Honduras expands deworming of children in remote communities during vaccination campaigns
The initiative aims at preventing problems in the physical and cognitive development of preschool children
A year ago, Cleotilde Acosta's four children were having problems sleeping and eating. "Before they received the deparasitation treatment, they would wake up frightened in the middle of the night," recalls this mother in Santa María del Carbón, an indigenous Pech community in the municipality of San Esteban, department of Olancho, Honduras. "Now their stomachs are better, they have healthy appetites, and the ones in school are learning to read," she adds with a grateful smile.
Cleotilde's children were among the children in the municipality benefiting from a pilot initiative to deparasitize children 1—4 years old, carried out in the context of Vaccination Week in the Americas in April 2012. As a result of the health workers' efforts and community and municipal support, deparasitation coverage of preschool children increased 55% in San Esteban that year.
In Honduras an estimated 2.6 million children 1—4 years old are at risk of infection by geohelminths, known as intestinal worms, according to 2012 PAHO/WHO data, based on the percentage of population lacking access to improved installations of basic sanitation, one of the main risk factors for this infection. Loss of appetite, inattention, and anemia are some of the symptoms and signs of this parasitic infection, which can affect a child's physical and cognitive development.
According to a national survey by the Ministry of Health conducted with technical support from PAHO/WHO in 2011, schoolchildren (children 5—14 years) presented an average prevalence of infection by these parasites of 43.5%, while anemia averaged 19.2% in the same age group.
The deparasitation initiative, which was coordinated with other interventions against neglected diseases, was promoted by the Honduran Ministry of Health and the Technical Committee on Neglected Diseases and received technical and financial support from the Pan American Health Organization/World Health Organization (PAHO/WHO).
"The experience of the San Esteban deparasitation initiative highlighted the importance and value added of community-level work coordinated with the education sector. It was also possible to integrate these actions into the National Immunization campaign, contributing significantly to health improvement activities and reduction of infant mortality in the country," affirmed Gina Watson, PAHO/WHO Representative in Honduras.
The experience was repeated this year in April during Vaccination Week, and activities to deparasitize preschool children were expanded to six more municipalities in four departments identified as priority (Copán, Comayagua, Choluteca and Olancho).
This week a meeting will be held in Bogotá, Colombia, in which Honduras will share its experience with 18 countries from the region to help determine how to expand the integrated efforts to control parasitic infections in the Americas. The meeting aims at promoting coordination and cohesion among partners and governments to increase deparasitation coverage without duplicating efforts, improving quality of data and complementary actions to ensure access to water and sanitation, among other factors.
Deparasitation initiatives were given priority in Honduras' strategic plan for the prevention, management, control, and elimination of neglected diseases, officially launched in 2012, the first of its kind in the Region of the Americas.
A Technical Committee on Neglected Diseases was formed by representatives of the Subsecretaría de Riesgos Poblacionales [Department of Public Health Risks], heads of neglected diseases programs, members of the National Public Health Laboratory, and with active participation by PAHO. Together they reached a consensus on this plan, which integrates different public health interventions and stakeholders (government, municipalities, nongovernmental organizations) in actions to eliminate the neglected diseases in the country.
"The perspective of the program directors changed radically after they received training in the design of comprehensive plans for neglected infectious diseases; they realized that it was an opportunity to support all programs," said Tamara Mancero, adviser for the Health Surveillance and Disease Prevention and Control of PAHO/WHO in Honduras. "This was the case in the leprosy and leishmaniasis programs, for example, which lacked the funds and visibility to be supported by other programs with more technical and financial resources. Solidarity and collective thinking was set in motion to work with the neediest populations," Mancero explained.
The deparasitation intervention that took place during the National Vaccination Campaign was one of the first steps in the country's strategic plan. Coordination by the Ministry of Health was key in the basic organization, search for partners, and training of staff. PAHO/WHO helped implement the integrated vaccination/deparasitation campaign, providing support for purchasing antiparasitic drugs as well as developing educational material, among other factors. The Canadian International Development Agency (CIDA) also provided fund to support these activities.
The dedication and commitment of the health workers were essential for the initiative's success. Many health workers had to travel long distances from San Esteban to reach the most remote areas; they also took on additional workloads to administer the vaccines and deparasitation medication.
"The personnel have made an enormous effort to reach the most backward areas. To get to places where there are no roads for vehicles, they came on horseback or by foot," explained Enma Figueroa, coordinator of the Comprehensive Child Care Program in the department of Olancho.
In Santa María del Carbón, nursing assistants of Pech origin working in the Rural Health Center were the ones who successfully persuaded mothers such as Cleotilde Acosta about the benefits of deparasitizing their children.
"I thank the people who have come because it benefits the children, and the parents as well because their children are healthy and alive," said Cleotilde, and added: "I am willing to come any time to deparasitize my children because that is a parent's responsibility."
Links
|
Communicable Diseases and Health Analysis Department |
