factors. Worm infestation is an important cause of anaemia and growth retardation in children. Worms produce toxins and injure the bowels. Some parasites may even migrate to other tissues and obstruct lymph vessels. There are a number of worms which can cause infection. All worm infestations must be treated. In this chapter worm infestations more common in India, the drugs used for their treatment, along with their dosage, adverse effects, and precautions have been included.

Roundworm

Ascaris lumbricoides (roundworm) is a common worm infestation. Roundworm disease spreads through handling of contaminated food or soil. In villages and in areas with poor sanitation, children defecate in the open. In dry climate, the eggs of the Ascaris get airborne and are ingested through the mouth. The eggs complete their life cycle partly in the lung and partly in the gut, and get lodged in the gut as adult worms. The disease is prevalent in areas where vegetables are grown on soil fertilized by human excreta. Adult worms may cause no symptoms in light infestation, but severe infestation may lead to abdominal pain, skin rashes, bronchopheumonia, and even cause obstruction of the intestines. The diagnosis is usually made when ova are found in the stool during a routine examination, or when an adult worm is vomited or passed out in the stools. The adult worm is cylindrical

in shape, brown or pinkish brown in color,15 to 50 cm in length and 3 to 5 mm in diameter.

Preventive Measures

Children should be trained to use toilets rather than defecating in the fields. They should not play in dirt and filthy areas.

Good sanitation must be observed. The Indian habit of washing hands before eating is extremely useful. This practice should be observed religiously.

Wash fruits and vegetables, if possible with potassium permanganate, before eating.

Drugs: Mebendazole, albendazole or pyrentel is the first choice. Piperazine or levamisole can also be used.