alis

2. What is
National
School
Deworming
Month?
- a massive, one month,
simultaneous school-based
deworming effort to approximately
16 million school-aged children
enrolled in public schools this
coming July 1 -29, 2016.

3. What are intestinal
worm infections?

4. Intestinal worms are parasites that live in
the human intestines or in the veins around
the bladder.
These worms are transmitted by eggs
excreted in human feces or urine, which
contaminate the soil or water sources in
areas that lack adequate sanitation.
The worms consume part of the nutrients
and vitamins that children ingest.

8. Why do children need
deworming?

9. Children are most vulnerable to worm
infections, as their immune system is not yet fully
developed.
Untreated worm infections prevent children’s
healthy growth, cause poor nutrition and reduce
their capacity to concentrate and learn.
The treatment is simple, safe, effective and free
of charge. A single dose of deworming treatment
drastically reduces the number of worms in each
child.

10. Regular treatment contributes to good health
and nutrition for children of school age, which in
turn leads to increased enrolment and
attendance, reduced class repetition and better
educational attainment.
Children need these deworming medicines to
grow healthier and learn better in school.

11. How to prevent these
infections?

12. Always use a toilet or latrine. This will prevent
feces from contaminating the soil.
Always wash hands with soap after using the
latrine, and keep hands clean.
Wash fruits and vegetables with clean water.
Always wear shoes and slippers and avoid
walking barefoot.
Take deworming tablets at least once a year.

13. Background
and
Rationale
The Department of Health (DOH), in
partnership with the Department of
Education (DepEd) through the
Health and Nutrition Center (HNC),
will conduct the National School
Deworming Month (NSDM) starting
on July 1 -29, 2016.

14. Background
and
Rationale
The NSDM aims to deworm
approximately 16 million school-
aged children enrolled in all public
elementary and high schools in one
month, to reduce the burden of Soil
Transmitted Helminthiasis (STH)
infections with a positive impact on
children’s education and health.

15. Definitions
ALBENDAZOLE- the drug of choice for the
control, prevention, and treatment of
helminth infections
DEWORMING- the administration of
albendazole (or mebendazole), without prior
diagnosis of current infection, to control and
treat intestinal helminth infecions, such as
hookworm, Ascaris, and Trichuris
ELIGIBLE POPULATION- a group of
individuals qualified for deworming; target
population for single day deworming will be
children age 5-18 years old or K- Grade 12
enrolled in public elementary schools

16. Definitions
MASS DRUG ADMINISTRATION (MDA)- a
strategy to provide deworming drugs to the eligible
population without the requirement of prior
diagnosis of current infection
MASS DRUG ADMINISTRATION PROVIDER
(MDAP)- a person who administer the deworming
drugs. This can be any teacher supervised by a
health worker from the department of health
(DOH), Department of education (DepEd), Local
Government Units (LGU), or volunteer groups (with
prior approval from DOH Regional Office) who
have the capacity and background in health,
administration of deworming drugs, and
management of adverse events.

17. Objectives
General: To deworm approximately 16 million school-
aged children enrolled in 38,659 public elementary
schools in one (1) day through the National School
Deworming Day initiative.
Specific:
 To increase and scale-up the MDA coverage for
school-aged children (5-12 years old or
Kindergarten to Grade 12) enrolled in public
elementary schools
 To facilitate and ensure timely reporting of
deworming intervention
 To promote partnership in all levels in the
implementation of deworming for school-aged
children enrolled in public elementary and high
schools

18.  The NSDM is a nationwide effort targeting all 5
to 18 years old (Kindergarten to Grade 12)
children enrolled in public elementary schools.
 School-aged children enrolled in private schools
and children who are not enrolled are
encouraged to participate. They can inform the
DepEd Regional Office regarding their
willingness to participate and in turn, the DepEd
Regional Office can refer them to the DOH
Regional Office.
SCOPE AND
COVERAGE

19. Expected
Outcome
Improved and better health outcome
which is among the targets in the
Roadmap of the Kalusugan
Pangkalahatan or Universal Health
Care through High Impact
Breakthrough.

