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1. By – SURESH KUMAR ( Nursing Tutor )
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2. Worm Infestation
• One of the leading causes of stomach ache in children is
intestinal infection which is mostly caused by
intestinal parasites such as worms. Worms tend to live in the
intestine and feed off the child’s nutrition. There are
different types of intestinal worms that can cause worm
infections, but the most common are roundworms,
tapeworms, pinworms or threadworms and hookworms

3. Roundworm
• Roundworm infestation is also known
as ascariasis . It is caused by a worm
known as ascaris lumbricoids. These
worms are parasites that use human
body as a host to mature from larvae
or eggs to adult worms. Adult worms,
which reproduce, can be more than a
foot (30 centimeters) long.

4. How it spreads
• An individual become infected with ascariasis after
accidentally ingesting the eggs of the ascariasis
lumbricoides roundworm. The eggs can be found in soil
contaminated by human feces or uncooked food
contaminated by soil that contains roundworm eggs. Children
often become infected when they put their hands in their
mouths after playing in contaminated soil.

5. How it Grows
• Swallowed eggs first hatch in the
intestine.
• The larvae then move through the
bloodstream to your lungs.
• After maturing, the roundworms leave
the lungs and travel to the throat.

6. How it Grows
• The individual cough up or swallow the roundworms from
the throat. The worms that are swallowed will travel back to
the intestine.
• Once they’re back in the small intestine, the worms will
mature, and lay more eggs.
• The cycle continues. Some eggs are excreted through the
feces. Other eggs hatch and return to the lungs.

7. Sign and symptoms
People with ascariasis often have no symptoms. Symptoms are
noticeable only when the number of roundworm increases.
Roundworms in the lungs can cause:
-Coughing -shortness of breath
-aspiration pneumonia -blood in mucus
-chest discomfort -fever

8. Sign and symptoms
Roundworms in the intestines can cause:
-Nausea -Vomiting -Weight loss
-Irregular stools or diarrhea -Visible worms in the stool
-Loss of appetite -Abdominal discomfort or pain
-Intestinal obstruction causes severe pain and vomiting
-Growth impairment in children due to malabsorption

9. Diagnostic investigations-
• Stool examination
• X-ray
• CT scan
• Ultrasound
• MRI scan
• Endoscopy

10. Treatment-
• Roundworm infestation can be treated with
antiparasitic drugs. Medications most commonly used
include:
• Albendazole , Ivermectin , Mebendazole
• In severe case when the roundworms are completely
blocking the intestines, patient may need surgery .

11. Tapeworm
• Tapeworms are flat, segmented worms
which look like a tape measure. Mainly two
types of tapeworms infest human beings
. Theses are taenia solium and taenia
saginata. Although tapeworms in humans
usually cause few symptoms and are easily
treated, they can sometimes cause serious,
life-threatening problems. .

12. How it spreads
• Eating undercooked meat from infected animals is the
main cause of tapeworm infection in people. Humans
can also become infected if there is contact with
animal feces or eating contaminated food or drinking
contaminated water. People can pass tapeworm eggs
to others when they don't wash their hands after using
the same bathroom.

13. How it Grows
• In animals the swallowed eggs first hatch in the
intestine. invade the intestinal wall, and migrate to the
striated muscles, where they develop into cysticercus. A
cysticercus can survive for several years in the animal.
Humans become infected by ingesting raw or
undercooked infected meat.

14. How it Grows
• In the human intestine, the cysticercus develops over 2
months into an adult tapeworm, which can survive for years.
The adult tapeworms attach to the small intestine by their
scolex and reside in the small intestine . Length of adult
worms is usually 5 m or less for T. saginata and 2 to 7 m
for T. solium. The adults produce proglottids which mature,
become gravid, detach from the tapeworm, and migrate to
the anus or are passed in the stool

15. Sign and symptoms
• Sometimes tapeworms cause symptoms such as:
• Nausea -Weakness
• Diarrhea -Abdominal pain
• Fatigue -Weight loss
• Increased Hunger or loss of appetite

16. Diagnostic investigations-
• Stool examination
• X-ray
• CT scan
• Ultrasound
• MRI scan
• Endoscopy

17. Treatment-
• Tapeworm infestation can be treated with antiparasitic
drugs. Medications most commonly used include:
• Niclosamide, Mepacarmine
• In severe case when the tapeworms reach to the brain
tissue, patient may need surgery .

