Mass Deworming Programs in Middle Childhood and Adolescence
Soil-transmitted helminths (STH) deworming programs remain among the largest public health programs in low- and lower-middle-income countries as measured by coverage. The actual scale of these programs remains unknown but substantial, with more than 1 billion donated doses of medicines effective against STHs delivered by formal programs and supplemented by widespread self-treatment and unprogrammed activities. STH infection declines worldwide likely reflect the influence of improved hygiene and sanitation associated with global declines in poverty, but it also reflects control efforts during the twentieth century that have largely eliminated STHs as a public health problem in previously endemic areas of North America (Mexico and the United States), Japan, Korea, and upper- middle-income countries throughout southern and eastern Asia. Much of the treatment targets delivery through schools and targets school-age children. STH infection associates with clinical and developmental outcomes that prove largely reversible by treatment. Both historical and contemporary trials of targeted treatment of infected individuals have also demonstrated benefit from treatment.