QuestionsQuestions (DOH ADMINISTRATIVE ORDER NO. 2010-0023)
AO 2010-0023 provides guidelines on administering deworming drugs to different age groups, managing adverse events following deworming (AEFD), and properly recording/reporting AEFD cases.
AEFD is a medical event that happens after ingestion of deworming drugs. While the drugs are generally safe and effective against helminths, mild and transient adverse reactions may occur within 8–12 hours after ingestion (the half-life period mentioned in the Order).
SAE is an adverse experience following treatment with a drug that results in: death; life-threatening condition; inpatient hospitalization or prolonging an existing hospitalization; persistent/significant disability or incapacity; congenital anomaly; cancer; or overdose.
Albendazole 400 mg chewable flavored tablet and mebendazole 500 mg chewable flavored tablet. They are recommended because they are WHO-recommended, safe, economical, effective against intestinal worms, and can be given as a single dose, making administration easier.
Both drugs shall be taken on full stomach.
Persons 1 year old and above, regardless of whether they currently have worms or when they were last dewormed, including children (preschool and school age), women of childbearing age including pregnant women in the 2nd and 3rd trimesters, lactating women, and high-risk adults such as food handlers/operators, farmers, miners, soldiers, and Indigenous peoples.
Deworming is done twice a year or every six months; for preschoolers, it is administered during the nationwide Garantisadong Pambata (GP) campaign in April and October.
Albendazole 400 mg (or 1 tablet) or mebendazole 500 mg, every 6 months.
Albendazole 200 mg (or 1/2 tablet as indicated in the Order) or mebendazole 500 mg (as specified in the table), given every 6 months. The Order also notes specific guidance for preschool/out-of-school youths on where they should be dewormed.
They should be given deworming drugs at the Rural Health Unit (RHU) or Municipal Health Center (MHC).
School children are dewormed in schools.
Seriously ill child/individual; child/individual with abdominal pain; child/individual with diarrhea; child/individual who previously suffered hypersensitivity to the drug; and severely malnourished (underweight) child/individual.
Examples listed: (1) Local sensitivity or allergy → give antihistamine; (2) mild abdominal pain → give antispasmodic; (3) diarrhea → give oral rehydrating solution; (4) erratic worm migration (pull out worms from mouth/nose).
Any serious adverse event experienced by the client within 8–10 hours after ingestion of the drug should be reported immediately.
Municipal Health Officer; Municipal Epidemiology Surveillance Office (if available); STH Coordinator; and a DOH representative.
Provincial Health Officer; Provincial Epidemiology Surveillance Officer (if available); STH Coordinator; and a DOH representative.
AEFD Teams investigate at their level and assess whether it was really AEFD using an investigation form (Annex 2). If it was drug-related, they recommend appropriate action; if further investigation is required, they refer the case to the next higher level.
They ensure treatment of referrals related to AEFD and report cases to the appropriate surveillance unit (MESU/PESU/RESU) as required by the Order.
The Integrated Helminth Control Program shall sub-allot Php 50,000 annually to each CHD to help defray expenses related to occurrence of AEFD during deworming; if no incident occurs, funds may be used for other STH activities.