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Letters to the Editor

the objective of escalating awareness of this entity among


treating physicians.
Acknowledgments
We acknowledge the Director of St. Stephens Hospital and
the Hospital management for allowing us to publish this work.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.

Sachin Sureshbabu, Laxmi Khanna, Sudhir Peter1,


Chindripu Sobhana1, Geeta Chopra1
Department of Neurology, St. Stephens Hospital, 1Department of
Pathology, Metropolis Labs India, Pvt Ltd, New Delhi, India
Address for correspondence:
Dr.Sachin Sureshbabu,
Department of Neurology, St. Stephens Hospital,
NewDelhi110054, India.
Email:drsachins1@rediffmail.com

References

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Morvans syndrome and acquired neuromyotonia. Brain
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5. LancasterE, HuijbersMG, BarV, BoronatA, WongA,
MartinezHernandezE, etal. Investigations of Caspr2, an
autoantigen of encephalitis and neuromyotonia. Ann Neurol
2011;69:30311.
6. TanKM, LennonVA, KleinCJ, BoeveBF, PittockSJ. Clinical
spectrum of voltagegated potassium channel autoimmunity.
Neurology 2008;70:188390.
7. KrogiasC, HoepnerR, Mller A, SchneiderGoldC, Schrder A,
GoldR. Successful treatment of antiCaspr2 syndrome by
interleukin 6 receptor blockade through tocilizumab. JAMA
Neurol 2013;70:10569.
8. PanagariyaA, KumarH, MathewV, SharmaB. Neuromyotonia:
Clinical profile of twenty cases from northwest India. Neurol
India 2006;54:3826.
9. SharmaS, SharmaP. Morvan syndrome: After scrotal sac drainage
and chemical instillation in hydrocele. Neurol India 2013;61:3002.
10. SinghG, PaulBS, BansalRK, PaulG. Autoantibodyinduced
encephalitis. Int J Nutr Pharmacol Neurol Dis 2014;4:4450.
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Access this article online
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Isaacs H. A syndrome of continuous musclefibre activity.


JNeurol Neurosurg Psychiatry 1961;24:31925.
2. Kkali CI, Krtnc M, Akay HI, Tzn E, ge AE.
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2015;26:23951.
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Website:
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DOI:
10.4103/0975-2870.197897

How to cite this article: Sureshbabu S, Khanna L, Peter S,


Sobhana C, Chopra G. Contactin-associated protein-2 antibodymediated peripheral nerve hyperexcitability. Med J DY Patil Univ
2017;10:106-8.
2017 Medical Journal of Dr. D.Y. Patil University | Published by Wolters Kluwer - Medknow

National deworming day: 10th February


Sir,
Soil-transmitted helminthiases (STH) are a group of intestinal
nematode infections caused by Ascaris lumbricoides
(roundworms), Trichuris trichiura (whipworms), Necator
americanus and Ancylostoma duodenale (hookworms),
and transmitted by eggs present in human feces, which
contaminate the soil in areas where sanitation is poor. More
than 1.5 billion people or 24% of the world population
are infected with STH. These parasitic infections cause
morbidity, decreased quality of life, adversely affect
108

nutritional status, and impair cognitive processes, especially


among vulnerable population. The control measures include
periodic deworming, health education to prevent reinfection,
and improved sanitation to reduce soil contamination with
infective eggs. The public health intervention (preventive
chemotherapy) for the control of morbidity associated
with STH is the periodic administration of antihelminthic
medicine in areas where the prevalence of any STH infection
equals or exceeds 20%, and the global target is to treat at least
75% of children living in STH-endemic countries by 2020.[1,2]

Medical Journal of Dr. D.Y. Patil University | January-February 2017 | Vol 10 | Issue 1