20. GENERAL
GUIDELINES
NSDM guidelines and protocols set by
the DOH-CO in collaboration with the
Department of Education (DepEd) shall
provide direction and serve as a
roadmap for Mass Drug Administration
Providers (MDAPs) in the
implementation of NSDD.

21. IMPLEMENTATION
The NSDD Implementers shall consist of the
following:
 i. Category 1: Health workers to oversee the MDA
 Regional, Provincial and Municipal Health Office Staff (Rural Health
Physicians, Public Health Nurses, Rural Health Midwives)
 DepEd school physicians and nurses
 Nurses and midwives from the Nurse Deployment Program/ Rural
Health Midwife Placement Program
 ii. Category 2: Front liners in the MDA
 School Teachers and clinic teachers will distribute the deworming
drugs
 Members of the Parent Teachers Community Association (PTCA)
will assist in the school deworming
 Barangay Health Workers will assist in the school deworming
 Community Health Teams will assist in the school deworming

22. Before
deworming
day
All children without other illness should
be treated during a school deworming
day.
Teachers must inform parents of the
importance of deworming so that parental
consent to treat their children is obtained
before the deworming day.
Inform parents by means of group
meeting. When this is not possible,
students are asked to hand a
notification letter to their parents.

23.  The NSDM is a nationwide effort targeting all 5
to 18 years old (Kindergarten to Grade 12)
children enrolled in public elementary schools.
 School-aged children enrolled in private schools
and children who are not enrolled are
encouraged to participate. They can inform the
DepEd Regional Office regarding their
willingness to participate and in turn, the DepEd
Regional Office can refer them to the DOH
Regional Office.
SCOPE AND
COVERAGE

24. MDAP Guide
1. Pre-deworming
Prepare enrollment list
Ensure availability of deworming & supportive drugs
 The Mass Drug Administration Provider must be
familiar with the following information:
Recommended drug for Mass Drug
Administration
The DOH recommends the following drugs for mass
treatment:
Albendazole 400mg chewable,flavoured tablet
Mebendazole 500mg chewable,flavoured tablet

25. MDAP Guide
Precautionary Measures on Mass Deworming
Albendazole or Mebendazole is not recommended if the
child has any of the following conditions:
Seriously ill child
Children experiencing abdominal pain
Children with diarrhea
Children who previously suffered hypersensitivity to the
drug
Serious Adverse Events (SAE) following deworming
MDAP shall ensure that the children will take
deworming drugs on Full Stomach

26. . MDAP Guide
2. Deworming
Clean drinking-water should be available
at the school on the treatment day
Each learner shall receive one tablet of
deworming drug.
The MDA providers should ensure that
each child swallows/chew the tablet.

27. MDAP Guide
The names of the children who are absent on
NSDD should be recorded by the teacher and
these children should be treated when they
return to school. Children who are ill on treatment
day should not receive drugs. This is not because of
any danger of adverse effects, but to prevent the
potential misperception that the deworming medicine
caused the illness. These children should be given the
anthelminthic drug later when they are well again
Ensure all RHUs and hospitals are ready for
SAE referrals
Ensure that the required number of drugs is
available

28. MDAP Guide
3. Post Deworming
The class teachers shall make sure that
all children listed in the masterlist were
given deworming drugs.
NSDD point person to collate and submit
report (Please see flow of reporting)

29. NSSD Form 1
Form 1
National School Deworming Day
Classroom Level
Province: Division: District:
School: School Address:
Total Enrolment: Grade Level & Section:
Name of
Child
Enrolment Hand
washing
Done
Feeding
Done
Dewormed Tooth
brushing
Done
Remarks Actions
Taken
4Ps Non
4Ps
1.
2.
Accomplished by: Noted:
Class Adviser Grade Level Chairman
Date:

30. NSSD Form 2
Form 2
National School Deworming Day
School Level
Province: Division: District:
School: School Address:
Grade
Level
Enrolment Total
Enrolment
No. of
Children
Dewormed
Dewormed Total No. of
Children
Dewormed
Remarks
4Ps Non
4Ps
4Ps Non 4Ps
Total
Accomplished by: Noted:
School Principal PSDS
Date:

