Stanford Researchers Fight Intestinal Worms in Rural China

Stanford’s Rural Education Action Project aims to show the Chinese government the best way to treat intestinal worm infections.

AsianScientist (Jun. 10, 2011) – Stanford’s Scott Rozelle is leading the Stanford Rural Education Action Project’s efforts to show the Chinese government the best way to treat intestinal worm infections – an affliction that could weaken the country’s boom and hurt its role in the global economy.

In a survey conducted last year of about 1,700 children in Guizhou and bordering Sichuan provinces, REAP found that about 35 percent of them had intestinal worms – parasites that thrive when poor sanitation, undercooked meat, and livestock mingle. The rates of worms were higher in Guizhou, reaching to 80 percent in some places.

Here in a village in Guizhou Province, 20 REAP researchers have come here to visit with the families who participated in the survey and talk to the doctors and government officials they’re urging to fight the high rates of worm infestation. The group consists of economists, doctors, and political scientists from Stanford and other American universities as well as Chinese academics.

REAP’s findings spurred the government to earmark about US$10 million to do something about worms in rural China.

A few years ago, officials spent some money on improving sanitation, educating parents, and giving children medicine. But they did all those things at the same time and didn’t measure the results, making it impossible to tell what – if any – method worked and how effective it was. Rozelle’s team also found high rates of worm re-infection, meaning whatever was done in the past had no lasting impact.

“What you really need to do is have the government give these kids medicine, medicine and more medicine for the next 10 or 20 years until they’re old enough to move to the city,” Rozelle says.

“They’ll get better, and the social return is that they’ll be able to work harder when they grow up and integrate into a society a generation from now.”

De-worming pills cost less than a piece of candy – about 15 cents for a single tablet that could make a big difference if taken just twice a year. But in order to convince the government to make that investment, Rozelle needs data. So REAP plans to conduct a set of experiments designed to demonstrate the best and most cost-effective way to deal with the problem.

Although intestinal worms aren’t usually a deadly affliction, they sap enough nutrients and vitamins to stunt growth, drain energy and sometimes lead to severe malnutrition. That makes it harder for children to do well in school and grow up strong, creating a disadvantage.

In these villages, toilets are almost always outside, consisting of little more than an opening over a large pit. There’s no running water for hand washing, making it easy for contaminated feces to spread.

“There’s lots of room for an ongoing risk of infection. I think this is just an accepted standard and it doesn’t strike anybody as unusual. They don’t feel that they need to do anything differently,” says Dr. Scott Smith, an expert on intestinal worms at Stanford’s School of Medicine.

Li Qunyan lives here with her six children. Her husband works in a city about 200 miles away and comes home a few times a year during Chinese festivals. Her only son, who is 5, is one of the kids diagnosed with worms in the REAP study. But after giving the boy a de-worming pill, she never really thought about the problem again. And she didn’t worry – or even wonder – whether her five other children had worms.

“That’s pretty typical,” said Matt Boswell, a project manager for REAP. “People have a completely different context for thinking about worms. They don’t see it as a problem, and they don’t even understand why we’re here asking them about it.”

The village doctor, who only has a middle school education and some additional health care training, says he’s sold a few dozen de-worming tablets in the past month. But he, too, is unfazed by the parasites. He hesitates a bit while thinking about what the village’s most common ailment is.

“Colds,” he finally says.

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Source: Stanford Rural Education Action Project.
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