Don't let these worm their way in

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Students are given worm medicine at a school in the central province of Ha Tinh. Photo courtesy of Ha Tinh Department of Health

Parents focus a lot on feeding their children, fretting when they think the little ones have not had enough, and rejoicing when they see a full meal taken.

However, there are other things about feeding that they need to worry about, and one of them is to check if the children are nurturing dangerous parasitic creatures like roundworms.

Doctors said the failure to do such check exposes children to the risk of infections that not only leave them skinny, but also cause severe complications when the roundworms cross the stomach to penetrate other organs like the liver, lungs or brain.

Vietnam is among the countries with highest worm infections across Asia, according to the World Health Organization, with figures in 2010 showing that 75 percent of people were infected, especially children between 2 and 12 years old.

Dang Thi Phuong Lan, deputy head of the Nutrition Faculty at Children's Hospital No.1 which is among leading pediatric facilities in Ho Chi Minh City, said many victims of the worms were brought to the hospital after they had been reduced to skin and bones, and parents having no idea why it was so.

"All the mothers say they were careful with meals and that their children ate well, but most shake their heads when asked if they ever dewormed the children.

"A common reason is that the task slipped their mind as they did not count it important," Lan said.

The hospital recently received one patient Man Nhi, a 7-year-old girl who was underweight and also shorter than normal at her age.

Her parents, busy vendors, had been giving her diarrhea medicine since she was little to treat her regular watery feces, and only decided to seek doctors' advice when she started to cough often and throw up bile.

Lan said the case was "hurtful" as parasitic worms had crawled into her lungs and bile duct, and were threatening to spread around her muscle.

The girl was transferred to the Hospital of Tropical Diseases.

Another 5-year-old girl, Hai Le, from the nearby Binh Duong Province was brought to the Children's Hospital No.2 after the area around her anus swelled from scratching, and she kept crying and grinding her teeth at night.

Her parents said the condition had lasted for some time, that the girl was too busy scratching her behind, tearing the area, and never could sleep well.  But they thought that was a normal way for a child to get attention and that this phase would pass.

It did not. Le was given medicines after being diagnosed with pinworm (threadworm) infection, in which the worms crawl out into the anus at night to lay eggs, causing night itches.

Doctor Nguyen Thi Thanh from the Children's Hospital No.2 said worm medicine must be a therapy that children receive every four to six months.

Current medicines are designed for children from two years onwards, but younger ones with signs of worm infection need to be looked at by doctors, Thanh said.

She said pinworms, hookworms and ascaris, a nematode worm the latter two living on dogs and cats cause most of the roundworm infections in Vietnam.

Ascaris, which can grow in the human brain, liver and other internal organs, is more common in urban areas due to the eating out habit, which exposes people to foods left out to dust and insects, as well as raw vegetables that may not be washed properly and thus carry worm eggs.

People in rural areas, particularly those walking barefoot, can catch hookworms that cause anemia.

Thanh said children are more vulnerable to worm infections as they can be attacked not only through food but also through crawling on the floor, playing with toys and with pets.

While intestinal infection causes digestive disorders resulting in weight loss and anemia, worms penetrating one's bile duct, muscles, liver or brain can be fatal, she said.

Thanh said worm medicine can be taken without need for diet changes, but it can cause several side effects such as stomachache, nausea, or diarrhea which will quickly subside, while allergic effects like rashes can be treated with skin solutions.

Dr. Le Thi Hai from the National Institute of Nutrition said parents can also prevent worm infections for their children by helping them build the habit of washing hands after using toilets and before meals, keeping their nails neat, their anus clean and avoid leaving their lower part naked.

Adults must also maintain their hygiene, especially while preparing meals and feeding the children, and provide the children with food that is well cleaned and cooked, Hai said.

She also said that if one member of the family is infected with pinworms, all others need to take worm medicine as well.

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