Deworming in children
Intervention | Last updated: 9 August 2023
Soil-transmitted helminth infections are among the most common infections in humans, caused by a group of parasites commonly referred to as worms, including roundworms, whipworms and hookworms. Those living in poverty are most vulnerable to infection which can impair nutritional status by causing:
- internal bleeding which can lead to loss of iron and anaemia;
- intestinal inflammation and obstruction;
- diarrhoea; and
- impairment of nutrient intake, digestion and absorption.
Evidence shows that preventive chemotherapy, or the periodic large-scale administration of anthelminthic medicines to populations at risk, can dramatically reduce the burden of worms caused by soil-transmitted helminth infections.
Preventive chemotherapy is an important part of a comprehensive package to eliminate morbidity due to soil-transmitted helminths in at-risk populations. However, long-term solutions to soil-transmitted helminth infections will need to address many factors, including improvements in water, sanitation and hygiene.
WHO Recommendations
Preventive chemotherapy (deworming), using annual or biannuala single-dose albendazole (400 mg) or mebendazole (500 mg)b is recommended as a public health intervention for all young children 12–23 months of age, preschool children 1–4 years of age, and school-age children 5–12 years of age (in some settings up to 14 years of age) living in areas where the baseline prevalence of any soil-transmitted infection is 20% or more among children, in order to reduce the worm burden of soil-transmitted helminth infection.
a Biannual administration is recommended where the baseline prevalence is more than 50%.
b A half-dose of albendazole (i.e. 200 mg) is recommended for children younger than 24 months of age.
Guidelines and guidance documents Learn More
GRC-approved guidelines
Other guidance documents
Evidence
Systematic reviews used to develop the guidelines
Taylor-Robinson DC, Maayan N, Soares-Weiser K, Donegan S, Garner P. Cochrane Database of Systematic Reviews. 2015; Issue 7. Art. No.: CD000371.
Summary of this reviewWelch VA. Awasthi S, Cumberbatch C, Fletcher R, McGown J, Merritt K et al. Campbell Systematic Reviews. 2016;12.
Related Cochrane reviews
Taylor‐Robinson DC, Maayan N, Donegan S, Chaplin M, Garner P. Cochrane Database of Systematic Reviews. 2019; Issue 9. Art. No.: CD000371.
Other related systematic reviews
Clarke NE, Clements AC A, Doi SA, Wang D, Campbell SJ, Gray D, Nery SV. Lancet. 2017;389(10066):287-297.
A review and meta-analysis of the impact of intestinal worms on child growth and nutrition.
Hall A, Hewitt G, Tuffrey V, De Silva N. Maternal and Child Nutrition. 2008, 4:118–236.
Welch VA, Ghogomu E, Hossain A, Awasthi S, Bhutta ZA, Cumberbatch C, et al. The Lancet Global Health. 2017;5:e40-e50.
Smith JL, Brooker S. Tropical Medicine & International Health. 2010; 15:776–795.
Does mass deworming affect child nutrition? Meta-analysis, cost-effectiveness, and statistical power
Croke K, Hamory Hicks J, Hsu E, Kremer M, Miguel E. Policy Research working paper; no. WPS 7921. Washington, D.C.: World Bank Group; 2016.
Cost-effectivenеss Learn More
Systematic reviews
Turner HC, Truscott JE, Hollingsworth TD, Bettis AA, Brooker SJ, Anderson RM.Parasit Vectors. 2015; 8:355.
Cost-effectiveness analyses
Does mass deworming affect child nutrition? Meta-analysis, cost-effectiveness, and statistical power
Croke K, Hamory Hicks J, Hsu E, Kremer M, Miguel E.Policy Research working paper; no. WPS 7921. Washington, D.C.: World Bank Group; 2016.
The cost-effectiveness of forty health interventions in Guinea
Jha P, Bangoura O, Ranson K.Health Policy Plan. 1998; 13(3):249-62.
Hall A, Horton S, de Silva N.PLoS Negl Trop Dis. 2009; 3(3):e402.
Awasthi S, Pande VK, Fletcher RH.Indian Pediatr. 2000; 37(1):19-29.
Category 1 intervention
Guidelines have been recently approved by the WHO Guidelines Review Committee
