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Repeated deworming of children fails to reduce malaria rate
Repeated deworming among schoolchildren in Africa did not appear to reduce the risk for clinical malaria or malaria parasitemia, suggesting that school-based deworming programs may not be beneficial, according to recent data.
In the open-label equivalence trial, researchers evaluated the effects of anthelminthic treatment administered to 2,346 school-aged children in western Kenya’s Bumula district from January 2013 to September 2014. The researchers randomly assigned children to a regimen of deworming treatments repeated every 4 months, or annually on incidence of clinical malaria and severity of malaria parasitemia. The primary outcome was incidence of clinical malaria as evaluated by 13 months of weekly active-case monitoring; secondary outcomes included the pervasiveness and concentration of Plasmodium spp. infection based on cross-sectional surveys completed at 3, 7, 11 and 15 months.
During the active-case monitoring, 606 incident cases of malaria were identified; 405 children had one case and 93 had at least two cases. The repeated treatment group had a malaria incidence rate of 0.27 episodes per person-year, compared with 0.26 episodes per person-year in the annual anthelminthic treatment group (incidence difference, 0.01; 95% CI, –0.03 to 0.06). Cross-sectional surveys did not reveal any difference in the prevalence and density of malaria parasitemia across groups. In a sensitivity analysis limited only to children with soil-transmitted helminth infection, the results were similar.
“The results from our study, together with other work, show that repeated anthelminthic treatment does not increase or decrease the rate of clinical malaria or risk of malaria parasitemia,” the researchers wrote. “These findings offer evidence for planning of school-based deworming in sub-Saharan Africa and show the up-scaling of deworming is unlikely to have adverse consequences for malaria among school-aged children.” – by Jen Byrne
Disclosure: The researchers report no relevant financial disclosures.