Helminthic infestations are a major public health problem in India due to improper disposal of human waste. Common helminths include roundworm, pinworm, hookworm, tapeworm, and flukes. Roundworm is the most common, inhabiting the small intestine and releasing hundreds of thousands of eggs daily that can survive months in soil. People become infected through ingesting roundworm eggs from contaminated food, water, or soil. Symptoms range from mild to severe depending on worm load. Treatment involves antihelminthic drugs and prevention focuses on proper sanitation and hygiene.

2.  Helminthic infestation
 Major public health problem in India
 Improper disposal of human excreta

3.  Round worm (ascaris lumbricoides)
 Pin worms or thread worms ( enterbious
vermicularis)
 Hook worms (ancylostoma duodenale and
necator americanus)
 Tape worms (taenia saginata or taenia
solum)

4.  Nematodes
› Round worm
› Pinworm
› Hook worm
 Cestodes
› Tape worms
 Trematodes
› Fish worms or flukes

6. Fluke worm

7.  Trichuris trichura (Whip worm)
 Stronglyoides stercoralis
 Drancunculus medinensis (guineaworm)
 Schistoma mansoni or S.hematobium (blood
fluke)
 Trichinosis or trichinella spiralis

8.  Most common infestation
 Lives in the lumen of small intestine
› Adult round worm measures 20-40 cm (female)
and 12-30 cm male
› Each female round worm produces 240000 eggs
per day.
› The eggs are excreted in the feces they become
infective in favorable conditions

9.  On the ingestion of mature egg by the human
host (definitive host), it hatches out in the
duodenum to release larvae.
 The larvae penetrates the intestinal wall and are
carried to liver then to the lungs through blood
stream.
 In the lungs they brake through the alveolar
walls and migrate into the bronchioles, then
coughed up through the trachea and re
swallowed to reach the small intestine.

10.  Where they become mature into adult worms
in60-80 days.
 The life span of an adult round worm is
between 6 and 12 months and maximum
1.5-2 years.

11.  Man is the only reservoir of infection
 The infective material is the feces containing
fertilized eggs
 Infection rates are high in children, they are
most important disseminators of infection

12.  Soil transmitted helminth. Clay soils are
most favorable for development of eggs. Egg
remains viable in the soil for months.
 Soil pollution due to OAD is the most
important factor.
 Ineffective eggs easily reaches children who
play on the ground

13.  Mode of transmission is feco-oral route
 The period of communicability continued
until all fertile female worms are destroyed
and stool are negative of round worm eggs.
 Incubation period is about 2 months.

14.  Asymptomatic
 Depend on the wormload, location or migration of larvae
and deprivation of nutrients of the host.
 Abdominal pain
 Abdominal distension
 Nausea
 Cough
 Loss of weight
 Growth failure
 Anemia
 Vitamin deficiencies
 Bruxism and voracious appetite

15.  Associated problems
are
› Pica
› Sleeplessness
› Irritability
› Urticaria
› Fever
› Eosinophilia
› Diarrhea
 May produce
› Intestinal obstruction
› Gangrene or
perforation
› Obstructive jaundice
› Appendicitis
› Pancreatitis
› Ascaris
encephalopathy
› Liver abscess
› Peritonitis
› Kwashiorkor ( protein
loss)

16.  Migration of the larvae through the lungs
may result in ascaris penumonia (Loeffler’s
syndrome)
 Larvae in the circulation may cause
convulsions
 Retinoblastoma
 Hepatosplenomegaly

17.  History of illness and passage of snake like
worm in stool or vomiting is important
diagnostic criteria
 Clinical examination and stool examination
› Round worm eggs

18.  Antihelminthics
› Single dose Albendazole 15mg/kg or mebendazole
(100 mg) twice daily for 3 days irrespective of patients
age
› Levamisole single dose with 2.5 mg/kg or single dose
of pyrantel pavomate 10mg/kgbody weight may be
used
 Piperazin citrate is ideal drug for eradication of
round worm infestations
› It is given in dose of 100-150 mg/kg for one or two days
at night before sleep in the form of syrup or tablet or
granules.
› The drug paralyses the worms, so the child should pass
stools within 12 hours of intake of piprazin.

19.  Interrupting its transmission
 Sanitary disposal of human excreta
 Reduction of fecal contamination of soil
 Provision of safe drinking water
 Food hygiene
 Good personal hygiene
 Hand washing
 Avoid OAD
 Special attention to be taken for foods such as
salads and vegetables or raw food items to
prevent spread of infestation

20.  Avoidance of pica and playing on
contaminated soils and dusts
 Health education
 Secondary prevention: effective drug
therapy, mass treatment periodic dewarming
at intervals of 2-3 months

22.  Trichocephalus trichiuris or whipworm, is a
parasitic roundworm that causes trichuriasis
when it infects a human large intestine.
 It is commonly known as the whipworm
which refers to the shape of the worm; it
looks like a whip with wider "handles" at the
posterior end.