What is - a massive, one month,

National simultaneous school-based

School deworming effort to
Deworming approximately 16 million school-
Month?
aged children enrolled in public
schools this coming July 1 -29, 2016.
What are intestinal
worm infections?
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.
Why do children need
deworming?
Children are most vulnerable to worm
infections, as their immune system is not yet fully
developed.

Untreated worm infections prevent childrens

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.
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.
How to prevent these
infections?
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.

 The Department of Health (DOH), in
partnership with the Department of
Background Education (DepEd) through the
and Health and Nutrition Center (HNC),
Rationale will conduct the National School
Deworming Month (NSDM) starting
on July 1 -29, 2016.
 The NSDM aims to deworm
Background approximately 16 million school-
and aged children enrolled in all public
Rationale elementary and high schools in one
month, to reduce the burden of Soil
Transmitted Helminthiasis (STH)
infections with a positive impact on
childrens education and health.
 ALBENDAZOLE- the drug of choice for the
control, prevention, and treatment of
helminth infections
DEWORMING- the administration of
albendazole (or mebendazole), without prior
Definitions 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
 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
Definitions 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.
 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
Objectives 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
 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
SCOPE AND DepEd Regional Office regarding their
COVERAGE willingness to participate and in turn, the DepEd
Regional Office can refer them to the DOH
Regional Office.
 Improved and better health outcome
which is among the targets in the
Roadmap of the Kalusugan
Expected Pangkalahatan or Universal Health
Outcome Care through High Impact
Breakthrough.
 NSDM guidelines and protocols set by
the DOH-CO in collaboration with the
Department of Education (DepEd) shall
GENERAL provide direction and serve as a
GUIDELINES roadmap for Mass Drug Administration
Providers (MDAPs) in the
implementation of NSDD.
 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
IMPLEMENTATION 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
 All children without other illness should
be treated during a school deworming
day.
Before Teachers must inform parents of the
deworming importance of deworming so that parental
day 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.
 The NSDM is a nationwide effort targeting all 5
to 18 years old (Kindergarten to Grade 12)
children enrolled in public elementary schools.

SCOPE AND School-aged children enrolled in private schools

COVERAGE 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.
 1. Pre-deworming
Prepare enrollment list
Ensure availability of deworming & supportive drugs
The Mass Drug Administration Provider must be
familiar with the following information:
MDAP Guide
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
 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
MDAP Guide 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
 2. Deworming
Clean drinking-water should be available
at the school on the treatment day
. MDAP Guide
Each learner shall receive one tablet of
deworming drug.

The MDA providers should ensure that

each child swallows/chew the tablet.
 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
MDAP Guide 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
 3. Post Deworming
The class teachers shall make sure that
all children listed in the masterlist were
MDAP Guide given deworming drugs.

NSDD point person to collate and submit

report (Please see flow of reporting)
 Form 1
National School Deworming Day
Classroom Level

NSSD Form 1 Province: Division: District:

School: School Address:
Total Enrolment: Grade Level & Section:

Name of Enrolment Hand Feeding Dewormed Tooth Remarks Actions

Child washing Done brushing Taken
4Ps Non
Done Done
4Ps
1.
2.

Accomplished by: Noted:

Class Adviser Grade Level Chairman

Date:
 Form 2
National School Deworming Day
School Level

NSSD Form 2 Province: Division: District:

School: School Address:

Grade Enrolment Total No. of Dewormed Total No. of Remarks

Level Enrolment Children Children
4Ps Non
Dewormed Dewormed
4Ps
4Ps Non 4Ps

Total

Accomplished by: Noted:

School Principal PSDS

Date:
 Form 3
National School Deworming Day
District Level Reporting Form

NSSD Form 3 Region Province: Division:

District:

Name of Enrolment Total No. of Dewormed Total No. of Remarks

Schools Enrolment Children Children
4Ps Non
Dewormed Dewormed
4Ps
4Ps Non 4Ps

Total

Accomplished by: Noted:

PSDS SDS
Date:
AO 2010-0023

I. Recommended drugs for mass deworming

Albendazole Mebendazole
400 mg, chewable, 500mg, chewable,
flavored tablet flavored tablet

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

 Dosage and Estimated Effectiveness of Drugs
in Current Use in Intestinal Helminth Infections
(Based on Drugs Used in Parasitic Diseases, WHO)
Roundworm Whipworm Hookworm
Albendazole1 (400 mg) +++ ++ - +++ +++
Levimasole1 (2.5
mg/kg) + ++ ++ - +++
Mebendazole1 (500 mg)
+++ ++ - +++2 ++ - +++2
Pyrantel1 (10
mg/kg)
+++ ++ - +++
++++ Highly effective 1 In single dose
+++ Effective 2 The usual dose of Mebendazole is 100 mg BID for 3 days.
++ Effective in light Single dose of 500 mg
to moderate infections
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
AO 2010-0023

II. Drug dosages and frequency of deworming by target groups

Target groups Drug Dosage Frequency
1223 months lbendazole: 200 mg or tablet Every 6 months
Mebendazole: 500 mg tablet

2 yrs old and above Albendazole: 400mg or 1 tablet Every 6 months

(preschoolers, school children, pregnant, lactating Mebendazole: 500 mg tablet
adults, women of child bearing age, special
population and special groups)

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

III. Adverse events following deworming (AEFD)

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
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
 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: 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
 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: 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.)
 Recommended Drugs for the management of Adverse
Events Following Deworming (AEFD)
For abdominal pain:

Drug Dose
Hyoscine N- Acute attacks of colicky pain:
butylbromide 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.
AO 2010-0023

IV. Precautionary Measures on Mass Deworming

Category Response
Seriously ill child Manage existing condition prior to administration of
Children experiencing abdominal pain deworming drug
Children with diarrhea
Children who previously suffered
hypersensitivity to the 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 .
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
 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.
Whom to report SAE?
Municipal Level Provincial Level Regional Level National Level
a. Municipal Health a. Provincial Health a. Regional IHCP a. Disease
Officer Officer Coordinator Prevention and Control
Bureau
b. Municipal b. Provincial b. Regional b. Epidemiology
Epidemiology Epidemiology Epidemiology Bureau
Surveillance Officer (if Surveillance Officer (if Surveillance Officer
available) available)

c. IHCP Coordinator c. IHCP Coordinator c. Food and Drug c. Food and Drug
Administration Officer Administration

d. DOH Rep d. DOH representative d. School Health

Coordinator (for d. Department of
e. School Health school based Education (for school
e. School Health Coordinator (for deworming) based deworming)
Coordinator school based
deworming)
 Flow of SAE Report and Investigation
DOH/DFA/DepEd
Recommend appropriate action

RESU / Regional Coordinator/DepEd School Governance and Operations Division

Confirms and validate Assist in investigation if Recommends appropriate
investigation findings needed action

Municipal/ Provincial/ City Health Office/ DepEd Division Office

Conducts and confirms initial investigation using adverse reaction Recommends
reporting form and submits to next level appropriate action

Health Worker/ Parent/Teacher

Reports any SAE in the area to higher level
 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

Province:
Region: ______________________ ________ 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 _____

Complete REMARKS
Name of patient Age Address Chief Complaint Action

and time of onset of signs and

symptoms Taken

Accomplished by: _______________________________

Print name and signature
Date: ________________________
AO 2010-0023

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.