Three 2017 graduates of the Eck Institute for Global Health Master of Science in Global Health program, Wyatt Kernell, Rosalie DePaola, and Alec Maglione, published findings from their Capstone research project in the July 2018 issue of the influential journal, PLoS Neglected Tropical Diseases. Their project examined risk factors for choking and other adverse swallowing events (ASEs) among young children receiving mass treatment for soil-transmitted helminth, or intestinal worm, infections.
The Capstone project was a direct outgrowth of their global health ethics class in the MS in Global Health program, in which students considered the rare, but measurable, risk of choking-related deaths in young children during mass deworming. Before this project, field-based observations upon which to base preventative recommendations were extremely limited. “Sometimes, the most important thing to do when faced with an ethical dilemma is to improve the scientific evidence,” noted adjunct professor, co-instructor for the ethics course, and Capstone supervisor David Addiss. “The data collected by these Notre Dame students have significant implications for policy and practice. They also remind us that in addition to focusing on the benefits of our global health interventions, we need to be mindful of the potential for unintended harmful consequences.”
Working in collaboration with the non-governmental organization Vitamin Angels, Wyatt and Rosalie collected information from deworming programs in India, while Alec worked in Haiti. Together, they observed 1677 children receiving deworming medicine (albendazole) in 65 sites. Of these, 248 (14.8%) had one or more ASEs, and 18 (1.1%) choked, none fatally. The most significant risk factor for choking was the demeanor of the child just before receiving the drug. Children who were fearful, fussy, or combative had a 20-fold increased risk of choking. In line with previous WHO recommendations, Kernell and colleagues concluded, “choking-related deaths in young children are preventable. Deworming tablets should not be given to young children who are fussy, fearful, or combative or who struggle to resist tablet administration.”
The full paper can be read at: Kernell JW, DePaola RV, Maglione AM, Ahern LN, Penney NG, Addiss DG. Risk of adverse swallowing events and choking during deworming for preschool-aged children. PLoS Negl Trop Dis 2018; 12(6): e0006578, https://doi.org/10.1371/journal.pntd.0006578.
Wyatt Kernell, Rosalie DePaola, and Alec Maglione.
Originally published by globalhealth.nd.edu on July 02, 2018.at