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Administration of Deworming to Preschool-Age Children in Vitamin a Distribution Projects

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Administration of Deworming to Preschool-Age Children in Vitamin a Distribution Projects Reference Manual for Administration of Deworming to Preschool-Age Children in Vitamin A Distribution Projects ® from A TechnicalVitamin Document Angels1 Our vision is to be a leading partner for the alleviation of essential micronutrient deficiency among underserved and at-risk infants and young children. Our mission is to help at-risk populations in need — specifically pregnant women, new mothers, and children under five — gain access to lifesaving and life changing vitamins and minerals. 2 Preface This manual is intended for healthcare providers and aims to This manual is designed for personnel responsible for managing promote the deworming of preschool-age children (PSAC) where and delivering health care services who seek to incorporate the vitamin A distribution campaigns are conducted.1 distribution of deworming into regular activities associated with community or facility-based health care. It has been produced in In this manual, preschool-age children are defined as all such a way that each section may be removed for individual use children who are at least 1 year and are not yet 5 years of age. and may be reproduced in whole or in part according to user Attention is focused on this group because while school-age needs, as long as this is not for commercial purposes. children who (classified from the age of 5 years onwards) are In initiatives for either MDA or targeted distribution of deworming normally dewormed through school health programs, preschool- tablets, it is likely that those who distribute deworming will age children are often not reached by deworming interventions. encounter young children who require treatment for more serious In recognition of the constant demands made on health planners worm infections. The information contained in this Reference to prioritize health interventions, often with limited financial and Manual is NOT intended as a guide to the diagnosis and human resources, this manual describes some of the advantages treatment of these or other conditions. A young child should of combining two programs that are often delivered separately: be referred to a qualified health care practitioner for evaluation vitamin A distribution and deworming. for conditions that might require treatment with deworming Vitamin Angels is a leading partner in the efforts to eliminate the medications. death and disease associated with micronutrient deficiencies, Vitamin Angels gratefully acknowledges the use and adaptation especially vitamin A deficiency among neonates, infants, and of materials from the World Health Organization (WHO), the children. We mobilize and deploy private-sector resources to Pan American Health Organization (PAHO), and the increase the availability, access and use of micronutrients – Micronutrient Initiative (MI) for inclusion in this Reference especially vitamin A – by at-risk infants and children in need. Manual. These sources are: Vitamin A supplements may be provided alone or in combination 1. World Health Organization (2004). How to add deworming with the deworming agent, albendazole, as recommended by the to vitamin A distribution. World Health Organization (WHO) to reduce the burden of intestinal worms that consume micronutrients that would 2. World Health Organization (February 2007). Action against otherwise be available to the growing preschool-age child. worms, Issue 8. An estimated 272.2 million preschool-age children under five 3. Pan American Health Organization (2001). Providing vitamin A years of age suffer from worm infections caused by soil- supplements through immunization and other health contacts transmitted helminths (STH), which is a major underlying cause for children 6–59 months and women up to 6 weeks of child morbidity. Vitamin Angels works to support preventive postpartum: A guide for health workers, Second edition. “mass drug administration (MDA)” or “targeted distribution” 4. Micronutrient Initiative (2007). Vitamin A in child health weeks: of deworming in countries defined by the WHO as being endemic A toolkit for planning, implementing, and monitoring. for STH. This manual provides information that is essential to think about when planning and implementing effective MDA or targeted 5. World Health Organization (2017). Guideline: Preventive distribution of deworming to PSAC. The focus of this manual is chemotherapy to control soil-transmitted helminth infections in to provide guidelines and technical information to aid in at-risk population groups. establishing MDA projects for preschool-aged children, including those that are paired with vitamin A supplementation for preschool-age children. 3 Contents Deworming Basics 1 An Introduction to Deworming ............................................................................................................................................................5 2 How to Prevent STH Infections .............................................................................................................................................................8 3 When Preschool-Age Children Should be Dewormed .............................................................................................................. 10 How to Administer Deworming to Children Ages 12-59 Months 4 How to Administer Deworming Tablets ......................................................................................................................................... 13 5 Giving Deworming to Children Ages 12–59 Months ................................................................................................................. 17 Storage and Organizing a Distribution 6 How to Ship, Transport and Store Deworming Tablets ............................................................................................................. 19 7 Organizing Mass Distribution of Deworming Tablets .............................................................................................................. 22 8 Training and Public Awareness .......................................................................................................................................................... 25 9 Requirements for Distribution Points .............................................................................................................................................. 28 10 Arranging Your Work Station .............................................................................................................................................................. 30 11 Recordkeeping ........................................................................................................................................................................................ 32 Appendices 45 Appendix A: VAS and Deworming Priority Countries ............................................................................................................................ 37 Appendix B: FAQs ............................................................................................................................................................................................... 42 Appendix C: Visual Checklist: Job Aid for Giving Vitamin A and Deworming............................................................................... 47 Appendix D: How to Give Vitamin A to Children..................................................................................................................................... 53 Appendix E: Guide for Vitamin A Supplementation Supervisors ...................................................................................................... 55 Appendix F: How to Give Deworming with Universal Distribution of Vitamin A ........................................................................ 57 Appendix G: Daily Tally Sheet ........................................................................................................................................................................ 59 Appendix H: Distribution Register ............................................................................................................................................................... 60 Appendix I: Child Health Card Sample ........................................................................................................................................................ 61 References 62 Notes 64 4 1 An Introduction to Deworming About this Chapter Soil-transmitted helminths (STH), commonly called intestinal worms, include roundworms, hookworms, and whipworms. STH are a serious public health problem and impair the health of preschool-age children 12-59 months of age. Deworming eliminates these parasites from the body, improving the nutritional status of young children. This chapter explains what STH are and how they are transmitted. Next, it explains who is most at risk for STH infections and why it is so effective to deliver deworming to preschool-age children. In addition, it looks at the effects of not treating STH and the benefits of deworming. Finally, the chapter tells us the importance of combining vitamin A supplementation with deworming and how both programs can benefit by delivering multiple health services. What are Soil-Transmitted Sources of STH Who Needs Deworming Helminths (STH)1 Transmission2 and Why Soil-transmitted helminths (STH), more STH are transmitted by eggs excreted in Globally—millions of children are commonly known as intestinal worms, human feces that contaminate the soil and infected with worms represent a serious
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