31. NSSD Form 3
Form 3
National School Deworming Day
District Level Reporting Form
Region Province: Division:
District:
Name of
Schools
Enrolment Total
Enrolment
No. of
Children
Dewormed
Dewormed Total No. of
Children
Dewormed
Remarks
4Ps Non
4Ps
4Ps Non 4Ps
Total
Accomplished by: Noted:
PSDS SDS
Date:

32. Mebendazole
500mg, chewable,
flavored tablet
Albendazole
400 mg, chewable,
flavored tablet
I. Recommended drugs for mass deworming
 All individual ages 1yo and above can take the deworming
tablet regardless of the schedule of their last deworming.
 It should not be taken on an empty stomach
AO 2010-0023

33. Dosage and Estimated Effectiveness of Drugs
in Current Use in Intestinal Helminth Infections
(Based on Drugs Used in Parasitic Diseases, WHO)
Albendazole1 (400 mg)
Levimasole1 (2.5
mg/kg)
Mebendazole1 (500 mg)
Pyrantel1 (10
mg/kg)
Roundworm Whipworm Hookworm
+++
+
+++
+++
++ - +++
++
++ - +++2
+++
++ - +++
++ - +++2
++ - +++
++++ Highly effective
+++ Effective
++ Effective in light
to moderate infections
1 In single dose
2 The usual dose of Mebendazole is 100 mg BID for 3 days.
Single dose of 500 mg

34. Why is albendazole or mebendazole the drug of choice in
the mass tx of STH?
• Included in the WHO model list of essential
medicines for single dose treatment of STH
• Safe, economical and simple because it is
given as a single dose
• Efficacy varies as a function of such
factors as pre-existing diarrhea,
gastrointestinal transit time, degree of
infection, and helminth strain

35. II. Drug dosages and frequency of deworming by target
groupsTarget groups Drug Dosage Frequency
12—23 months Ãlbendazole: 200 mg or ½ tablet
Mebendazole: 500 mg tablet
Every 6 months
2 yrs old and above
(preschoolers, school children, pregnant, lactating
adults, women of child bearing age, special
population and special groups)
Albendazole: 400mg or 1 tablet
Mebendazole: 500 mg tablet
Every 6 months
 Pre-school aged children and unenrolled school-aged children should be given deworming drugs at the Rural Health Unit or
Municipal Health Center.
Enrolled school-aged children are given deworming drugs in schools
AO 2010-0023

36. III. Adverse events following deworming (AEFD)
AO 2010-0023
Common Adverse Effects How to Manage*
Local sensitivity or allergy Give antihistamine
Mild abdominal pain Give antispasmodic
Diarrhea Give oral rehydration solution plus Zinc
Erratic worm migration Pull out the worms from mouth/nose and
dispose worm properly
Parents/caregivers are allowed to manage the adverse reactions, but if these reactions persist, a doctor
shall be consulted and any of the AEFD team shall be informed

37. Why do we say that adverse effects are relatively mild?
 Poorly absorbed
 Primary metabolite, sulfoxide, is rapidly
metabolized to sulfone
 Negligible or undetectable in the plasma 24
hours after ingestion
 Half life of the sulfoxide is about 8.5 hours
 No treatment is necessary if the child
experienced any of the adverse reactions since
they are mild and transient

38. Recommended Drugs for the management of Adverse
Events Following Deworming (AEFD)
For local hypersensitivity and allergy:
Drug Dose
Diphenhydramine For oral dosage forms: Syrup 12.5mg/5ml
• Children younger than 6 years of age: ½ tsp to 1
tsp every 6 – 8 hours until symptoms subside
• Children 6 to 12 years of age: 1tsp to 2 tsp every 6
– 8 hours until symptoms subside

39. Recommended Drugs for the management of Adverse
Events Following Deworming (AEFD)
For abdominal pain:
Drug Dose
Dicycloverine GI spasm:
For oral dosage forms:
Syrup 10 mg/5ml
• Children 6 months – 2 years old: ½ tsp to 1 tsp every
6 – 8 hours.
• Children 2 – 12 years old: 1 tsp every 6 – 8 hours.
* Dicycloverine: May be taken with or without food. (May
be taken before or after meals.)

