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Bulletin of the World Health Organization

Print version ISSN 0042-9686

Bull World Health Organ vol.82 n.8 Genebra Aug. 2004 



Cambodia leads the way in the protection of children against worms



Cambodia has become the first country to protect three out of four school-aged children against intestinal worms since the global anthelminthic control target was established at the World Health Assembly in 2001. The recent completion of Cambodia's latest treatment campaign, involving more than 6500 schools, saw the country become the first of 105 endemic countries to reach the global target — six years ahead of schedule.

Only five years ago, more than 70% of Cambodian children were infected with intestinal worms. Now the situation is reversed with 75% of Cambodia's nearly three million school-aged children protected.

"This is a huge step forward not only for Cambodia, but for all countries working to control intestinal parasitic diseases," said Dr Lorenzo Savioli, WHO's Coordinator of Parasitic Diseases Control. "Cambodia's experience provides hard evidence that it is completely within the realm of possibility to protect the vast majority of children against parasites. Cambodia has done it, and so can other countries."

Weighing as much as 2 kg less than healthy children, those who are infected have a much higher chance of becoming anaemic. Anti-parasite treatment has led to a dramatic increase in short- and long-term memory among affected children, as well as an improvement in their reading capacity and comprehension. The intervention, therefore, represents a powerful tool for combating school absenteeism which can drop by as much as 25% as a result of a treatment campaign.

Schistosomiasis and intestinal worm infections affect at least two billion people worldwide and are a significant public health threat in regions where sanitation and hygiene levels are inadequate. Infection occurs when skin comes into contact with contaminated water or soil through ingestion. Heavy infection can result in retarded growth and intellectual and physical development. If left untreated, progressively severe organ damage occurs which becomes irreversible. Despite the potentially serious consequences of carrying intestinal worms, treatment is cheap — costing only US$ 0.02 per tablet — and simple to administer.

Cambodia's success follows the progressive expansion of intestinal parasite control to the national level involving a twice-yearly anti-parasite campaign. Drugs are administered across all 24 provinces by thousands of teachers, who distribute the pills to students in classrooms. The campaigns were conducted by the Cambodian Ministry of Health, Education and Sport, with the support of WHO, UNICEF, the Japanese Embassy in Cambodia and the Sasakawa Memorial Health Foundation.

"This clearly wouldn't have been possible without the strong commitment of Cambodia's Ministry of Health," said Dr Kevin Palmer, Regional Adviser in Parasitic Diseases for the Western Pacific Regional Office of WHO. "Reaching the target this early wasn't accidental. It demonstrates what can be achieved when the political will is there together with financial support from donors and partners."