It’s a worm day in December

The cool weather may be contributory to the sniffles that one may get during this season. However, did you know that asthma-like symptoms could also indicate worm infestation? Apart from the common manifestations like abdominal discomfort, diarrhea, constipation, and weight loss, an allergic reaction to toxins that the parasites produce can cause asthma, eye pain, insomnia, and skin rashes. And thus, if your child has mysterious asthma-like symptoms without abnormal results in the usual laboratory exams, or if the sudden and unexplained onset of symptoms baffles you, you might consider the possibility of asking your physician for tests to count out worms.

The idea of worm infection is unappetizing particularly in this holiday season of food and feasting. However, previous studies show that seven out of 10 children, or a total of approximately 4.6 million school children, aged seven months to six years old, suffer from diseases associated with intestinal helminthiasis. The chance that your child has parasites is substantial and you need to eliminate the possibility of infection. Even in private schools, studies indicate that one of three children is infected.

Food handlers who pass on the parasites to unsuspecting diners can compound the problem. In 2006, a study showed that six out of 10 food handlers were infected. This resulted to additional guidelines implemented by the Department of Health in issuing health permits to food handlers. It was a positive move towards reducing the occurrence of helminth infection.

The most recent program being undertaken to lower the incidence of intestinal parasitism has been dubbed WoW-V or War on Worms in the Visayas. The advocacy involves a donation of Antiox Choco (Mebendazole) doses by Johnson and Johnson that will benefit 262,000 school children from Antique, Aklan, and Capiz. The project, to run for two years, is part of the company’s goal to donate 50 million doses of Mebendazole to benefit more than 25 million children worldwide. Mebendazole is an affordable, one-dose treatment proven effective in preventing and eradicating a broad spectrum of worm infections. Since studies have shown that 73 percent of public school children in the Western Visayas provinces are affected, the elimination of intestinal parasites should have a positive effect on school performance.

“It is well established that chronic worm infection leads to malnutrition, poor school performance, and learning impairment,” says Dr. Jun Belizario, deputy director of the National Institutes of Health-UP Manila. He cites the results of studies involving schoolchildren showing that there is a higher infection rate in lower-performing sections as compared to honor sections. “The crucial thing is in the administration and delivery of doses. Worm control without drugs is like going to war without bullets,” explains Dr. Belizario. A school-based worm control program is seen as an effective means of ensuring that the correct dosages are given at the right intervals. The World Health Organization recommends that anti-helminth tablets be administered two times a year.

In the Visayas, the aim is to reduce the cumulative prevalence of soil-transferred helminth (STH) infections to less than 50 percent after a period of two years. The initiative also seeks to reduce the prevalence of heavy-intensity STH infections to near 0 percent and lower malnutrition rate by 10 percent. Ingesting the larvae of the worms as they play in schoolyards is a mode of infection. Likewise, hookworm larvae can easily penetrate skin, usually the soles of the feet, as the children play barefoot. Success rates in the fight against helminthiasis in Western Visayas appear promising since efforts are boosted by the support of the local government.

“We are fighting health wars on many fronts (but) we can push further to control and eliminate intestinal parasitism,” said Secretary of Health Dr. Francisco Duque at the regional launch of WoW-V in Pandan, Antique. He cited the importance of partnering with local governments to be able to achieve tangible and lasting success. “The efforts would also have to be stepped up. Just giving the antihelminthic is a stopgap measure. (Local governments) need to address issues of sanitation, proper food handling, and personal hygiene. It is important for communities to band together to ensure that there is proper sanitation, potable water, and advocacy for personal and social hygiene,” he explained.

In addition, if all parents do their share by instilling good personal hygiene and providing uncontaminated food and water to their children; by maintaining a clean environment at home, they can effectively reduce the risk of cross-infection in the schools. The textbooks say that ascaris, the common roundworm, can reach a length of 16 inches and adult parasites can leave the small intestine to enter other organs, such as the bile duct and appendix. Ascaris and other helminths may migrate to the trachea and lungs to cause suffocation. They are capable of boring through the intestinal wall and, by carrying harmful bacteria to the site, cause serious complications. And thus, awareness is important to avoid serious complications for something as common in this country as helminthiasis.

Antiox is a one-dose treatment that is effective in preventing and eradicating helminth infections for four to six months. It is available in 10 ml chocolate-flavored suspension or 500 mg chewable tablet containing 500 mg of broad-spectrum Mebendazole.