ArticleBMJ global health2026
Disparities in deworming coverage between children with and without disabilities: insights from the DeWorm3 trial in India.
Article in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChildren with disabilities experience lower school enrolment rates and may be systematically excluded from school-based deworming programmes. The DeWorm3 trial provided an opportunity to evaluate whether community-wide mass drug administration (cMDA) could reduce these disparities by reaching children outside the education system.
methodsWe conducted a secondary analysis of the data from the DeWorm3 trial in Tamil Nadu, India. Children aged 5-17 years (n=82 417) who participated in at least one of the six rounds of cMDA were included. Disability was assessed using the UNICEF/Washington Group's Child Functioning Module. Mixed-effects logistic regression models examined associations between disability status and treatment coverage, adjusting for sociodemographic factors.
resultsChildren with disabilities (1.1% of the population) had higher unadjusted odds of not receiving deworming treatment compared with children without disabilities (OR=1.49, 95% CI 1.19 to 1.84), though this association was attenuated after adjustment (adjusted OR=1.10, 95% CI 0.86 to 1.37). Among school-attending children who received treatment, those with disabilities had significantly lower odds of receiving school-based treatment (adjusted OR=0.57, 95% CI 0.44 to 0.73). Subgroup analyses revealed that age, school attendance, parental marital status, geographical location and the COVID-19 pandemic significantly modified these associations.
conclusionWhile cMDA reduced some disparities in deworming coverage, children with disabilities remained less likely to receive school-based treatment. Public health programmes should combine school-based approaches with targeted community outreach strategies to ensure equitable inclusion of children with disabilities, particularly those experiencing multiple vulnerabilities.
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