02826nas a2200253 4500000000100000008004100001260001200042100001400054700001500068700001200083700001400095700001600109700001500125700001600140700001400156700001400170700001600184245014900200856009100349300000800440490000700448520210300455022001402558 2021 d c04/20211 aVegvari C1 aGiardina F1 aBajaj S1 aMalizia V1 aHardwick RJ1 aTruscott J1 aMontresor A1 ade Vlas S1 aCoffeng L1 aAnderson RM00aDeworming women of reproductive age during adolescence and pregnancy: what is the impact on morbidity from soil-transmitted helminths infection? uhttps://parasitesandvectors.biomedcentral.com/track/pdf/10.1186/s13071-021-04620-w.pdf a2200 v143 a

BACKGROUND: Soil-transmitted helminths (STHs) are a major cause of poor health in low- and middle-income countries. In particular, hookworm is known to cause anaemia in children and women of reproductive age (WRA). One goal of the World Health Organization's (WHO) 2030 roadmap for neglected tropical diseases is to reduce STH-related morbidity in WRA. As a minimal intervention, the WHO recommends deworming adolescent girls annually during human papilloma virus vaccination programmes and WRA during pregnancy and lactation. These routine interventions are low cost and can be implemented even by the most basic health services in endemic countries. In this study we use a cohort model to investigate the potential impact on STH-related morbidity in WRA.

RESULTS: Annual deworming treatment of adolescent girls reduces the prevalence of moderate- and heavy-intensity infections in this age group by up to 60% in moderate transmission settings and by 12-27% in high transmission settings. Treatment of WRA during pregnancy and lactation on its own has a small (< 20%) but significant effect on morbidity although it does not lead to the achievement of the morbidity target (< 2% moderate- to high-intensity infections) in this age group. However, depending on the age-intensity profile of infection, which may vary geographically, and assumptions on the density-dependence of egg production by fertilised female worms, continued school-based treatment may be able to reduce the force of infection acting on WRA, both through an indirect effect on the overall population-based force of infection and via reducing the burden of infection as children age and move into the WRA age classes. As a result, morbidity in WRA may be eliminated.

CONCLUSION: While deworming during pregnancy and lactation does not lead to the achievement of the morbidity target in WRA and its efficacy may vary by setting, it is still expected to be beneficial for maternity and child health. Monitoring of any WRA-based intervention is recommended to evaluate its effectiveness.

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