Worm infections, also known as helminthiasis, occur when parasitic worms live inside the human body and absorb nutrients meant for the host. These worms can often be seen with the naked eye and commonly affect children and adults living in areas with poor sanitation.
The most common intestinal worms include:
- Roundworms – Ascaris lumbricoides
- Whipworms – Trichuris trichiura
- Hookworms – Necator americanus
Worm infections spread easily when infected people defecate in open areas. The eggs in their stool contaminate soil, water or food. When others ingest contaminated food or come in contact with contaminated soil, infection occurs. These worms steal nutrients, leading to weakness, malnutrition, intestinal inflammation and sometimes bowel obstruction.
Prevention is possible through proper sanitation, regular deworming and good health education.
Signs and Symptoms
Worm infections may present with a wide range of symptoms depending on worm load and type.
- Diarrhea
- Fever
- Abdominal pain
- Fatigue and weakness
- Enlarged liver or spleen
- Cough due to larval migration
- Eosinophilia
- Malabsorption
- Constipation or bowel obstruction
- Vomiting
- Distended abdomen
- Itching (especially around anal region in pinworm infection)
Worm larvae may enter the body through:
- Insect bites
- Walking barefoot on contaminated soil
- Contaminated water
- Eating raw or unwashed vegetables
- Undercooked meat or fish
- Direct human or animal contact
Pharmacotherapy
Anthelmintics are drugs used to eliminate worms. These medicines act either locally in the intestine or systemically in tissues where worms migrate.
1. Mebendazole
Mebendazole is a benzimidazole derivative and one of the most widely used anthelmintics.
Mechanism of Action:
- Prevents microtubule formation in worms
- Blocks glucose uptake
- Depletes glycogen stores
- Results in gradual death of the worm
It is effective against:
- Pinworm
- Whipworm
- Hookworm
- Roundworm
Killing of intestinal worms continues for up to three days after administration.
Side Effects:
- Diarrhea
- Abdominal pain
- Neutropenia
- Thrombocytopenia
2. Albendazole
Albendazole is another benzimidazole drug with broad-spectrum activity.
Uses:
- Highly effective against pork tapeworm
- Effective against dog tapeworm
- Drug of choice for neurocysticercosis (larval infection affecting brain tissue)
Side Effects:
- Liver toxicity
- Leukopenia
- Thrombocytopenia
3. Quinacrine
Quinacrine is an older anthelmintic with specific uses.
Uses:
- Giardiasis
- Beef tapeworm
- Pork tapeworm
Its use today is limited due to availability of safer alternatives.
General Treatment Principles
- Identify the type of worm based on symptoms or stool examination
- Provide deworming therapy—single dose or short course depending on drug
- Repeat dosing if reinfection is suspected
- Treat all family members in case of pinworm infection
- Provide nutritional support to correct deficiencies
Prevention
Preventive steps are crucial because helminth infections spread easily in the community.
- Avoid open defecation
- Use clean toilets
- Wash hands before eating and after using the restroom
- Wash fruits and vegetables thoroughly
- Drink clean, safe water
- Cook meat and fish properly
- Wear footwear when walking outside
- Maintain good personal hygiene
- Conduct regular deworming in children as per public health guidelines
When to Refer
Referral is important when:
- Severe abdominal pain or obstruction symptoms occur
- Worms are passed frequently despite treatment
- Signs of anemia or malnutrition are present
- Neurological symptoms suggest neurocysticercosis
Detailed Notes:
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