Objective
To test the impact of anthelmintic treatment on the extent of change in the prevalence and intensity of intestinal parasite as well as nutritional status of female workers in different time and dose schedules.

Methodology
Study design – Single blind placebo control trial.
Study population – Female workers of all ages in Ayesha Abed Foundation (AAF).
Study area – Three centers were selected from Manikganj Sadar, Gorpara and Betila area in Manikganj district.
Intervention period – 24 weeks.
Drug – Albendazol 400 mg.
Sample size - A total 668 female workers were randomly allocated into 5 groups and finally it was 620 after dropping out.
The groups were as follows:
Group 1 (n=127) = Single dose at baseline, single dose after 12 weeks, single dose after 24 weeks;
Group 2 (n=121) = Double dose at baseline, double dose after 12 weeks, double dose after 24 weeks;
Group 3 (n=124) = Single dose at baseline, single dose after 24 weeks;
Group 4 (n=125) = Double dose at baseline, double dose after 24 weeks; and
Group 5 (n=123) = Placebo at baseline, placebo after 24 weeks.

Measurements:
Hemoglobin (Hb) was measured by HemoCue machine in the study area directly, body weight by Uniscale with precision of nearest 100 g and height was taken in cm using a wooden board fixed with a plastic tape to the nearest 1 cm. Intestinal parasite infestation was estimated by stool examination on high power field. In addition, information on socioeconomic and demographic profiles, health status, hygiene- knowledge and practice, and morbidity history were collected.

Results:
Nearly half (47%) of the workers of the Foundation were aged 20-35 years and 31% were adolescents (10-19 years). About 80% women were married. The mean family size was 5. Thirtyseven percent of the workers were illiterate. Only 7% were SSC (Educational status) or above. Nearly 70% had no self-perceptio n regarding financial deficit during the last year and 62% were more solvent compared to the other village women. The source of drinking water of 77% workers was tube-well while only 53% used it for cooking purpose and 78% of them used it for hand washing and bathing. Nearly 80% of workers used safe latrine (sanitary or pit). There were no significant group differences in any of the above variables. Body weight was increased in all groups, ranged 0.32 kg to 0.67 kg during the intervention period. However, there was no significant difference in the increases of body weight between intervention and placebo groups. But this increase was highest in adolescent group (1.8 kg). MUAC was also increased after 24 weeks, the highest (3.5 mm - 3.8 mm) were in groups 2 and 4, who received double dose at baseline, compared to (2.6 mm – 3.0 mm) groups 1 and 3 who received a single dose at baseline and 2.7 mm in the placebo group.
Again, the differences in these increases were not statistically significant (p=0.958). The mean BMI of the study population was 19.6 kg/m2 with no significant group difference (p=0.214) at baseline. This indicates that the workers of AAF were on average nutritionally healthy to begin with. At baseline, about one- fourth of all workers had parasitic infestation. Ascaris infestation was the highest (21%), followed by hookworm (8%) and Trichuris Trichiura (1.4%). Ascaris infestation was comparable (19–28%) in all groups at baseline, which significantly decreased to 5-7% (p=0.000) after 12 weeks and further to 1-6% after 24 weeks of intervention. But in the placebo group, the infestation was still at a high level of 11% after 24 weeks. Mean Hb concentration of the workers was 125 g/L at baseline, with no group difference. After 12 weeks of treatment, Hb concentration increased significantly (p=0.000) to 134 g/L in groups 1 and 2, but at the end of intervention (at 24 weeks) Hb concentration decreased to 121 g/L, which was significantly lower even then the baseline level. The decrease in Hb concentration between baseline and 24 weeks was also observed among groups 3, 4 and placebo groups, Hb concentration decreased from 126 g/L at baseline to 122 g/L at 24 weeks (p=0.002), indicating progressive depletion of Hb in the women.
As a result of these changes in Hb concentration, anaemia prevalence (Hb < 120 g/L) decreased from 29% at baseline to 9% after 3 months in groups 1 and 2 but increased to 43% after 6 months, although worm infestation, especially Ascaris, became almost nil in these groups.

Conclusions:
It is understood from workers’ perception in this study that the economic status of the female workers of AAF is comparatively better than that of other village women. Their nutritional status is satisfactory. Worm infestation rate is relatively less in this population. Treatment with Albendazol for 12 weeks even in single dose is enough to control infestation, which can raise Hb level and reduce anaemia significantly. However, this situation was not being sustainable after 24 weeks, even after receiving a second dose (single or double) at 12 weeks. Dietary supplementation is possibly needed to sustain the effect of deworming on anaemia control.