The strategy for control of soil-transmitted helminth infections is to control morbidity through the periodic treatment of at-risk people living in endemic areas. People at risk are:
- preschool children
- school-age children
- women of childbearing age (including pregnant women in the second and third trimesters and breastfeeding women)
- adults in certain high-risk occupations such as tea-pickers or miners.
AHO recommends periodic medicinal treatment (deworming) without previous individual diagnosis to all at-risk people living in endemic areas. Treatment should be given once a year when the baseline prevalence of soil-transmitted helminth infections in the community is over 20%, and twice a year when the prevalence of soil-transmitted helminth infections in the community is over 50%. This intervention reduces morbidity by reducing the worm burden. In addition:
- health and hygiene education reduces transmission and reinfection by encouraging healthy behaviours; and
- provision of adequate sanitation is also important but not always possible in resource-poor settings.
Periodical treatment aims to reduce and maintain the intensity of infection, and to protect infected at-risk populations from morbidity.
Deworming can be easily integrated with child health days or supplementation programmes for preschool children, or integrated with school health programmes. In 2016, over 385 million school-aged children were treated with anthelminthic medicines in endemic countries, corresponding to 68% of all children at risk.
Schools provide a particularly good entry point for deworming activities, as they allow the easy provision of the health and hygiene education component, such as promotion of handwashing and improved sanitation