New Vision (Kampala)

29 November 2012

Uganda: When Did You Last Deworm?

You may have experienced itchiness around the rectal area and wondered why, but before you rush to the doctor, have you thought about the last time you dewormed?

According to the World Health Organisation, nearly two billion people worldwide are infected with intestinal worms or water-borne worms called schistosomes. Most of these cases are found in low-income countries where access to clean water and a functional sanitation system are limited.

Dr. Mukasa Kasozi, a health consultant, says worms live in the intestines, usually in small numbers and may stay there without causing much harm. However, when the worms reproduce, they block the intestines, causing intestinal obstruction.

The worms can also leave the intestines and get into the lymphatic system, or their eggs may get carried somewhere else in the body through the bloodstream.

Causes:

Dr. Elizabeth Kiboneka, the head of the Mwanamugimu Nutrition Unit at Mulago Hospital, says the prime cause of worm infection is poor sanitation and consumption of contaminated food and water.

Types of worms:

There are several types, some microscopic and others large enough to be visible to the naked eye. Worms that affect humans include:

Tapeworms:

These worms are flattened like a tape measure and mainly result from eating half-cooked meat such as pork, beef and fish. Usually one may not be aware he is hosting the worms, but symptoms may include tiredness, abdominal pain, weight loss and diarrhoea.

Pinworms:

These commonly occur in children and are spread by close, crowded living conditions. They are transmitted through contaminated hands, surfaces or bedding and swallowing airborne eggs.

The worms usually come out at night to lay eggs and deposit them around the anal opening in the skin folds. Many people with pinworms have no symptoms, however, itching around the anus at night is common as well as Irritability, loss of appetite and abdominal pain.

Hookworms:

These are caused by coming into contact with soil or water where the worms reside. This parasite lives in the intestines, where it feeds on blood. Hookworms can cause severe anaemia and diarrhoea.

Roundworms:

These are caused by coming into contact with infected soil, food or stool. Children are more susceptible because they tend to stick their fingers in the mouths without washing them first. Roundworm eggs can find their way from the intestines to other organs, causing damage.

Liver flukes:

These make their home in the body where they attack the liver and make holes. They are transmitted by eating contaminated foods.

Worms can affect any one, though children are more prone because they tend to eat anything they come across. One should deworm at least once every six months.

Common symptoms

Kiboneka says because worms usually infect the digestive system first, causing problems such as loss of appetite, stomach ache, abdominal discomfort, bloating, diarrhoea, bloody stool, vomiting, constipation and gas accumulation.

A rash, insomnia, eye pain, protein deficiency, nausea, mental dullness, coughing, fever, nervousness, anaemia, cold chills, weakness and fatigue are the other signs of worm infestation.

Kiboneka adds that when worms increase in the body, they weaken one's immunity, as the antibodies constantly try to fend them off.

Cancer patients need to keep the lymphatic system clear by deworming at least every after three months because they are prone to infections and the worms can go to the lungs and heart, weakening them.

Dr. Mukasa Kasozi, a health consultant and a physician, says if one has a lot of worms in the body, some may be visible in the stool.

Treatment

Worms have a life cycle, so they have to be killed at every stage. For instance if you kill the adults, but not the eggs, the eggs hatch and the cycle will continue. If you kill the eggs, but not the worms, they will lay more eggs, thus the vicious cycle.

He recommends albendazole and mebendazole because they decrease the worm's ability to absorb sugar, resulting in their death.

Depending on the physician's prescription, worms can also be eliminated through colon cleansers, antibiotics as well as herbal remedies.

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