Mass drug administration (MDA) campaign for soil-transmitted worm infection

On October 3, 11-year-old Rivaldo da Conceicao received the albendazole tablet at his school in Taibessi through the mass drug administration (MDA) campaign for soil-transmitted worm infection. Within less than an hour of taking the tablet, Rivaldo passed out a 27 centimetres long white worm in the school premises.

Rivaldo was the first child in the school who passed out the worm within such a short time, which initially alarmed his teachers. However, they were reassured by the team of health professionals and volunteers who were at the school to support and supervise the drug distribution. “I am not scared nor am I feeling sick,” said Rivaldo with a sheepish smile as he responded surrounded by teachers and doctors having become the centre of attraction.

The following day Ministry of Health (MoH) and World Health Organization officials visited Rivaldo house, and learnt more about Rivaldo’s health and hygiene.

“We, fortunately, have all the basic amenities in place,” said Rivaldo’s father, Ricardo da Conceicao. “We have tap water, a toilet which is just outside the house, and even electricity,” he added.

When asked if Rivaldo observes basic hygiene practices his mother, Domingas da Conceicao admitted that he’s not particular when it came to hygiene. “Simple things like washing hands before and after meals is something that he has not been particular about, and unfortunately, we neither were so aware to have made it a normal practice,” she said.

The parents of the 11-year-old admitted that Rivaldo, in the past as well complained of stomach aches often but nothing ever so alarming. Whenever he did, he was taken to the nearest health centre. The family barely manages to make ends meet as Ricardo does not have a regular job, but they have never resorted to traditional healing methods. “Every time there has been a health problem in the family we have visited a health centre,” said Rivaldo’s parents in unison.

“According to the national parasitic survey conducted in Timor-Leste in 2012, soil-transmitted helminthic infections is a public health concern. The study showed the highest prevalence in Dili up to 55%, meaning that 1 out of 2 children in Dili is infected with intestinal worms, said Dr Rajesh Pandav, WHO Representative to Timor-Leste.

Unhygienic practices like open defecation, not using footwear, not washing hands before and after meals are some of the most common ways that increase the chances of the worms entering the body of children are the most vulnerable. To tackle the STH infection, MDA Round 2 for STH was conducted in Dili in two stages targeting children from 1 to 15 years. The first phase ran from 1 to 5 October in schools and the second from 8 to 12 October in the communities.

The Round 2 of MDA in 2018 for STH is a part of the five-year Integrated Neglected Tropical Diseases Programme Control and Elimination programme in Timor-Leste, 2016 -2021.

The goal of the programme is to eliminate lymphatic filariasis (LF ─ also known as elephantiasis) and yaws and control STH. The programme is funded by the Korea International Cooperation Agency (KOICA) and WHO is the technical partner to MoH for executing and implementing the programme.