18. Pinworm or
Threadworm
• Pinworms are tiny, narrow worms.
They're white in color and less than a
half-inch long. Enterobius vermicularis is
widely known as the human pinworm
due to the female’s long, pointed tail.
They're the most common type of
human worm infestation

19. How it spreads
• Accidentally swallowing or breathing in pinworm eggs
causes a pinworm infection. The tiny (microscopic)
eggs can be carried to the mouth by contaminated
food, drink or the fingers. Once swallowed, the eggs
hatch in the intestines and mature into adult worms
within a few weeks.

20. How it Grows
• Gravid adult female Enterobius vermicularis deposit eggs on
perianal folds. Infection occurs via self-inoculation
(transferring eggs to the mouth with hands that have
scratched the perianal area) or through exposure to eggs in the
environment (e.g. contaminated surfaces, clothes, bed linens,
etc.). Following ingestion of infective eggs, the larvae hatch in
the small intestine .

21. How it Grows
The time interval from ingestion of
infective eggs to oviposition by the adult
females is about one month. Gravid females
migrate nocturnally outside the anus and
oviposit while crawling on the skin of the
perianal area. The larvae contained inside
the eggs develop (the eggs become infective)
in 4 to 6 hours under optimal conditions .

22. Sign and symptoms
• Symptoms of pinworm infection may include:
• Itching of the anal or vaginal area
• Insomnia, irritability, teeth grinding and restlessness
• Occasional stomach pain and nausea
• Pinworms often cause no symptoms.

23. Diagnostic investigations-
• A tape test is the most reliable method for
diagnosing a pinworm infection. This test
consists of taking a piece of cellophane tape
and pressing the sticky, adhesive side against
the skin around the anus. This tape is placed
on a slide and examine it under a microscope
to see if it contains pinworm eggs.

24. Treatment-
• The most common and effective medications to treat
pinworm infection are:
• Mebendazole , Albendazole , Pyrantel pamoate
• One course of medication usually involves an initial dose,
followed by a second dose two to three weeks later. More
than one course may be necessary to fully eliminate the
pinworm eggs

25. Hookworm
• Hookworm disease in humans is
caused by Ancylostoma duodenale, A.
ceylanicum, and Necator americanus.
Hookworms affect the lungs, skin,
and small intestine. Humans contract
hookworms through hookworm larvae
found in dirt contaminated by feces.

26. How it spreads
• The Child can become infected with hookworms by coming
into contact with soil that contains their larvae. The larvae
enter the skin, travel through bloodstream, and enter the
lungs. They are carried to your small intestine when you
cough them out of the lung and swallow. Fully grown, they
can live in your small intestine for a year or more before
passing through your feces.

27. How it Grows
• Eggs are passed in the stool, and under favorable conditions (moisture,
warmth, shade), larvae hatch in 1 to 2 days and become free-living in
contaminated soil. Filariform (third-stage) larvae of hookworm are
infective . These infective larvae can survive 3 to 4 weeks in favorable
environmental conditions. On contact with the human host, typically
bare feet, the larvae penetrate the skin and are carried through the
blood vessels to the heart and then to the lungs.

28. How it Grows
• They penetrate into the pulmonary alveoli,
ascend the bronchial tree to the pharynx, and are
swallowed . The larvae reach the jejunum of
the small intestine, where they reside and mature
into adults. Adult worms live in the lumen of the
small intestine, typically the distal jejunum, where
they attach to the intestinal wall with resultant
blood loss by the host

29. Sign and symptoms
• Colic, or cramping and excessive crying in infants
• Nausea -Fever
• Blood in stool -Loss of appetite
• Itchy rash -Loss of Weight

30. Diagnostic investigations-
•Physical Examination
•Stool examination
•Blood examination (CBC)

31. Treatment-
•The most common and effective medications to
treat hookworm infection are:
•Mebendazole , Albendazole , Pyrantel pamoate
•For severe anamemia Iron supplementation may
also be given

32. Prevention of
worm infestation-
1. Keep children’s fingernails short and clean to keep dirt
containing worm eggs from getting lodged under their nails.
2. Stop pets from giving worms to the family by putting them on a
parasite control programme from veterinary doctor.
3. Wash hands before preparing, distributing and eating food.
4. Wash all fruit, salads and vegetables before use.
5. Rinse all meats before preparing them for cooking.

33. Prevention of
worm infestation-
6. Make sure children wash their hands with soap and clean water
after using the toilet.
7. Do not drink water that may be dirty.
8. Wear shoes to stop worms entering through the feet.
9. Use of sanitary latrines by all.
10. Deworming your child also effectively reduces the overall
spread of worm infestations in the community.

34. By – SURESH KUMAR ( Nursing Tutor )