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Letters to the Editor

Developing countries such as India is endemic for STH and


Government of India has taken up a renewed emphasis
and active intervention on controlling soil-transmitted
parasitic infection among children in the age-group of
1-19 years through annual mass drug administration of
albendazole starting from the year 2016. Henceforth,
National Deworming Day (NDD) will be observed on
February 10 followed by mop-up day on February 15
every year in the country with the view to cover left out
children. The preparatory activity would start at least 1
week to 1 month before observance of day depending
on administrative level. Under the proposed activity,
children in the age-group of 2-19 years will receive one
tablet of albendazole (400 mg), whereas children in the
age-group of 1-2 years will receive half-tablet (200 mg)
under direct supervision at fixed facility (schools and
Anganwadi centers). This activity will be aligned and
integrated with other interventions such as iron and folic
acid supplementation or Vitamin A program or midday
meal program. States endemic for lymphatic filariasis
are already carrying out this activity in some form and
would be encouraged to synergies this component also.
Children who are sick would be skipped from receiving
the medicine. National level operational guidelines
have been recently released to guide states and union
territories in rolling out the implementation plan.[3] The
guidelines detail the implementation approach, magnitude
of problem, objective, target age-group of preschool (1-5
years) and school (6-19 years) children to be captured
within and outside school purview, preparatory activities,
training, drug procurement and logistics management,
administration of medicine and observance of day,
stakeholders involvement, community awareness and
mobilization, adverse event protocol, monitoring,
supervision, recording, and reporting activities.
Some attempts at deworming existed at primary health
care, maternal and child health, school health program, and
integrated child health scheme[4,5] in the country but could
not garner visible impact. Further, multiple administration
needs to be checked, especially during weekly iron and
folic acid supplementation activity; where-n, albendazole
is currently administered biannually. At population
level, vicious cycle of infections, worm infestation, and
suboptimal including poor quality nutrient intake and
unsatisfactory health practices has an adverse impact on
nutritional status of vulnerable population. Some of the
known reasons for this state of affairs are lack of vision,
incoherence, low priority and budgetary provisions,
malpractices, deworming drug availability, distribution
and compliance issue, poor community mobilization in
conjunction with insanitary environmental conditions,

unhygienic practices (untrimmed nails and unclean hands),


and high-risk practices such as walking barefoot and
poverty at large. It is heartening to note that the Global
Millennium Developmental Goal 2015 (target) for drinking
water has been achieved with 91% of the global population
(94% of Indian population) have an improved drinking
water sources, whereas only 68% of the global population
uses an improved sanitation facility with challenges still
prevailing in African and Asian countries.[6] Census 2011
confirmed that nearly 50% Indian still practiced open
defecation, especially in rural areas.[7]
Multipronged strategy may reduce the burden when
simultaneously all causal and associated risk factors, i.e.,
health determinants are also addressed in an integrated
manner. A meta-analysis study concluded that STH
reinfections occur rapidly after treatment and prevalence
and intensity of reinfection were positively correlated
with pretreatment infection status.[8] The prevalence of
reinfection at 3, 6, and 12 months postdrug administration
for A. lumbricoides was 26%, 68%, and 94%; T. trichiura
was 36%, 67%, and 82%, and for hookworm reinfection
was 30%, 55%, and 57%, respectively. Therefore, conscious
synergy of Swachh Bharat Mission, Total Sanitation
Campaign, and National Cleanliness (human and system)
drive is critical to add impetus to NDD activity. The
definitive advantage of this roll out activity would be
large-scale targeted intervention, visibility, consolidation,
better monitoring, and follow-up of coverage at the national
level. National legacy and learning of and on pulse
polio immunization would assist and captain many such
health campaigns in times to come. On a positive note,
we wish NDD to be a new day and beginning which
sustains through successfully over the years and does not
end hopelessly as a redone marketing gimmick under the
international partnership.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.

Sandeep Sachdeva
Department of Community Medicine, North DMC Medical College and
Hindu Rao Hospital, New Delhi, India
Address for correspondence:
Dr. Sandeep Sachdeva,
Department of Community Medicine, North DMC Medical College
and Hindu Rao Hospital, New Delhi - 110 007, India.
E-mail: sachdevadr@yahoo.in

Medical Journal of Dr. D.Y. Patil University | January-February 2017 | Vol 10 | Issue 1

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Letters to the Editor

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3.
4.
5.

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110

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Available from: http://www.who.int/mediacentre/factsheets/
fs366/en. [Last accessed on 2015 Dec 10].
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2015. p. 701-12. Available from: http://www.who.int/wer.
[Last accessed on 2016 Feb 02].
National deworming day: Operational guidelines. Child health
division. New Delhi: Ministry of Health and Family Welfare;
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Kapil U. Integrated Child Development Services (ICDS) scheme:
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J Pediatr 2002;69:597-601.
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http://www.censusindia.gov.in/2011census/hlo/Data_sheet/
India/Latrine.pdf. [Last accessed on 2016 Feb 05].

8. Jia TW, Melville S, Utzinger J, King CH, Zhou XN.


Soil-transmitted helminth reinfection after drug treatment:
Asystematic review and meta-analysis. PLoS Negl Trop Dis
2012;6:e1621.
This is an open access article distributed under the terms of the
Creative Commons Attribution-NonCommercial-ShareAlike 3.0
License, which allows others to remix, tweak, and build upon the
work non-commercially, as long as the author is credited and the
new creations are licensed under the identical terms.
Access this article online
Quick Response Code:

Website:
www.mjdrdypu.org

DOI:
10.4103/0975-2870.197909

How to cite this article: Sachdeva S. National deworming day: 10th


February. Med J DY Patil Univ 2017;10:108-10.
2017 Medical Journal of Dr. D.Y. Patil University | Published by Wolters Kluwer - Medknow

Medical Journal of Dr. D.Y. Patil University | January-February 2017 | Vol 10 | Issue 1