Worm infections are among the most common diseases affecting children from low- and middle-income countries. Soil-transmitted Helminths infects nearly 2 billion of the world’s population and India alone contributes 25% of the total global cases. Major worm infections of public health importance include Ascariasis (roundworms), Trichuriasis (pinworms) and Hookworm which are transmitted through contaminated soil.
Most helminthic infections are mild and often asymptomatic. Common symptoms are abdominal pain, weakness, diarrhoea, loss of appetite, weight loss, vomiting. Itching around anus and vagina, inability to sleep, urinating in bed is seen in pinworm infection. But it is studied that both the symptomatic and asymptomatic group has anaemia, malnutrition with deficiencies of vitamins, minerals (iron), fats, and protein leading to significant morbidity. It results in malnutrition, growth faltering and suboptimal academic performance among children.
WHO recommends preventive chemotherapy (deworming) as a public health intervention for soil-transmitted helminths in children periodically in an endemic region. There are efficacious and broad-spectrum anthelmintics to treat worm infestation. The management includes individualized worm infection treatment, community management (mass drug administration) as well as preventive measures. Albendazole and Mebendazole and Ivermectin are the most commonly prescribed medicine for worms. Other medicines that may be prescribed for the various types of worm infections treatments for children include Levamisole, Niclosamide, Pyrantel pamoate, Praziquantel and Diethylcarbamazine. In mass drug administration (MDA) albendazole or mebendazole is given as a single dose [ children of 2 years and upwards -1 tablet Albendazole (400 mg) or 1 tablet Mebendazole (500 mg) and for children of age 1 – 2 years - ½ tablet of Albendazole (400 mg) or 1 tablet of Mebendazole (500 mg)]. The treatment is given periodically every 6 months. There are National Deworming days which target all children between 1-19 years (both boys and girls). Individualised treatment is also given empirically or after screening with stool examination for ova and cyst of worms. Besides this maintaining personal hygiene and good sanitation practices go a long way in controlling worm infection. Anthelmintics are well-tolerated among children and there are very mild and occasional side effects of deworming like dizziness, nausea, headache, and vomiting which settle in some time.
Deworming has a huge impact on the health, education and livelihoods of treated children. It decreases anaemia and improves nutrition thereby causing a positive impact on growth, cognition and mental and physical development. Thus, deworming for kids indirectly supports school attendance and children’s ability to learn better. Deworming adolescent girls and women of childbearing age and also a pregnant woman after the first trimester improves their anaemia. Deworming benefits other members of the community who do not receive treatment benefit, as there are fewer worms in the environment and this is especially important for children who are too young to be treated but for whom worms can seriously impair cognitive development. Consult worm infection specialists in Delhi immediately if you see any related symptoms.
Consultant, Department of Paediatrics
Manipal Hospital Delhi
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