Six-monthly de-worming in infants to study effects on growth

The study was conducted to assess the effectiveness of six monthly albendazole (ABZ) for improving the weight and height of preschool children when initiated at 0.5-1 year of age in populations with a high transmission rate of intestinal roundworm, Ascaris lumbricoides. It was a cluster randomized trial in the urban slums of Lucknow, North India.

Control children received 2 ml (1 ml to infants) of Vitamin A every six month whereas those in the ABZ areas received, in addition, 400 mg of ABZ suspension (Zentel, SKB) every six month. Sixty-three and sixty-one slum areas were randomized to albendazole (ABZ) or to control groups, respectively. Children aged 0.5-1 year were recruited in April 1996 and followed up for 1.5 years. Of 1022 children recruited from control and 988 from ABZ areas, the loss to follow-up at 1.5 year was 15.6% and 14.6% respectively. Mean (+/- SE) weight gain in Kg in control versus ABZ areas was 3.04 (0.03) versus 3.22 (0.03), (p = 0.01).

After controlling for the presence of weight-for age z-score < -2.00 at enrollment in the ordinary least square's regression model, the extra weight gain in 1.5 years in those who received ABZ plus vitamin A was 0.13 Kg (95% CI: 0.004 to 0.26 Kg., p value = 0.043) when compared to those who received only vitamin A; underweight children at enrollment benefiting more than the normal ones.

It was concluded that there was an improvement in weight with six monthly ABZ over 1.5 years. However, a much larger trial would be needed to determine whether there is any net effect of improvement in weight on under five mortality rate.