Parenting – Deworm Your Family

Infection by intestinal worms is widespread in South Africa – and beyond the yuck factor, can cause serious problems, from malnutrition to anaemia, retardation, even death. Yet they’re easy to prevent

An alarming 40-90% of school children in South Africa are estimated to be infected with parasitic worms, according to the Medical Research Council and Department of Basic Education. So big is the problem that in 2015, Minister Angie Motshekga rolled out a National School Deworming Programme linked to the National School Nutrition Programme. But while this helps ensure children in poorer primary schools that qualify for the nutrition programme are regularly dewormed (provided parents sign consent forms), it still leaves other children vulnerable. Could yours be among them?

WHO’S AT RISK?

Children living in disadvantaged, crowded communities without running water and sewage, such as informal settlements, are the most at risk, but anyone can get worms, at any age, however well-heeled and hygiene aware they may be. Worms are spread through contaminated soil, water, air, pet fur (and licking), raw meat, unwashed fruit and vegetables, toilet seats and door handles. They can be breathed in, ingested from unwashed hands, or enter through the skin if you walk barefoot on contaminated soil. And while there can be signs that you have them, depending on the type of worm and the intensity of the infestation (see SPOT THE SIGNS), some people show no signs at all.

WHAT’S THE DANGER?

Unchecked, intestinal worms can lead to complications from weight-loss and anaemia (caused by internal bleeding) to intestinal obstruction, liver congestion, even lung and brain infections. And in informal areas, particularly, worms have been cited as the main reason young children are admitted to hospitals for abdominal emergencies in South Africa. But the problem goes beyond that. According to health authorities, worms in children can stunt their growth and intellectual development, and have been linked to attention deficit and learning problems, affecting their education and disadvantaging them for life.

WHICH WORMS ARE WORST?

Intestinal worms are parasites living off the food in your gut or your blood. In South Africa, the main culprits are soil-transmitted worms such as roundworms, whipworms and hookworms, but there are many others, none pleasant, and all

worth keeping at bay by regular deworming. Just reading about them should convince you that this is a smart thing to do!

Roundworms: The most common worms found in children’s guts, these are pink and smooth like pale, plump earthworms, and can grow about 25 cm long. They can obstruct the intestines, causing painful, persistent cramps. And they can lay thousands of eggs a night, which pass out of the body in the host’s faeces. Eggs leak toxins that cause itchiness, especially around the anus. Sometimes you can see the worms when you go to the loo – or even blow your nose! This is because as they multiply, they leave your body to find a new host, and do so through any orifice, including your nose and mouth. “It’s been documented, but is not commonly seen,” says Umhlanga GP Dr Megan Broughton. Other possible symptoms of roundworms include jaundice, as they pass via the liver to reach the lungs, and pancreatitis,” says Cape Town GP Dr Neville Wellington.

Whipworms: These are thin and about 4 cm long, and attach themselves to the membrane lining the digestive tract, especially the large bowel. They cause inflammation, bleeding and intestinal blockages, and bring cramping and nausea. With heavy infestation they cause bloody diarrhoea, and if left, anaemia, and occasionally rectal prolapse, where part of the last part of the bowel protrudes from your behind.

Pinworms (threadworms): These small, thin worms, 2-13 cm long, are common where children play together. Once unwittingly ingested (if kids don’t wash hands), the adult females pass out of the anus at night and lay eggs, causing itchiness and bottom-scratching. In scratching, eggs can get under kids’ fingernails and be spread, or reinfect the child if they put their fingers in their mouths. The scratched skin areas can get infected. Worse, worms can enter a girl’s vulva and cause irritation and discharge. The eggs can also release toxins that get into the blood stream, and when carried to the brain, interfere with normal brain functioning, causing mood swings, anxiety, tooth-grinding, even seizures. “Toxins carried to muscles and joints can cause inflammation and pain,” Dr Wellington adds.

Hookworms: These tiny worms, just 1-2 cm long, usually enter the body through the skin as lavae and cause itching, swelling and redness in that area, mostly on hands or feet. Once they enter the intestine, they release toxins that disrupt your digestive system and cause nausea, cramps and diarrhea. They feed directly on the host’s blood, so watch for signs of this in stools (tell-tale red or black), and for symptoms of anaemia (paleness, fatique, shortness of breath, chest pain and headache).

Tapeworms: Perhaps the nastiest intestinal worms of all, these are flat and segmented and can grow up to 15 m long. What’s more, they can live up to 30 years in a host, until you find them one day in the toilet bowl or your underwear. Because they feed on blood, they cause iron deficiency and anaemia, and when they obstruct the intestines, pain, nausea, vomiting and diarrhea. But often they cause no symptoms, and the only sign may be seeing segments of the worm moving in a bowel movement. You get tapeworms mainly from eating undercooked meat, especially pork, beef and fish. And because the eggs are passed with bowel movements, if someone with a tapeworm doesn’t wash their hands well after using the loo, then prepares food, this can spread the problem. Pork tapeworm larvae can sometimes enter the bloodstream and move to other parts of the body, damaging the liver, eyes, heart, brain and spinal cord, and becoming lifethreatening. “They’re a major source of adult-onset seizures,” Dr Wellington says.

WHATYOUCANDO

Not all is doom and gloom. Wormstop’s single dose tablet and suspension offers the most affordable treatment in its category. Wormstop is effective against up to nine different common worm types and offers easy dosing options for children from age two and above. It kills the worms in the digestive system, but not the eggs, which is why a repeat is advised every six months. Ask your pharmacist or doctor about the best dose for their size and weight. If over-the-counter deworming medication doesn’t solve the problem in your family, your healthcare provider can prescribe a broader spectrum solution.

Prevention is obviously the best approach. Start by having a good hand-washing routine in your family after using the bathroom or playing outside or with pets. But even with good hygiene, it’s possible to get infected by something as simple as touching an infected surface. That’s why it’s important to deworm everyone in your household from the age of one or two, including any carers and your pets, once or twice a year.