Controlling neglected tropical diseases (NTDs) is an important part of improving nutrition. Diseases such as schistosomiasis and intestinal worms are underlying causes of stunting, wasting and micronutrient deficiencies. At the same time, poor nutrition increases susceptibility to NTD infection. The combination of NTD infections and malnutrition perpetuates a cycle of disease, malnutrition and poverty.
Roundworm (ascariasis) is among the most prevalent intestinal worm infections in young children and has serious consequences for child health and development, including cognitive delays. Roundworms compete with children for nutrients in order to grow and as a result, children living with these worms absorb less Vitamin A, even after they take oral supplementation.
Hookworm and schistosomiasis are among the leading causes of anemia worldwide because of the role they play in contributing to the loss of blood and iron. Pregnant women especially need iron and nutrients during pregnancy to ensure their babies have proper nutrition from the start. Hookworm exacerbates the loss of iron during pregnancy, increasing the likelihood of delivering a low birthweight newborn, and putting newborns at a disadvantage from the start of life.
Roundworm, hookworm and whipworm affect 870 million children worldwide. Additionally, schistosomiasis affects another 240 million people – including children and pregnant women. Because NTDs can impact nutritional status at any point of life — including during pregnancy, childhood and adulthood — populations living in endemic areas should receive routine deworming treatment.
Several studies have shown that combining deworming with other nutritional improvement programs – such as Vitamin A and iron supplementation – can lead to better outcomes than providing supplements alone. In response, a number of multilateral organizations, governments, NGOs and endemic countries are implementing programs that deliver deworming for intestinal worms and schistosomiasis alongside other nutrition and health interventions:
1. The United Nations World Food Programme has incorporated deworming into its school-based feeding programs in countries around the world. For those infected with schistosomiasis, treatment will also reduce anemia and improve nutritional status.
2. The 2012 Copenhagen Consensus—a project intended to set priorities for improvements in global welfare—includes deworming as a “best buy” in public health when included as part of a comprehensive approach to food security. The project’s team of leading economists found malnutrition to be the single most important area for investment and argued for bundling interventions, including treatment for intestinal worms, in order to provide a greater return on this investment.
3. To advance its commitment to maternal and child health, the Canadian government has supported expanded health and nutrition programs, which incorporates micronutrient supplementation, deworming and screening for acute malnutrition. In Ethiopia, their support provided 1.5 million children under the age of 5 with Vitamin A supplementation and deworming treatments during Community Health Days.
5. In 2015 India brought together its school and community deworming efforts under the umbrella of the newly launched National Deworming Day. National Deworming Day encourages coordination between community healthcare workers, government-funded preschool centers and primary and secondary school teachers. Community-based deworming leverages existing health and nutrition programs like Integrated Child Development Services Program which provides mid-day meals for children under five, National Iron Plus Initiative and the Weekly Iron Folic Acid Supplementation Program, relying on community healthcare workers to distribute the supplements and deworming medications. In February of 2015, more than 89 million children under the age of 19 in 12 states received medicine, and the government plans to expand the program to provide national coverage.
- NTDs and Nutrition Video
- NTDs and Moms Video
- Toward a Healthy Future: Working Together to End Neglected Tropical Diseases and Malnutrition Policy Brief (2014)
- NTDs and Nutrition Factsheet
- Childhood Malnutrition and Parasitic Helminth Interactions, May 2014, Clinical Infectious Diseases
- Acute Malnutrition: An Everyday Emergency, Sabrina de Souza, Nutrition Advocacy Coordinator at RESULTS UK, part of the ACTION Partnership – End the Neglect, August 19, 2014
- Nutrition and health: The opportunity cost of opportunities lost, Joel Spicer, President of the Micronutrient Initiative – Devex, July 23, 2014
- Copenhagen Consensus (2012), which ranks deworming of school children 4th out of 16 cost effective investments for policymakers
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