40. Recommended Drugs for the management of Adverse
Events Following Deworming (AEFD)
For abdominal pain:
Drug Dose
Hyoscine N-
butylbromide
Acute attacks of colicky pain:
For oral dosage forms:
Syrup 5 mg/5ml or Tablet 10mg
• Children ≥ 6 years: I tablet every 6 – 8 hours or 2
tsp every 6 – 8 hours.

41. IV. Precautionary Measures on Mass Deworming
AO 2010-0023
Category Response
Seriously ill child
Children experiencing abdominal pain
Children with diarrhea
Children who previously suffered
hypersensitivity to the drug
Manage existing condition prior to administration of
deworming drug
Severely malnourished children Assess for presence or absence of medical complication
and edema of both feet.
If present, manage medical complications before
deworming. (Source: Community-based Management of
Acute Malnutrition)
For uncomplicated severe malnutrition, (absence of
medical complication and edema) children may be
dewormed .

42. REMEMBER!
Target clients or caregivers should be
adequately informed of the possible
adverse reaction to the drug and how
to manage it in case it occurs
Adverse reactions should be accurately
recorded and proper authorities (AEFD
team) informed
Health personnel at the community
level should be informed of the on-
going deworming activity. Support
drugs should be available at the
nearest health facility

43. When to report SAE?
 Any Serious Adverse Event (SAE) experienced by
the client within 8-10 hours after ingestion of the
drug should be reported immediately to the
appropriate authority.
 Any AEFD or non-serious adverse event shall also
be recorded for reference.
 Any AEFD or non-serious adverse event reported
after 10 hours since the administration of the drug
should be investigated and managed
appropriately.

44. Whom to report SAE?Municipal Level Provincial Level Regional Level National Level
a. Municipal Health
Officer
b. Municipal
Epidemiology
Surveillance Officer (if
available)
c. IHCP Coordinator
d. DOH Rep
e. School Health
Coordinator
a. Provincial Health
Officer
b. Provincial
Epidemiology
Surveillance Officer (if
available)
c. IHCP Coordinator
d. DOH representative
e. School Health
Coordinator (for
school based
deworming)
a. Regional IHCP
Coordinator
b. Regional
Epidemiology
Surveillance Officer
c. Food and Drug
Administration Officer
d. School Health
Coordinator (for
school based
deworming)
a. Disease
Prevention and Control
Bureau
b. Epidemiology
Bureau
c. Food and Drug
Administration
d. Department of
Education (for school
based deworming)

45. DOH/DFA/DepEd
Recommend appropriate action
RESU / Regional Coordinator/DepEd School Governance and Operations Division
 Confirms and validate
investigation findings
Assist in investigation if
needed
Recommends appropriate
action
Municipal/ Provincial/ City Health Office/ DepEd Division Office
 Conducts and confirms initial investigation using adverse reaction
reporting form and submits to next level
Recommends
appropriate action
Health Worker/ Parent/Teacher
Reports any SAE in the area to higher level
Flow of SAE Report and Investigation

46. INTEGRATED HELMINTH CONTROL PROGRAM
Adverse Events Following deworming
REPORTING FORM
To be filled in by the Physician/Midwife/Barangay Health Worker or Teacher as needed during every mass deworming campaign
Region: ______________________
Province:
________ Municipality: _______________________
Service outlet: (Please check and indicate name of RHU, School, Daycare
______ Barangay Health Station/RHU: ________________ School:_________________
______ Day Care Center: _____________________
Date of deworming: ___________ Time of Deworming _____
Name of patient Age
Complete
Address Chief Complaint Action
REMARKS
and time of onset of signs and
symptoms Taken
Accomplished by: _______________________________
Print name and signature
Date: ________________________

47. Support to DOH Regional Offices for
AEFD and SAE
 The Integrated Helminth Control Program shall
sub-allot the amount of Fifty Thousand Pesos
(PhP 50,000 – 100, 000) to each DOH Regional
Office annually to help defray the expenses
incurred related to the occurrence of AEFD or
SAE during the conduct of deworming activity.
AO 2010-0023