National Deworming Day (NDD)
Introduction
National Deworming Day (NDD) is a flagship initiative launched in February 2015 by the Ministry of Health and Family Welfare (MoHFW), Government of India. It is one of the largest single-day public health programs in the world, aimed at performing mass deworming to reduce the prevalence of Soil-Transmitted Helminths (STH) among children and adolescents.
Rationale And Objectives
- Prevalence: India has a high burden of STH, primarily involving Roundworm (Ascaris lumbricoides), Whipworm (Trichuris trichiura), and Hookworm (Ancylostoma duodenale/Necator americanus).
- Impact of Infestation: Chronic helminthiasis leads to nutritional deficiencies, impaired physical growth, cognitive deficits, and iron-deficiency anemia.
- Core Objective: To deworm all children and adolescents between the ages of 1 to 19 years to improve their overall health, nutritional status, and quality of life.
Strategy And Implementation
- Biannual Approach: Conducted twice a year (February and August).
- Platform-Based Delivery:
- Anganwadi Centers: For children aged 1–5 years and out-of-school children.
- Schools: For all school-going children and adolescents aged 6–19 years.
- Mop-up Day: A follow-up day conducted 1 week after NDD to capture children who missed the dose due to sickness or absence.
Dosage And Administration
The drug of choice is Tablet Albendazole (400 mg), administered as a single dose under direct observation (DOT).
| Age Group | Dosage | Mode of Administration |
|---|---|---|
| 12 – 24 Months | 200 mg (Half tablet) | Crushed tablet mixed with drinking water. |
| 2 – 19 Years | 400 mg (Full tablet) | Chewed tablet (must be chewed to be effective). |
Management Of Adverse Events
Adverse events are generally mild and transient. They often occur in children with high worm burdens as the parasites are neutralized.
- Common Symptoms: Nausea, vomiting, abdominal pain, fatigue, or dizziness.
- Management: Usually self-limiting. Children should rest in a shaded area and be given clean drinking water. Supportive care is provided by the teacher/Anganwadi worker; severe cases are referred to the nearest health facility.
Integrated Interventions (WASH)
Deworming is most effective when combined with environmental and personal hygiene measures (Water, Sanitation, and Hygiene):
- Hand Hygiene: Washing hands with soap, especially before eating and after using the toilet.
- Sanitation: Using functional toilets and avoiding open defecation.
- Personal Protection: Wearing footwear to prevent hookworm penetration.
- Food Safety: Washing fruits and vegetables with clean water; drinking safe/boiled water.
Linkage With National Programs
- Anemia Mukt Bharat: Deworming is one of the "6-6-6" strategy's core pillars to combat nutritional anemia.
- WIFS (Weekly Iron and Folic Acid Supplementation): Coordination ensures children receive both deworming and micronutrient support.
- RBSK (Rashtriya Bal Swasthya Karyakram): Utilizing the deworming platform for screening children for the 4Ds (Defects, Deficiencies, Diseases, Developmental delays).