Risk of adverse swallowing events and choking during deworming for preschool-aged children.
In areas where the prevalence of soil-transmitted helminthiasis (STH) is >20%, the World Health Organization (WHO) recommends that deworming medication be given periodically to preschool-age children. To reduce risk of choking-related deaths in children <3 years old, WHO recommends that deworm...
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ftdoajarticles:oai:doaj.org/article:95ca6e7e49814b3c9a32c22b20701e65 2023-05-15T15:16:21+02:00 Risk of adverse swallowing events and choking during deworming for preschool-aged children. James Wyatt Kernell Rosalie V DePaola Alec M Maglione Lacey N Ahern Naomi G Penney David G Addiss 2018-06-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0006578 https://doaj.org/article/95ca6e7e49814b3c9a32c22b20701e65 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC6014639?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006578 https://doaj.org/article/95ca6e7e49814b3c9a32c22b20701e65 PLoS Neglected Tropical Diseases, Vol 12, Iss 6, p e0006578 (2018) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2018 ftdoajarticles https://doi.org/10.1371/journal.pntd.0006578 2022-12-31T01:12:53Z In areas where the prevalence of soil-transmitted helminthiasis (STH) is >20%, the World Health Organization (WHO) recommends that deworming medication be given periodically to preschool-age children. To reduce risk of choking-related deaths in children <3 years old, WHO recommends that deworming tablets be crushed and given with water. Little is known about how widely this is practiced or its effectiveness.Albendazole distributions for STH were observed for children 1-4 years old in 65 sites in India and Haiti. Information was recorded on child demographics; child demeanor immediately before, as well as struggling or resistance during albendazole administration; tablet form (i.e., crushed or not); and adverse swallowing events (ASEs), including choking, spitting; coughing; gagging; vomiting; and expelling a crushed tablet in a "cloud" of powder. Of 1677 children observed, 248 (14.8%) had one or more ASEs. ASE risk was 3.6% with whole tablets, 25.4% with crushed tablets, and 34.6% when crushed tablets were mixed with water. In multivariate analysis, ASE risk was significantly associated with children 1 year (OR 2.7) or 2 years (OR 2.9) of age; male gender (OR 1.6); non-content child demeanor (fearful, fussy, or combative) before albendazole administration (OR 4.3); child struggling when given albendazole (OR 2.1); and giving water, either after the tablet or mixed with it (OR 5.8). Eighteen (1.1%) children choked, none fatally; 17 choking incidents occurred with crushed tablets. In a multivariate analysis that controlled for distribution site, the only significant risk factor for choking was non-content demeanor (OR 20.6).Deworming-related choking deaths in young children are preventable. In our sample, risk of choking could have been reduced by 79.5% if deworming tablets were not given to young children who were fussy, fearful, or combative or who struggled to resist tablet administration, with only an 18.4% reduction in drug coverage. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 12 6 e0006578 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 James Wyatt Kernell Rosalie V DePaola Alec M Maglione Lacey N Ahern Naomi G Penney David G Addiss Risk of adverse swallowing events and choking during deworming for preschool-aged children. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
In areas where the prevalence of soil-transmitted helminthiasis (STH) is >20%, the World Health Organization (WHO) recommends that deworming medication be given periodically to preschool-age children. To reduce risk of choking-related deaths in children <3 years old, WHO recommends that deworming tablets be crushed and given with water. Little is known about how widely this is practiced or its effectiveness.Albendazole distributions for STH were observed for children 1-4 years old in 65 sites in India and Haiti. Information was recorded on child demographics; child demeanor immediately before, as well as struggling or resistance during albendazole administration; tablet form (i.e., crushed or not); and adverse swallowing events (ASEs), including choking, spitting; coughing; gagging; vomiting; and expelling a crushed tablet in a "cloud" of powder. Of 1677 children observed, 248 (14.8%) had one or more ASEs. ASE risk was 3.6% with whole tablets, 25.4% with crushed tablets, and 34.6% when crushed tablets were mixed with water. In multivariate analysis, ASE risk was significantly associated with children 1 year (OR 2.7) or 2 years (OR 2.9) of age; male gender (OR 1.6); non-content child demeanor (fearful, fussy, or combative) before albendazole administration (OR 4.3); child struggling when given albendazole (OR 2.1); and giving water, either after the tablet or mixed with it (OR 5.8). Eighteen (1.1%) children choked, none fatally; 17 choking incidents occurred with crushed tablets. In a multivariate analysis that controlled for distribution site, the only significant risk factor for choking was non-content demeanor (OR 20.6).Deworming-related choking deaths in young children are preventable. In our sample, risk of choking could have been reduced by 79.5% if deworming tablets were not given to young children who were fussy, fearful, or combative or who struggled to resist tablet administration, with only an 18.4% reduction in drug coverage. |
format |
Article in Journal/Newspaper |
author |
James Wyatt Kernell Rosalie V DePaola Alec M Maglione Lacey N Ahern Naomi G Penney David G Addiss |
author_facet |
James Wyatt Kernell Rosalie V DePaola Alec M Maglione Lacey N Ahern Naomi G Penney David G Addiss |
author_sort |
James Wyatt Kernell |
title |
Risk of adverse swallowing events and choking during deworming for preschool-aged children. |
title_short |
Risk of adverse swallowing events and choking during deworming for preschool-aged children. |
title_full |
Risk of adverse swallowing events and choking during deworming for preschool-aged children. |
title_fullStr |
Risk of adverse swallowing events and choking during deworming for preschool-aged children. |
title_full_unstemmed |
Risk of adverse swallowing events and choking during deworming for preschool-aged children. |
title_sort |
risk of adverse swallowing events and choking during deworming for preschool-aged children. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2018 |
url |
https://doi.org/10.1371/journal.pntd.0006578 https://doaj.org/article/95ca6e7e49814b3c9a32c22b20701e65 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 12, Iss 6, p e0006578 (2018) |
op_relation |
http://europepmc.org/articles/PMC6014639?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006578 https://doaj.org/article/95ca6e7e49814b3c9a32c22b20701e65 |
op_doi |
https://doi.org/10.1371/journal.pntd.0006578 |
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PLOS Neglected Tropical Diseases |
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12 |
container_issue |
6 |
container_start_page |
e0006578 |
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