Evaluation of the Feasibility, Acceptability, and Safety of Policies and Procedures During Albendazole Distribution for Preschool-Aged Children
Location: India and Haiti
Alumni: Alec Maglione
Faculty: David Addiss
Soil-transmitted helminthiases (STH) have a detrimental health impact on preschool-aged children. The World Health Organization (WHO) recommends periodic mass deworming with albendazole in endemic areas to reduce STH burden. The WHO recommends crushing albendazole tablets to reduce risk of choking in children less than three years old. However, Vitamin Angels (VA) has implemented a different deworming policy; they require crushing all tablets for children less than 59 months of age. The goals of this project are to assess current practices in delivery of albendazole to determine how they compare with VA’s recommended best practices, the VA approach, and to provide recommendations to improve feasibility, acceptability, and safety of albendazole distributions. Using observational checklists, children receiving albendazole and service providers administering the tablets were evaluated; 513 children were observed. This evaluation found that 14.4% of children experienced an adverse event and two children (0.4%) choked. Risk factors for adverse events were young age, fussy or upset demeanor of the child, and providing water with the crushed tablet. Under-dosing also seems to be common in two-year-old children. While the VA approach does not result in decreased risk of adverse events overall, it is recommended that service providers use the VA approach of crushing the tablet for all children less than five years old because it offers significant advantages over the non-VA approach, including correct form and better infection control methods.