Integrated programme for control of geohelminths: a perspective

Infestation by geohelminths is an important public health problem in developing countries like India. It is a major cause of morbidity in school-age children who have the highest burden of worm infestation. Some of the morbid conditions attributed to intestinal helminthiasis are malnutrition, growth retardation, anaemia, vitamin A deficiency and impaired intellectual performance. Chemotherapy targeted at school-age children has been recommended as a cost-effective and feasible control programme for the control of geohelminths. To optimize resources a geohelminth control programme can be integrated with other existing national health programmes. The availability of drugs such as diethyl carbamazine (DEC) and albendazole, which have anthelminthic and antifilarial properties, opens the possibility of integrating a geohelminth control programme with a filaria control programme. However, co-administration of DEC and albendazole raises several issues of frequency of administration, efficacy, compliance and cost-effectiveness. Thus, integrating a geohelminth control programme with the existing mid-day meal or anaemia prophylaxis programme would be a more appropriate and cost-effective strategy to control geohelminths, alleviate the morbidity caused by them and improve the overall health of the community.