There has been much debate over
the last few weeks among Western scientists about the efficacy of school-based
mass deworming programs. Notably missing from this debate have been the voices
of people from countries where parasitic worms are prevalent.
Worm infections may not be a
concern in high-income countries where sanitation infrastructure is well
developed, but here in Kenya, like in many countries around the world, these
parasites invade our children’s bodies and compromise children’s health and well-being.
Globally, it is estimated that more than 870 million children worldwide are
infected with soil-transmitted helminths and schistosomiasis, neglected
tropical diseases that cause havoc on a child’s health.
As a scientist and a Kenyan, I
have reviewed the evidence, and authored numerous studies that quantify the
problem and that show how mass deworming lowers prevalence of STH and
schistosomiasis. And I have visited hundreds of schools and spoken to thousands
of Kenyan school children and members of the community.
I have studied and seen myself
the negative effects chronic parasitic worm infections have on childhood
development. Children with severe or recurring infections have impaired growth
and cognitive development because the worms lodge in their bodies, stealing the
nutrients a child is able to take in. Heavy infections can result in serious
clinical disease. To combat infection and give our children a chance at good
health, many countries, including Kenya, run school-based mass deworming programmes
that have been shown to be a simple and cost-effective strategy to reduce the
disease burden of parasitic worms in school-age children, the group at highest
Safe, low-cost drugs are
available to treat intestinal worm infections and are the standard of medical
care. The World Health
Organization (WHO) recommends periodic mass treatment in areas where worm
infections are above certain thresholds. Some have challenged this WHO policy,
accepting that those who are known to be infected should be treated, but
questioning whether the existing evidence base is strong enough to support mass
Let me say unequivocally: Mass
school-based deworming works. Just three years ago, Kenya launched a national
deworming program. Prevalence of parasitic worms has been reduced from 35% to
17% and as low as 6% right after a deworming round. Our focus in the National
Deworming Programme in Kenya is on the reduction of infection and possibly even
elimination of the public health threat of worms.
What cannot be disputed is that
in taking steps needed to achieve this reduction in children, their general
health and nutritional status are immensely improved. Children who do not
compete with parasitic worms for their food are more likely to participate in
daily activities, including going to school.
We are closer than ever to
eliminating the public health risk of parasitic worms in children. Let us not
get distracted, from giving our children the very best chance in life to
succeed. Until access to water and sanitation is widespread and reliable, we
simply cannot deny them an intervention that works.