In October and November 2016, researchers from the London Applied & Spatial Epidemiology Research Group (LASER) at LSHTM helped coordinate the deworming of over 300,000 people as part of its TUMIKIA research Project in Kwale County in Kenya.
The two-year study, including 1,000 villages and approximately 650,000 individuals, aims to determine whether combining school- and community-based deworming is more effective at controlling and eliminating intestinal worms called soil-transmitted helminths than school-based deworming. In this latest round a third of the county were targeted for deworming.
LASER’s Dr Katherine Halliday took along her camera to document the training, community sensitisation and most importantly the people who made this latest round of deworming for this ambitious study programme possible.
Community leader sensitization baraza
Before beginning implementation, community leaders from the 323 villages taking part in this round of deworming are invited to a local baraza to learn about the upcoming deworming campaign. Each village is grouped into a larger area known as a cluster
Community health assistant training in Msambweni subcounty
Each cluster is overseen by a health worker known as a community health assistant (CHA). These individuals are responsible for managing the deworming campaign in their cluster. 41 CHAs attended training workshops to learn how to coordinate the community deworming.
Community health volunteer Training in Bumbani sublocation, Lunga Lunga subcounty
Deworming was carried out at the village level by community health volunteers (CHVs). In total 513 CHVs were trained in a one-day workshop where they learnt what data they needed to collect and how to safely administer the deworming tablets.
Behaviour Change Communication Materials
Specifically designed information leaflets (in Kiswahili) were used to help explain the need for deworming and share health education messages with the target communities.
CHVs collecting treatment packs from their CHA on the first day of the campaign
Treatment packs included deworming tablets, spoons for distributing the tablets, health information leaflets and treatment registration booklet.
CHVs Mwanasha and Badi beginning their village treatment rounds
On average each CHV had to treat around 100 households over the course of the 8-day deworming campaign.
Registering households for treatment
The first step on reaching a household is to register each household member in a treatment booklet, to ensure that all the treatment data is captured effectively for all households and communities.
A CHV explaining the purpose of the deworming tablets to a family.
This builds on the sensitisation barazas held with community leaders before deworming began.
Dispensing deworming tablets.
Every eligible member of the family ie those aged over 2 years, not pregnant, not given birth in the last 2 weeks or not currently unwell, receive a deworming tablet which is documented in the treatment booklets.
Halfway check up
Midway through the campaign, the CHVs meet back at the health dispensary and check in with their CHA. This provides an opportunity to check progress and replenish treatment supplies.
A collaborative approach
The TUMIKIA programme is a collaboration between LASER, Kenya’s Ministry of Health, Ministry of Public Services and Administration, Ministry of Interior and the Kenya Medical Research Institute.
From right to left -
Dr Hussein, Head of the Community Health Unit; Dr Sultani, Head of the Neglected Tropical Diseases (NTDs) Unit and myself (Katherine Halliday) joined up with Mejumaa, a CHA for Mwapala village to monitor the programme’s progress.
TUMIKIA stands for 'Tuangamize Minyoo Kenya Imarisha Afya,' which means “eradicate worms in Kenya to improve health,” in Swahili.
The two-year trial is providing the drug albendazole to all residents from 150 communities in Kwale County on the coast . There are three study groups:
- Base: annual school-based deworming (ages 2-14)
- Increased coverage: annual school- and community-based deworming (ages 2-99)
- Increased coverage and frequency: bi-annual school- and community-based deworming (ages 2-99)
The TUMIKIA Project is a collaboration between Kenya Medical Research Institute (KEMRI), London School of Hygiene & Tropical Medicine, Imperial College London, Evidence Action's Deworm the World Initiative in Kenya, the Ministry of Health, and the Ministry of Education, Science and Technology.
To find out more about the programme visit www.thiswormyworld.org/tumikia-project
(All photos copyright Dr Katherine Halliday and the TUMIKIA Team)