinal helminths and lymphatic filariasis:
initiatives in the WHO Western Pacific Region K. Palmer,
K. Ichimori 75
The Hashimoto Initiative and the control of soil-transmitted helminth
infections: the Japanese challenge Tsutomu Takeuchi, Takeshi Kasai,
Takaaki Hara 81
A deworming programme in Nepal supported by the World Food
Programme Gian Petro Bordignon, Deepak Raj Shakya 87
Partnership for Child Development: an international programme to
improve the health of school-age children by school-based health
services including deworming Satoto, Sri Hendratno,
Herbanto Subagyo, Zen Rafilluddin, Michael Mogensen, Andrew Hall,
Don Bundy 93
Focusing resources on effective school health: a FRESH start to
improving the quality and equity of education D.A.P. Bundy 99
v
CONTROLLING DISEASE DUE TO HELMINTH INFECTIONS
Part III Anthelminthic chemotherapy 107
Treatment of soil-transmitted helminth infection: prescribing information
for disease control Marco Albonico 109
Control of intestinal helminthiasis in pregnancy—the Sri Lankan
experience M.M. Ismail, T.M.S. Atukorala, T.S. Naotunne,
N.R. de Silva, I. Hettiarachchi 127
Anthelminthic treatment during pregnancy H. Torlesse,
D.W.T. Crompton, L. Savioli 135
The efficacy of anthelminthics: past, present, and future J. Horton 143
Effectiveness of selective treatment in the control of soil-transmitted
helminthiases Hoang Thi Kim, Nguyen Van De, Nguyen Van Tien,
Nguyen Thi Dang, Pham Thi Tuyet, Nguyen Thi Mai,
Hoang Van Tan, Nguyen Thi Duc, Nguyen Thi Viet Hoa 157
Part IV Experience from national control programmes 169
Control of schistosomiasis due to Schistosoma mekongi in Khong District,
1989–1999 T. Khamkeo, K. Pholsena 171
Community-managed control of soil-transmitted helminthiasis in the
Philippines Y.C.F. Lumampao, L.C. David 183
Experience and progress in controlling disease due to helminth
infections in the Republic of Korea Han-Jong Rim 191
Control of soil-transmitted helminth infections in schoolchildren in
Cambodia: implications for an integrated approach C. Urbani,
P. Odermatt, D. Socheat, M. Sinoun, S. Hoyer, C. Hatz 201
Effectiveness of deworming schoolchildren through school feeding in
Indonesia V. Hadju, A.R. Thaha, Z. Agus, F. Jalal 211
Practical experience from the primary school-based soil-transmitted
helminth control programme in Jakarta (1987–1999) Adi Sasongko,
Firman Lubis, Mundi Mahaswiati, Dewi Ratnawulan 225
The Seychelles experience in controlling helminth infections
Nicholas Shamlaye 239
vi
Preface
This book originated from the presentations and discussions that took place at
a conference held in Bali, Indonesia, in February 2000. The conference was
convened and administered by the Government of Indonesia and the World
Health Organization, with technical assistance from Cornell University, Ithaca,
NY, USA, and the University of Glasgow, Scotland. The main purpose of the con-
ference was to review activities for the control of disease due to soil-transmitted
helminth infections in Indonesia and neighbouring countries. This theme was par-
ticularly timely and apt since, in November 1999, the Cabinet of the World Health
Organization had concluded that there should be a scaling-up of worm control
to encompass soil-transmitted helminthiasis and schistosomiasis. Earlier impetus
for such a conference had already come from the G8 summits held in 1997 and
1998, at which the then Prime Minister of Japan, Mr Hashimoto, had called on
member governments to increase aid and assistance for the control of parasitic
diseases in developing countries.
The book is not intended as a comprehensive guide to planning and imple-
menting helminth control programmes, nor is it a simple compilation of confer-
ence proceedings. Some of the articles were invited from experts who were unable
to attend the conference. However, we hope that the contents will encourage
fellow health professionals to reappraise the public health significance of helminth-
induced disease in their regions and note that deworming is a feasible and cost-
effective option, even when resources are in very short supply. The contents seeks
to draw attention to: the public health significance of a selection of helminth infec-
tions; current ideas about approaches to the control of helminth-induced disease;
information about anthelminthic drugs and their use; and recent experiences of
control programmes in several countries.
Although there was little discussion in Bali about dracunculiasis, lymphatic
filariasis, onchocerciasis, or schistosomiasis, these topics are included in the book.
We hope to urge health managers to consider the integration of control measures
for soil-transmitted helminth infections into existing health care programmes; the
new initiative to eliminate lymphatic filariasis, for example, offers opportunities to
include measures for the control of disease caused by soil-transmitted helminths.
Many friends and colleagues have earned our sincere thanks for all the efforts
that led to the success of the Bali conference. We thank Fasli Jalal and his staff
from the Ministry of Planning in Indonesia, the WHO Secretariat in Indonesia,
and Muriel Gramiccia at WHO in Geneva for preparing for the conference and
for making arrangements to bring delegates to Bali and support them there. We
vii