Deworming: One Sure Answer to School Enrolment and Retention

About 582 LGAs have been confirmed to be endemic to worms- one leading factor militating against school enrolment. With 2021-2022/2025 being pegged by the World Health Organisation as the year for control and elimination of worms, Nigeria’s answer to the reduction of its approximately 10.5 million out- of- school children would just have been answered. Kuni Tyessi writes

Worm infection is one of the Neglected Tropical Diseases (NTDs) which is usually associated with low socioeconomic status affecting the poorest communities and the most neglected vulnerable people. Infants and children are especially prone to the infection due to their less developed immune system.

Worms infect people when they pierce through the skin into the blood system and travel with the blood to the liver. Male and female worms pair up and move to the veins around the intestinal tract or the veins around the urinary tract. In children, they have the potency to cause malnourishment, wasting, stunting and other barriers to growth and development which in turn is bound to affect school attendance and reduce the capacity to learning.

Medical experts as well as educationists’ have through constant research and documented facts stated that the first five years of a child are so important that medical and nutritional values when missed, are bound to affect the cognitive abilities of a child which will also trail him/her in latter years, thereby decreasing the nations GDP and placing a huge burden on its human strength and capacity.

Infection usually occurs when individuals, particularly children come in contact with contaminated water. This has led to over 200 million people living at risk of infection, with over 90 per cent infected living in sub-Saharan Africa in which Nigeria is one.

On the other hand, while deworming is safe, free and effective, it improves children’s school participation, growth and nutritional intake and the tablets improve health, appetite and energy levels as well as reduce school absenteeism and improve learning ability in children.

Already, latest statistics made available by the Universal Basic Education Commission (UBEC)show that enrolment into public schools at basic level is higher compared to what is obtainable in private schools- so also, the rate of drop outs and class repetition, a clear indication that the case of worms as a part of NTDs affects more of the marginalised and downtrodden of the society.

Disturbingly, a report from the Federal Ministry of Health reveals that 582 LGAs are endemic to worms. 279 LGAs require once in two years treatment. 294 LGAs require annual treatment, while 10 high risk LGAs require treatment in school age children and adults.

School age children, the targeted population are in need of Praziquantel and Mebendazole in the figures of 40,078,133 and 27,194652 respectively. Out of the stated figures, 19,294,892, a percentage of 48.23 and 19,752,887, a percentage of 72.76 was recorded for Praziquantel and Mebendazole.

The United Nations Children’s Fund (UNICEF) which is an advocate for the protection of children’s rights, to help meet their basic needs which include WASH, education and health amongst others, and to expand their opportunities to reach their full potential, has continued to reiterate through its campaigns that the effects of worms will not only stop children from engaging in academic activities but also limit their potential in life.

In a paper titled “Overview of Schistosimiasis and Soil Transmitted Helminthiasis Elimination Programme in Nigeria”, Deputy Director/programme manager in the Federal Ministry of Health, Dr. Obiageli Nebe, said Nigeria’s vision and mission for worms targeted programme has goals and targets set for 2021-2025.

Done in collaboration with all stakeholders, the programme is set in a prevalence survey and mapping, policies and guidelines, advocacy, health education and the promotion of using safe environmental drugs like Praziquantel (PQZ) and Mebendazole (MEB) tablets in all endemic communities.

Mapping surveys started in 1999 in Plateau and Nasarawa States and were supported by the Jimmy Carter Centre and states ministries of health. In 2008, Ekiti, Ogun and other states joined in and the scale up was between 2013-2017.

With school age children in mind, Nebe who spoke in Ibadan, the Oyo state capital during a media dialogue on NTDs and which was organised by UNICEF, said

a pediatric formulation of Praziquantel is available for mass treatment, with the Federal Ministry of Health deciding on how to systematically treat the ravaging effects of worms.

She said when a child has been infected, symptoms such as diarrhoea, bloody stool, anaemia, stunted growth, enlarged liver and spleen, severe damage of the liver leading to liver fibrosis and portal hypertension emerge. Others are blood in urine, painful urination, damage to genitals, kidneys and bladder, as well as bladder cancer.

Nebe said it is not victory song all through as challenges are also being encountered in the eradication of worms. She said they include insecurities, limited resources and lack of updated data among others.

She said: “Significant gaps exist in the treatment due to low scale-up of interventions in all endemic LGAs. Data gap equally exists due to non disaggregation of survey data into sub districts and under mapping data by LGAs as implementation units.

“Delay in arrival of PZQ tablets and submission of data and issues of reverse logistics, cases of reinfection,, missed children, no worms control activities and little or no WASH intervention in all endemic LGAs, difficult terrain and insecurity, as well as limited resources.”

She stressed that through capacity building, resource mobilisation, periodic deworming, especially through the school feeding programme that has been adopted by states to encourage school enrolment and retention and also to cushion the hardship being faced by most families, Nigeria can win the war against worms.

Others are water, Sanitation and Hygiene (WASH), integrated vector management to control worms cannot be over emphasised, albeit a programme background which is saddled with” mandate to access the burden of Schistosimiasis infections and the control/elimination of the diseases among school age children.”

According to her: “Capacity building, resource mobilisation, periodic deworming, Water, Sanitation and Hygiene (WASH), integrated vector management to control snail intermediate hosts of Schistosimiasis are all factors required in the elimination of worms.

Others are, “Develop and implement policies and sustainable quality programmes for Schistosimiasis elimination as public health problems that contribute to significant reductions in disease mobility and transmission.

“Benefits of deworming: Worms are harmful to children’s health, education, growth and development. It improves children’s school participation, growth and nutritional intake.

Deworming tablets improve health, appetite and energy levels, reduce school absenteeism and improve learning ability in children. It is safe, free and effective.”

In the same vein, a clarion call was made by Acting UNICEF Nigeria representative, Renu Wadhwa, in a new-year statement. She said more than 14 million Nigerian children are chronically malnourished and 2.7 million acutely malnourished while cross-sectoral solutions to strengthen the health, food, water, sanitation and social protection systems can reverse these high numbers and keep children alive.

“More than 14 million Nigerian children are chronically malnourished and 2.7 million acutely malnourished. Cross-sectoral solutions to strengthen the health, food, water, sanitation and social protection systems can reverse these high numbers and keep children alive.

“As much as 43 per cent of Nigerian children do not receive all their recommended vaccinations at the right time – a critical step towards ensuring survival and good health.

“One in three Nigerian children do not complete primary school. Education is known to improve health and life outcomes throughout a child’s life.

“Only one in every 8 babies born will make it to their fifth birthday. Those who do survive will face other challenges as young Nigerians, especially girls.

“We can make Nigeria a better place for children to survive and thrive. This new year offers a new slate with opportunities to re-imagine, respond, recover and indeed build a more equitable and safer Nigeria for children, especially the girl child.”

If there was any favourable time for Nigeria to key into foreign donations and assistance it gets in the eradication of worms, that time is now. The journey so far has not only proved effective but possible with high untapped hopes for the country’s school age children.