August 02,2015

What's the Deal Here? Worms in the News

During the last few days, intestinal worms have received a great deal of attention in the media. This attention was stimulated by the publication of a Cochrane Collaboration review on the benefits of mass deworming and a series of articles in the International Journal of Epidemiology that featured reanalysis of Miguel and Kremer’s 2004 article on the educational benefits of deworming. These articles were followed by a flurry of blogs, tweets, and op-eds in the public media, many with a sensational angle. What are we to make of all of this?

First, the authors of the Cochrane Collaboration Review draw their conclusions from only one type of scientific evidence, randomized clinical trials (RCTs). They ignore other evidence. RCTs are expensive and, in this case, typically require that deworming is withheld from infected children in the “control” group – at least in the short term. This raises obvious ethical considerations. So, there are valid reasons why other types of studies have been used to research the health, educational, and economic benefits of deworming.

Second, when all the scientific evidence is examined, there is no question – even among the Cochrane Collaboration review authors – that “children infected with worms should be treated.” We call these intestinal worms ‘parasites’ for good reason. They feed off their hosts – especially children living in communities where adequate nutrition and access to potable water sources and sanitation facilities are limited. These children need all the nutrition they can get to grow healthy and strong. They can scarcely afford to share the nutrients they receive with parasitic hitchhikers.

Third, interest and investment in soil-transmitted helminthiasis (STH) control have increased dramatically since nine donors met in April 2014 to launch what has become the STH Coalition, now with 39 members. Commitment and momentum toward achieving the World Health Organization (WHO) goals for STH control by 2020 are at an all-time high. The rapid growth and prominence of our collective work together makes STH newsworthy.

Therefore, while we as a global community work to improve access to clean water, sanitation, hygiene, and good nutrition, we should also take full advantage of available medicines and distribution channels to move us closer to a world in which children are living without worms. This strategy, led by WHO, is endorsed by Ministers of Health from the nations of the world and supported by an increasingly diverse cross-sectoral group of partners who are committed to a vision of healthy children – without worms.

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