The deworming exercise and distribution of iron and folic acid tablets that is suspected to have caused giddiness, nausea, vomiting and abdominal pain in over 400 children aged 12-13 years at Sanjay Nagar Municipal Urdu School in Govandi on Friday, is conducted regularly by the Brihanmumbai Municipal Corporation (BMC) under the National Health Mission.
Deworming is a process to kill worms — commonly tape, round and hook worm — that infest bodies of children below 18 years of age. The Ministry of Health and Family Welfare (MoHFW) conducts this drive twice a year. As per the guidelines, children aged below two years are given 200 gm of Albendazole tablet, a drug to treat parasitic worm infestation, and school-going children are administered 400 mg tablets. Dr Santosh Revankar, deputy executive health officer in BMC, said, “The Albendazole tablet paralyses the muscles of these worms. The worm loses its grip of intestinal tract and is flushed out of the human body.” A worm takes six months to mature and start sucking, therefore the exercise is carried out biannually.
Parasitic worms and their larvae are generally found in contaminated food and water. In slums, where children walk barefeet, they frequently contract worms. “The worm first enters the blood circulation system and its larvae land up in the larynx, from where it finally reaches the gastrointestinal tract. The worms thrive there,” said Dr Revankar. The hook, round and tapeworm grow by sucking blood from its host — in this case the human body. Loss of blood leads to a drop in haemoglobin level and causes anaemia. The National Family Health Survey-3 data suggests anaemia is widely prevalent in all age groups. Its prevalence is 56 per cent among adolescent girls (aged 15-19) and 70 per cent among children below five years. Deworming kills these worms and helps prevent anaemia.
What are the side effects of deworming?
Deworming has no serious side effects. “But it can cause nausea and vomiting if a child has worms. The medicine disrupts the worms, which leads to uneasiness in the stomach,” said Dr Satish Pawar from the Directorate of Health Services (DHS). He said the exercise is conducted across 40,000-50,000 schools in Maharashtra, of which 30-40 report minor side effects.
Why do children require iron and folic acid tablets?
Under the National Iron Plus Initiative of the Union Health Ministry, children aged 1-18 years must be given a weekly dose of iron and folic acid tablets to prevent iron deficiency and chances of anaemia. In Mumbai, municipal schools conduct this drive every Monday, by giving a weekly dose of 100 mg iron and 500 mg folic acid to adolescents (10-19 years) — dosage varies for different age groups. In Mumbai, 25 lakh iron and folic acid tablets were procured by the BMC in the last batch from the state government. “It is from this batch that we administered medicines to children in Govandi. The same batch has been used earlier but showed no side effects,” said Dr Padmaja Keskar, executive health officer, BMC.
What is the testing mechanism for these medicines?
According to health officials, Maharashtra procures 50 crore iron and folic acid tablets, and 1-2 crore Albendazole medicines, annually, for deworming. “A batch of one lakh medicines comes to us. From these, we randomly select samples,” said a state health official. The medicine undergoes testing at two levels. The first laboratory test is conducted by the manufacturer, from which a few samples are preserved for the Food and Drug Administration. The second test is conducted by the Maharashtra government in an NABL accredited laboratory. “Until the laboratory results approve the drug, we don’t use them. The waiting period is called quarantine,” said Dr Pawar from DHS.
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