Tackling Worm Infestations with a Multifactorial Approach in the 21st century: An Indian Perspective

Abstract

Soil-Transmitted Helminths (STH) or geohelminths are an important cause of morbidity worldwide. A large proportion of the infection burden occurs in India, including STH infections due to roundworms (Ascaris lumbricoides), whipworms (Trichuris trichura) and hookworms (Necator americanus or Ancyclostoma duodenale). Apart from direct health impacts, they are also implicated in anaemia, nutritional deficiencies and delayed cognitive development in children. They also have been shown to have detrimental impact on economic development and future income earning potential. The current global strategy on STH control is through increased utilisation of Preventive Chemotherapy (PC) for at-risk population, comprising mainly pre-school and school age children. This is crucial for India, as there can be significant proportion of untreated subjects in the community, who may act as a reservoir of infection for treated subjects to get re-infected. Additionally, inculcating healthy behaviour modifications and adopting WASH interventions meant a major shift in social and cultural norms in many societies. Overall, the multifaceted nature of STH control in India requires concerted efforts and significant mobilisation of human and financial resources. In this regard, several recent initiatives including Swachh Bharat Abhiyan, Nirmal Gram Puraskar, Water Sanitation and Hygiene (WASH) interventions, Clean India: Clean schools etc., have brought a positive change, apart from the provision of deworming for morbidity control through National Deworming Day. In this paper, authors have narrated major initiatives in recent years that are expected to bring a lasting solution to the problem of STH infection in India.