What is deworming? Worms have been and still continue to be part and parcel of everyone’s childhood. There are very few children who have been lucky enough to not have them in their system, but there are loads of children out there whose health is impaired because of the presence of worms in their intestines. We spoke to Dr Foo Chee Hoe, a paediatrician associated with Docktorbudak and here is what he has as advice.
GetDoc: Hello Doctor. We would like to start off with the basic question - What are worms? How do they enter a child’s system?
Dr Hoe: Worms are parasites that can thrive in the intestines of a human. Types of worms include hookworm, pinworm and threadworms. These worms lay eggs which will then be excreted together with the infected human faeces. In an area with poor sanitation, these eggs will contaminate the soil which may then be accidentally ingested by a child who plays outdoors.
When children are outdoors, they may get their hands dirty with egg infested soil and when they eat without washing their hands, these eggs enter into the system which will then hatch into worms.
They may also eat the eggs via soil-contaminated unwashed vegetables, or via contaminated water.
GetDoc: What are the symptoms of presence of worms in the child’s body/system?
Dr Hoe: You may be surprised but the infected child may not have any symptoms until it becomes very severe in which case the symptoms maybe abdominal pain, diarrhoea, lethargy and poor performance in studies (cognitive impairment). The child may also have poor appetite.
GetDoc: What is deworming? How important is deworming?
Dr Hoe: Deworming is done using a medicine to eliminate the worms from the system. An example of a common anti-worm medicine is Albendazole.
WHO strongly recommends deworming especially in areas with poor sanitation. This is especially important in third world and developing countries which are endemic areas.
GetDoc: How often must deworming be done?
Dr Hoe: Once or twice a year. Depending on the incidence of rate of worm infection in the area. The areas with more than 50% of prevalence rate should be given twice a year.
GetDoc: Is deworming applicable only for children up to a particular age or should it be continued till adulthood?
Dr Hoe: It is not exactly just for children, but children are one of the most susceptible groups of people to get worm infection and their growth and development will be significantly affected. Anyone in an area of poor sanitation with high possibility of the soil being contaminated with worm eggs should be dewormed too. This is especially true for people who come into direct contact with soil such as those who work in farms, tea pickers, and miners. Women of childbearing age and pregnant women should also be treated.
GetDoc: A friend told me her son has the habit of eating up non-edible things. Is this Pica? Is the presence of worms one of the symptoms of this disorder?
Dr Hoe: Yes, Pica is a disorder in which the child would eat non-edible materials such as soil, paint flakes, crayons, paper, etc. They seem to have an appetite for such things. As a child with Pica may tend to put soil in their mouths, they will have a higher chance to have eaten worm eggs from the soil.
Pica is mainly recognised as a mental disorder with triggers from stressors but it is also linked to mineral deficiencies such as iron deficiency which can be caused by hookworm infection. So, Pica can cause worm infection and worm infection can cause pica too, if you see it this way. So yes, a child with Pica should be investigated for worms and iron deficiency, amongst other things.
GetDoc: How does presence of worms in a child’s body affect their growth and development?
Dr Hoe: Worms are parasites. They feed on the nutrients that are meant for the child and also cause the nutrients to be poorly absorbed. They also feed on the blood and protein of the child, causing anaemia and poor growth. Therefore, the presence of worms will deprive the child of adequate nutrients. Poor appetite and lethargy will also affect their growth and development.
GetDoc: How do parents ensure that their child is not affected by these worms? Any preventive measures?
Dr Hoe: Deworming is a preventive measure; don’t wait till your child has the symptoms before deciding to deworm your child especially if you live in an endemic area. Do it regularly like once or twice a year. Ensure good hygiene, avoid playing with soil, walking barefoot on soil, wash all vegetables thoroughly before cooking, good hand hygiene especially before meals.
GetDoc: Can anyone deworm their child by themselves with OTC medication? Or should I consult my paediatrician?
Dr Hoe: Yes, you can buy deworming medicine over the counter. However, for very young children it is advisable to consult your doctor. If you have doubts at all or feel that you may have other concerns about your child’s growth and possibility of infected by worms, then you should consult your doctor.
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by Hridya Anand
A biochemist by education who could never put what she studied to good use, finally found GetDoc as a medium to do what she loved - bring information to people using a forum that is dedicated to all things medical. View all articles by Hridya Anand.