{
  "abstract": "Background Children 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.Methods We 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.Results Children 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.Conclusion While 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.",
  "authors": [
    {
      "affiliations": [
        "School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China",
        "International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK"
      ],
      "name": "Shanquan Chen"
    },
    {
      "affiliations": [
        "The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences and Center for Public Health, Christian Medical College Vellore, Vellore, India"
      ],
      "name": "Rohan Michael Ramesh"
    },
    {
      "affiliations": [
        "The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences and Center for Public Health, Christian Medical College Vellore, Vellore, India"
      ],
      "name": "Kumudha Aruldas"
    },
    {
      "affiliations": [
        "The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences and Center for Public Health, Christian Medical College Vellore, Vellore, India"
      ],
      "name": "Saravanakumar Puthupalayam Kaliappan"
    },
    {
      "affiliations": [
        "Department of Physical Medicine and Rehabilitation, Christian Medical College, Tamil Nadu, India"
      ],
      "name": "Bobeena Rachel Chandy"
    },
    {
      "affiliations": [
        "Department of Developmental Paediatrics and Center for Public Health, Christian Medical College, Tamil Nadu, India"
      ],
      "name": "Beena Koshy"
    },
    {
      "affiliations": [
        "Department of Ophthalmology, Christian Medical College, Tamil Nadu, India"
      ],
      "name": "Smitha Jasper"
    },
    {
      "affiliations": [
        "London School of Hygiene and Tropical Medicine Faculty of Infectious and Tropical Diseases, London, UK"
      ],
      "name": "Katherine E Halliday"
    },
    {
      "affiliations": [
        "Departments of International Health, Medicine and Pediatrics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"
      ],
      "name": "Judd L Walson"
    },
    {
      "affiliations": [
        "RTI International, Research Triangle Park, North Carolina, USA"
      ],
      "name": "William Oswald"
    },
    {
      "affiliations": [
        "The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences and Center for Public Health, Christian Medical College Vellore, Vellore, India"
      ],
      "name": "Sitara Swarna Rao Ajjampur"
    },
    {
      "affiliations": [
        "International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK"
      ],
      "name": "Hannah Kuper"
    }
  ],
  "title": "Disparities in deworming coverage between children with and without disabilities: insights from the DeWorm3 trial in India",
  "uid": "f0fbda22-374f-5246-ab11-205bac593913"
}