The Case for Maternal Postpartum Deworming

Mofid, Layla S.; Gyorkos, Theresa W.

doi:10.1371/journal.pntd.0005203

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…Consequently, mass deworming campaigns should, in future, also include the parents. In view of the high maternal positivity rates for O. viverrini , we suggest that targeted treatment of women and teenage girls and in particular of mothers during postnatal care should be included in the national strategy towards the control of this trematode and of STH (Mofid and Gyorkos, 2017; Gyorkos et al., 2018). At this timepoint, the benefits of breastfeeding and of other effective measures for the prevention of helminth infections, as well as the inherent risk associated to repeated reinfections and treatments could also be comprehensively explained.…”

Section: Discussionmentioning

confidence: 99%

“…From other tropical regions, it was reported that maternal infections with STH were associated with an increased risk of infection for children (Menzies et al., 2014; Mehta et al., 2012). Hence, deworming of the mothers during postnatal care and possibly also during antenatal care (after the first trimester of pregnancy) is considered a sound approach to improve the health of both the mother and the child (Mofid and Gyorkos, 2017; Salam et al., 2015). While a single dose of mebendazole or albendazole is effective to reduce the overall STH burden, it is ineffective against liver fluke.…”

Section: Introductionmentioning

confidence: 99%

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High prevalence of helminth infections in mother-child pairs from three central provinces of Lao People's Democratic Republic

Pauly

Sayasinh

Sayasone

et al. 2019

Parasite Epidemiology and Control

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In Southeast Asia, the large majority of the population remains affected by parasitic worms despite longstanding mass treatment and health education campaigns. Soil-transmitted helminths and also the fish-borne liver fluke negatively affect development during early childhood.Here, the prevalence of helminth infections in stool samples of 610 mother-child pairs from Khammouane, Bolikhamxay and Vientiane provinces in Lao People's Democratic Republic was determined by formalin-ethyl acetate concentration technique.Overall, 15.1% of the children and 46.9% of the mothers were positive for at least one helminth species. Helminth detection rates varied significantly by province with the highest prevelance in Khammouane and the lowest in Bolikhamxay province. Mothers that were positive for soil-transmitted helminths were significantly more likely to have children positive for the same helminth species (p < 0.01) but this was not the case for the liver fluke Opisthorchis viverrini. A protective effect of breastfeeding against soil-transmitted helminths was revealed.Our data reconfirm the generally high helminth burden among mother-child pairs who likely share a number of risky lifestyle behaviors also with other family members. To reduce maternal burden of helminths, we propose that anti-helmintic treatment of women of childbearing age and of mothers during postnatal care should be included in the national strategy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High prevalence of helminth infections in mother-child pairs from three central provinces of Lao People's Democratic Republic

Pauly

Sayasinh

Sayasone

et al. 2019

Parasite Epidemiology and Control

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“…Women of reproductive age are a large and diverse group of individuals who are at different stages in their reproductive life. Each stage presents different challenges for PC programmes in terms of delivery strategies [ 13 ]. For this reason, in this paper, we have differentiated WRA into four sub-groups (adolescent girls, pregnant women, lactating women and adult not pregnant and not lactating women), recognizing that each group requires a specific approach in terms of programme implementation: Adolescents girls could be reached through school-based deworming programmes by extending the targeted age groups to include the 15-to-19 year-old age group and/or integrating this age group into existing community-based programmes.…”

Section: Discussionmentioning

confidence: 99%

“…WRA can be divided into four sub-groups representing distinct phases of a woman’s reproductive lifespan, each with its different interface with the health care system: adolescent girls from 15 to 19 years of age are not usually included in school deworming; pregnant and lactating women may be more easily reachable through health services and facilities; and non-pregnant and non-lactating women may only be reachable through community-based programmes. Additional benefits and challenges associated with deworming programmes for each sub-group have recently been summarized [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Estimation of the number of women of reproductive age in need of preventive chemotherapy for soil-transmitted helminth infections

et al. 2018

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BackgroundSoil-transmitted helminth infections are among the most common infections in developing countries. Globally, as many as 2 billion people are considered to be at risk for soil-transmitted-helminth (STH) infections. Preschool children (PSAC), school-age children (SAC) and women of reproductive age (WRA) are at high risk of STH-attributable morbidity and preventive chemotherapy (PC) for STH is recommended by the World health Organization (WHO).Methodology/Principal findingsOver the last five years, PC coverage in PSAC and SAC has gradually increased, while coverage in WRA has lagged. Estimating the numbers of WRA in each endemic country would inform scale-up in this group. A two-step process was used: 1) total numbers of girls and women between 15 and 49 years of age were obtained from the United Nations World Population Prospects 2015 database; and 2) the proportion in need of PC was obtained primarily from extrapolation from the WHO PC Databank. WRA were divided into four sub-groups reflecting different reproductive life stages, each having a potentially different interface with the health care system and, consequently, presenting different opportunities for intervention strategies.Worldwide, we estimated that 688 million WRA in 102 countries were in need of PC for STH in 2015. The South-East Asia (49%) and Africa regions (26%) had the highest numbers. Adolescent girls accounted for 16%, while pregnant and lactating women each represented 10%. Over 25 million pregnant women alone were estimated living in areas where the prevalence of hookworm and T. trichiura infection was ≥ 20%. Approximately 20% of at-risk WRA had received deworming with albendazole through the Global Programme to Eliminate Filariasis.Conclusions/SignificanceTo close current gaps in coverage, numbers of WRA in need of PC for STH are essential for operational strategies to control STH infection.

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“…Operational research is currently underway to identify an efficient approach to ruling out first-trimester pregnancy to respond to these concerns [ 10 ]. In order to expand treatment among WRA, new community-based strategies are required, with strategies tailored to reaching each of the different subgroups of WRA (i.e., adolescent girls, pregnant women, lactating women, and nonpregnant nonlactating women) [ 11 , 12 ]. For example, deworming can be added to iron supplementation programs targeting pregnant women, and it can be offered to lactating women at well-baby clinics.…”

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confidence: 99%