The challenge of unreported and unprogrammed deworming for soil-transmitted helminth control programs

Soil-transmitted helminthiasis (STH) affects more than one billion people worldwide. WHO aims to control STH as a public health problem by providing periodic anthelminthic treatment to ≥75% of all at-risk children. Tracking progress toward this 2020 goal relies on accurate reporting of drug coverage. For STH, this is difficult because an unknown-but substantial-proportion of deworming occurs outside nationally-administered STH control programs, so-called 'unprogrammed deworming.' Further, coordination of intersectoral efforts needed to administer drugs to different risk groups-and to report coverage to WHO-is inadequate. This paper describes these challenges and offers suggestions to overcome them.