The World Health Organization (WHO) has grouped Helminthiasis along with 16 other diseases under the category of Neglected Tropical Diseases. WHO estimates show that India has 241 million children (aged 1 to14 years) who are at a risk of parasitic intestinal worm infection, further implying that 68% of Indian children are at a risk of developing Helminthiasis, a macro parasitic worm infection caused by a group of worms called helminths. While worldwide, nematodes and roundworms cause most infections, in countries like India, Ascaris, hookworm, Trichuris, and Strongyloides contribute most to infections.

Diagnosis

Diagnosing helminthiasis can be quite challenging as physical examinations alone do not provide confirmation. The infection usually requires a stool or sputum test to detect the presence of helminth eggs. Test samples can be further investigated to find out the causative organism.

The WHO-recommended Kato-Katz technique is the best and the most reliable tool for diagnosing helminthiasis especially in places with poor resources and setting due to its higher efficacy, accuracy, and predictive value. However, this technique is not widely used. The Kato Katz technique involves placing small pieces of cellophane onto a stool sample to visualize the eggs. These cellophane tapes are later soaked in methylene blue glycerol solution one night before use. This helps in better visualization of the eggs and facilitates in long-term storage of the slides.

Treatment

Anthelminthic (deworming) medications, such as Albendazole and Mebendazole could be used to treat Helminthiasis as they are inexpensive, effective, and can be easily administered by non-medical personnel. Dose is determined based on age. Generally, the prescribed dose for Albendazole is 200 mg for toddlers (12 to 24 months) and 400 mg for kids above 2 years of age. For Mebendazole, the dose is 500 mg for all kids above 12 months. Both the drugs fall under pregnancy category C.

Prevention

WHO’s strategy aims to reduce the morbidity through periodically treating people at substantial risk in endemic areas. People who are at high risk include pre-school children, school-age children, women (includes childbearing age, pregnant women in the second and third trimesters and breastfeeding women) and adults in certain high-risk occupations like tea-pickers or miners.

Management

According to WHO, a basic way to manage the disease and reduce reinfections is to provide periodic treatment involving anthelminthic medications to everyone in endemic areas. The preventive treatment should be divided as per the prevalence of helminthiasis, once in a year if prevalence is more than 20% and twice a year if prevalence exceeds 50 %. This way the worm burden can be considerably reduced.

Additional steps for preventing transmission and reinfection of Helminthiasis include instructing people on the following:

• Limiting or avoiding contact with contaminated soil
• Basic day-to-day hygiene practices like washing hands before handling food and washing vegetables and fruits before cooking or eating
• Rightly disposing human waste
• Avoiding outdoor defecation