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4 months ago
National Deworming Day: All about deworming for kids and adults

A few weeks after 18-year-old Rohan joined the college hostel, he started experiencing severe stomach pain. At first he ignored the pain, but when he began vomiting off and on, and found himself losing more than 15 kilos over the next few months, he decided to consult a doctor. The doctor prescribed deworming pills. Soon after, he excreted a long tapeworm. However, by then his intestines were severely damaged! Worms in the body block our digestive track, rob us of nutrients and stop the digestive system from functioning. Tapeworm is not the only worm that affects our digestive system, there are several types of worms that can cause problems, including whip worms, thread worms, hook worms and round-worms.

Here’s how you can get infected

  • Walking barefoot in the garden, playground or any infected soil; for example, hookworm larvae burrow through the skin of bare feet.
  • Ingesting worm eggs through eating fruits, vegetables, grains, fish and meat contaminated with roundworm or whip worm.
  • Washing fruits and vegetables with contaminated water.
  • Transfer of the parasitic worms from pets to owner.
  • Coming in contact with the soil that has been contaminated with human faeces from an infected person.
  • Not washing hands with soap and water after defecating. Open air defecation also increases the risk of worm infestation.

Signs and symptoms of worm infestation

Signs and symptoms are more or less same for children and adults, except that children are more likely to develop abdominal symptoms, as they have smaller intestines so the risk of blockage is higher. Your doctor will prescribe deworming pills when you or your child have the symptoms such as —

  • Worms in stool
  • Abdominal pain
  • Loss of appetite
  • Fever
  • Wheezing or cough
  • Itchy bottom
  • Disturbed sleep
  • Irritability and general weakness

More severe infestations can cause —

  • Abdominal distention (swelling)
  • Severe abdominal pain
  • Diarrhoea
  • Shortness of breath
  • Weight loss (in cases of tapeworm infestation)
  • Anaemia (in cases of hookworm infestation)
  • Fatigue

Deworming for infants and children ‘A worm infestation can cause stomach pain and vomiting. It affects normal growth and can cause malnutrition in children. That is the reason doctors recommend deworming your baby every six months after he turns one’, says Dr Saroja Balan, a senior consultant neonatologist at the Indraprastha Apollo Hospital, New Delhi. ‘Deworming medication kills adult worms but not the eggs. So repeating the dose every six months is vital,’ she continues. Doctors generally prescribe a single dose of albendazole 400mg tablet once every six months for children. It works for most parasitic worms in the gut except for tapeworm. Researchers at King George Medical University, Lucknow, India, conducted a clinical trial and found that albendazole remains almost wholly inside the intestine, and the tablet does not have any significant adverse effects. [1] (Read: 4 natural remedies for intestinal worms)

Heavy worm infection can constrain physical development. Although earlier studies suggested that in areas where worm infection is common, periodic deworming of school-age children can improve weight gain. The researchers at Lucknow did not find any improvement in height and haemoglobin level with albendazole treatment. [1] Severe worm infestation may cause death in malnourished children due to diarrhoea and other complications. So, in addition to albendazole treatment, doctors may also prescribe vitamin A (retinol) capsule of 200 000 IU retinyl acetate in oil every 6 months, especially in malnourished children under 5 years and more than 6 months of age. [2]

Vitamin A is important for the regeneration of the lining of the stomach and intestine, and also helps in regulating immune function. Vitamin A supplementation has a preventive effect on all-cause and disease-specific mortality of diarrhea, measles, pneumonia, meningitis and sepsis. An added benefit of deworming is that routine administration of deworming drugs marginally improves haemoglobin concentration thereby reducing anaemia. [3] (Read: 7 signs that your child has worms)

Pyrantel pamoate is another drug that your child may be prescribed for worms such as pinworm and roundworm. Dosage is as per the weight of the child, viz. 10mg per kilo of the child’s weight. It is usually prescribed as a single dose. Side effects may include vomiting, dizziness or headache. The drug does not work for tapeworm. [4]

Praziquantel and niclosamide are the two drugs that are prescribed for tapeworm infestation. It is again a one-time dosage that is calculated as per the weight of the child, or age of the child. For example, a one-time dose of niclosamide 500mg is given to children under 2 years of age, 1000mg for children aged 2 to 6 years, and 2000mg for children above 6 years of age.  [4] (Read: Intestinal worms — know the symptoms)

The World Health Organization recommends periodic deworming of all children living in endemic areas once a year when the prevalence of soil-transmitted parasitic worms in the community is over 20 percent, and twice a year when it is over 50 percent. [5] They also suggest health and hygiene education in schools to reduce transmission and reinfection by encouraging healthy behaviours, and also to ensure adequate sanitation.

Deworming in adults Deworming drugs for adults are the same as those for children. It’s just the dosage that is different. For example, the most common drug your doctor will give you is albendazole 400mg tablet. The treatment course is two tablets altogether over a period of two weeks, that is, one tablet once a week. Consult your doctor before using deworming drugs [6] if you —

  • Have liver problems
  • Are pregnant or nursing your baby
  • Are taking other prescription or non-prescription medicines, including supplements

Alternative remedies for worm infestation Homeopathy: Examples of homeopathy remedies are given below. [7]

  1. Teucrium: Remedy for pinworm and roundworm, and to treat an itchy bottom.
  2. Ignatia: It is prescribed when the child has a tickly sensation near the anus.
  3. Sabadilla: Is prescribed to people with symptoms of vomiting, nausea, and colic.
  4. Indigo: Is prescribed for treating threadworm and roundworm. Symptoms include intense pain around the navel area and convulsions.
  5. Cuprum oxydatum nigrum: It treats all kinds of worms, including tapeworm.

Ayurveda: The following herbs are useful as deworming agents. [8]

  1. Ajwain (carom seeds): Ajwain seeds taken with jaggery dissolved in cold water early in the morning expels worms during defaecation.
  2. Bael (Bengal quince, wood apple): The fruit kills the worm within the body which is then expelled with stools.
  3. Palasha (flame of the forest): Effective in treating roundworms. Take the seeds with buttermilk twice daily.
  4. Tulsi (sweet basil): Seeds of tulsi in water or even chewing the leaves on an empty stomach is an effective remedy for all parasitic worms, including tapeworm.

Photo source: Shutterstock

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