School-aged children typically have the highest intensity of worm infection of any age group, with significant consequences for their health and development. However, much of this morbidity can be rapidly reversed by treatment. School-aged children are therefore natural targets for mass treatment (deworming).
The most cost-effective way to deliver deworming regularly to such children is through schools. These offer a readily available, extensive and sustained infrastructure with a skilled workforce that is in close contact with the community.
An important element of school-based deworming is to minimize the need for diagnosis, which is often more expensive than the treatment itself, and to focus instead on presumptive mass treatment. Evidence suggests that mass deworming without diagnosis is preferable on efficacy, economic and equity grounds to approaches that require screening. Treatment should therefore be offered to all children in schools in areas of high prevalence.
In the context of the global response to worm control, the importance of targeting school-aged children was recognised in 2001 by the 54th World Health Assembly of the WHO. This passed a resolution to provide regular deworming treatment to 75% of school-aged children at risk by 2010.