A mid-day meal queue in a school. (PTI)

New Delhi, Feb. 4: A mass programme to eliminate intestinal worms in schoolchildren that is about to be launched in Bihar next week may soon expand to Delhi and other states, including Bengal, technical experts with the programme have said.

About 21 million children in Bihar will get de-worming tablets over the next three months in a scaled-up version of a school-based project introduced in Andhra Pradesh two years ago by Deworm the World (DtW), a global NGO active in 25 other Asian and African countries.

The programme will deliver single dose de-worming tablets to children in areas with high prevalence of intestinal parasites such as roundworms or hookworms that can cause anaemia and malnourishment, and even impair their learning ability. Worm infections can also make young children too tired and sick to concentrate in school and lead to absenteeism.

“There’s a well-known simple and safe treatment — we think the model of delivering this medication to children through school teachers is one of the most cost-effective ways to deal with worms,” said Lesley Drake, the executive director of DtW.

Children typically pick up worm infections through contaminated water or soil. Public health experts believe that less than 15 per cent of children at risk are actually receiving the standard treatment — a drug called albendazole.

India has about 250 million school-going children and research studies have suggested that chronic worm infections are a significant cause of anaemia and low growth, said a clinical microbiologist at the All India Institute of Medical Sciences, New Delhi.

Drake said the DtW initiative in India first seeks to develop prevalence data and any area with higher than 20 per cent prevalence of worm infections would be a candidate zone for the school-based de-worming campaigns.

Although health authorities have long recognised the problem of worm infections, public health specialists believe that other health priorities and the challenge of directly reaching out to millions of schoolchildren may have held back de-worming initiatives.

In 2009, DtW worked with the Andhra government and de-wormed two million children from 21,600 schools in six districts. The Bihar programme, to be rolled out on February 7, will cover 67,000 schools in the state’s 38 districts.

“Some areas in Bihar had up to 80 per cent prevalence rate,” said Prerna Makkar, the regional director with DtW in India. “We’re trying to play a catalytic role with the active involvement of local health and education departments.”

Makkar said a large-scale prevalence study had been initiated in Delhi to identify at-risk areas and DtW has also received queries of interest from state officials in Bengal, Orissa, and Uttar Pradesh.

DtW plans to propose a nation-wide exercise to map worm infections in different states, creating an atlas of prevalence that could help identify priority areas where urgent de-worming initiatives are needed.

The funding for the programme comes from multiple sources, including government funds. “We’d like to embed this programme in the government so that it can continue when we move away,” said Makkar.