Business Daily Africa focuses on Kenya's deworming efforts

Intestinal worms contribute to the burden of malnutrition among Kenyan children

Business Daily Africa's Sarah Ooko highlights the work of Kenya's Ministry of Health and LSHTM researchers to tackle neglected tropical diseases

19 May 2017

Kenya's Ministry of Health is urging Kenyans to undergo regular deworming - at least once a year - so as to avoid complications brought about by intestinal worms.

The parasites deplete the body of vital nutrients or impede their absorption, leading to malnutrition that lowers an individual's immunity to infections.

In severe cases, thousands of worms can infest the body and clog intestines, causing bowel and stomach complications.

Without timely surgery to remove the worms, which usually resemble long entangled spaghetti strands, affected patients end up losing their lives.

According to Dr Sultan Matendechero, head of the Neglected Tropical Disease (NTD) unit at the Ministry of Health (MoH), most people tend to ignore these parasites as they lack awareness of the hazards they pose.

Pregnant women, children most affected

He said that children and expectant women are the most affected by intestinal worms which include roundworms, hookworms and whipworms - collectively referred to in medical terms as soil transmitted helminths (STH).

“But that doesn’t mean others are safe. We are all vulnerable since the worms are endemic to Kenya,” he said.

Aside from causing diarrhoea which is a leading cause of child mortality in Kenya, malnutrition caused by intestinal worms also impedes optimal mental and physical development in children.

In pregnant women, the parasites cause anaemia, which increases the risk of premature delivery and death resulting from excessive bleeding at birth.

Nyanza, Western, Costal and South Rift regions bear the highest burden of the intestinal worms in Kenya.

In these areas, the government has been conducting mass drug administration (MDA) campaigns where children of school going age (between 5 and 15 years) are given deworming tablets each year to treat and lessen the burden of the worms.

The World Health Organization and the Bill and Melinda Gates Foundation have supported deworming programmes in low-income countries, with previous studies indicating that treatment could help keep children in school.

Improving impact

Despite the successful scale-up of such programmes, in many communities the highest levels of infections continue to be found in adults, who are not routinely treated through mass deworming programmes.  As a result, re-infection occurs rapidly, requiring the re-treatment of school-children to be conducted every year.

“We usually treat the children then they end up becoming infected again after some months. We suspect that they get the worms from other members of the community who weren’t treated,” said Dr Matendechero.

To address this challenge, the MOH - in collaboration with the London School of Tropical Hygiene and Medicine (LSHTM) and the Kenya Medical Research Institute (KEMRI) - is conducting a study to determine whether deworming campaigns targeting school children and other community members in high-risk regions can effectively lower the prevalence of intestinal worms.

The results of the research, which will be replicated in other African countries, are expected to inform WHO guidelines on the management of intestinal worms.

“Kenya is leading the way in this major research that will provide a way forward in the management of intestinal worms,” said Dr Katherine Halliday, assistant professor at LSHTM who is the coordinator of the TUMIKIA study.

She said as well as deworming campaigns, proper hygiene, safe water and good sanitation practices play a significant role in eradicating worms and preventing re-infection after treatment.

Intestinal worms are transmitted by eggs present in human faeces which contaminate the soil in areas where sanitation is poor.

People infested with this parasite can be effectively treated using a sweet flavoured deworming medicine known as Albendazole that is available in many public and private health facilities.

Intestinal worms contribute to the burden of neglected tropical diseases (NTDs) in the country that are hampering the nation’s development.

The above is adapted from an article posted on the Business Daily website on 11 May 2017 - Read the original article on the Business Daily website