Growing up, I used to look forward to that day in primary school, when we lined up in a long winding single file to get deworming tablets from visiting health workers. I remember the pink circular deworming tablet had a lingering sugary taste.
Many years later as an adult, I still deworm only that now, I have to take initiative; walk to a pharmacy and buy the medicine myself.
“When did you last deworm?”, was a question I paused to a few friends. Most of them could not remember when they last dewormed.
Dr Badru Matovu of Kibuli Hospital says deworming is important because it prevents worms from colonising or taking over the gastro-intestinal system or the alimentary canal. Dr Matovu says most adults don’t deworm because they do not know how important it is.
“People lack adequate knowledge about deworming because worm infestation is not like other condoitions. They may not spend money on deworming tablets because they don’t see any physical problem or manifestation,” he says.
Dr Matovu says some of the common types of worms include tiny worms called thread worms and long worm called tape worms which come from eating uncooked meat and they are as long as quarter a metre.
“Worms thrive in both small and large intestines, and while there, they suck blood and nutrients rendering a child malnourished and an adult anemic,” he adds.
At times they can cause allergic reactions causing the host to develop chronic cough and skin rash.
Uganda Clinical Guidelines from the Ministry of Health explain that intestinal worms enter the human body through ingestion of the worm eggs in food or water using dirty hands or through injured skin when walking barefoot. Examples of such infestation include round worms which attack small intestines.
Soil and animals such as cows, pigs, goats, cats and sheep can also be worm carriers.
People who play with dogs may get worms from them just like people who eat poorly cooked meat.
The clinical guidelines also indicate that worms cause a few symptoms such as a persistent dry irritating cough and a patient may pass out live worms through the anus. Heavy infestations may cause nutritional deficiencies and worms may also cause obstruction of the bowel, bile duct, pancreatic duct, or the appendix.
“Thread worms mainly affect children and can cause anal itching. Hook worms cause chronic parasitic infestation of the intestines. Worms are largely transmitted through penetration of the skin by larvae from the soil.Hook worms if left untreated can cause dermatitis characterised by a reddish itchy skin; inflammation of the trachea and iron deficiency anemia,” the clinical guidelines state in part.
Other intestinal symptoms according include: Reduced blood proteins in heavy infestations, abdominal pain, diarrhea, and weight loss while lung symptoms due to larvae in the lungs lead to cough and wheezing. Most of the symptoms occur when immunity against auto-infection fails.
Tape worms are intestinal infestations mainly caused by ingestion or eating of food or drinking water contaminated by eggs. The eggs hatch in the intestine, the embryos invade the intestinal walls and disseminate in the brain, muscles and other organs of the body.
Prevention and treatment
“A deworming dose removes all the eggs and worms from the body and stops worm infestation,” Dr Matovu says.
He adds that children should be dewormed from as early as six months after birth.
“At six months, most children have been weaned and can be dewormed. Chances are high that weaned children may come into contact with worms especially if food has been poorly prepared,” Matovu stresses.
Deworming should be between every three and six months because that is the time researchers have found that provides enough time for worms to create a new colony in the gastrointestinal system.
“The drug used in deworming pregnant women is different from that given to non- pregnant women. This is because, some drugs could affect the unborn baby,” Dr Matovu says.
Common drugs prescribed for deworming and Mebendazole and Albendazole.
“The drugs are best taken before eating food because worms have adaptive measures which help them to survive. For instance, worms have attachment devices, producing mucus, so if there’s food, they provide protection to them. But when you take medicine on an empty stomach, then they are exposed,” Matovu explains.
Home treatment for worms
A natural remedy that shows promise is pumpkin seeds, which have been found to be high in amino acids, fatty acids, and the compounds berberine, cucurbitine, and palatine.
Research on the use of pumpkin seeds for intestinal parasites includes a preliminary study published in the International Journal of Molecular Sciences in 2016, in which pumpkin seed extracts were found to have some anti-parasitic activity. .
For a pilot study published in the Journal of Medicinal Food in 2007, 60 children with intestinal parasites received immediate doses of either an elixir containing a mixture of papaya seeds and honey or honey alone. After seven days, a significantly greater number of those given the papaya-seed-based elixir had their stools.