Deworming in Children and it’s Importance

Deworming Day

National Deworming Day is celebrated all over in India on 10th of February, every year. Deworming day is a day dedicated to deworm all the school going children (1 to 19 years) of the country to give them a healthy digestive system.

Indian go vernment (Ministry of Health and Family Welfare) launched the National Deworming Day (NDD) in February 2015 as part of the National Health Mission.

Why Deworming is Required? 

Soil-transmitted helminth infections are among the most common infections worldwide in areas where sanitation is poor. The main worm infections are roundworm (Ascaris lumbricoides), the whipworm (Trichuris trichiura) and hookworms (Necator americanus and Ancylostoma duodenale).  According to WHO, more than 1.5 billion people, or 24% of the world’s population, are infected with soil-transmitted helminth infections worldwide. India has the greatest number of children with soil-transmitted helminths infections in the world – more than 220 million which accounts for over one quarter of the world’s infected children.

How can one get Infection?

– Adult worms in the intestine of infected person produce thousands of Eggs each day which are passed in the faeces. In areas with inadequate sanitation, these eggs contaminate the soil.

– These eggs can infect other human being  which can happen in several ways:

  • Eggs can get attach to vegetables. Ingestion of vegetables can infect healthy person.
  • Eggs can contaminated water sources.
  • Eggs are ingested by children who play in the contaminated soil and then put their hands in their mouths without washing them.
  • Hookworm eggs hatch in the soil, releasing larvae that mature into a form that can actively penetrate the skin. People become infected with hookworm primarily by walking barefoot on the contaminated soil.

Effects of Worm Infestations

Intestinal worms produce a wide array of symptoms. Severity of symptoms depend upon the quality of worms, the greater the number of worms in the infected person, the greater will be the severity of disease. Symptoms of worms infection:

– Intestinal manifestations (diarrhoea, abdominal pain,causing intestinal bleeding, loss of appetite, and reducing absorption of micronutrients.

– General malaise ,weakness, impaired growth and physical development.

– Hookworms can cause chronic intestinal blood loss which leads to a loss of iron and protein resulting in anemia. Round worms may compete with Vitamin A.

-Worsening school performance, lack of concentration

– Causing complications that require surgical intervention (i.e. intestinal obstruction and rectal prolapse).

Who Requirs Deworming? 

People at Risk are:

  • preschool children
  • school-age children
  • women of childbearing age (including pregnant women in the second and third trimesters and breastfeeding women)
  • adults in certain high-risk occupations such as tea-pickers or miners.

-WHO recommends preventive chemotherapy (deworming), using annual or biannual single-dose albendazole (400 mg) or mebendazole (500 mg) as a public health intervention  to all at-risk people living in endemic areas without previous individual diagnosis

– Dose is to be given to all young children 12-23 months of age, preschool children 1–4 years of age, and school-age children 5-12 years of age (in some settings up to 14 years of age)

– all non-pregnant adolescent girls and women of reproductive age

– Pregnant women

How Deworming is Done? 

– Deworming should be done in areas where the baseline prevalence of any soil-transmitted infection is 20% or more among children,

– Twice a year deworming dose is recommended where the baseline prevalence is over 50%.

  Dose of Albendazole (i.e. 200 mg) should be reduced to half for children younger than 24 months of age.

– Single dose albendazole (400 mg) or mebendazole (500 mg), is recommended as a public health intervention for pregnant women, after the first trimester, living in areas where both:

(i) the baseline prevalence of hookworm and/or T. trichiura infection is 20% or more among pregnant women,

(ii) where anaemia is a severe public health problem, with a prevalence of 40% or higher among pregnant women , in order to reduce the worm burden of hookworm and T. trichiura infection.

Prevention is Always better than Cure

– Periodical deworming to eliminate infecting worms

– Health education to prevent re-infection

– Improved sanitation and hygiene to reduce soil contamination with infective eggs.

– Wash fruits and vegetables properly.

– Maintain personal hygiene- wash hands properly, keep nails short, use of toilets, wearing shoes or slipper

-Always drink clean water and safe food.

– Never keep food uncovered.

 

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