Worm Infestations in Children (Child Health Nursing).pptx

This ppt discusses about common worm infestations present in children.

1. Worm Infestation (Helminthiasis) Ms. Garima chaudhary Ph.D. scholar

2. Worm Infestation Children often complain of stomachache. One of the leading causes of stomachache 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 your child’s nutrition. There are different types of intestinal worms that can cause worm infections, but the most common are tapeworms, roundworms, pinworms or threadworms and hookworms. Worm infestations and related infections are common in children and are also easily treated.

3. Common Symptoms

4. Causative Agent Worms can be generally classified as •ROUND WORMS: pin worms, hook worms •FLAT WORMS: tape worm •FLUKES: liver fluke

5. Round Worms •Some of the most common types of Roundworms include Pinworms or Threadworms, Hookworms and Ascaris. •Roundworms have hollow bodies and openings at either end and generally grow between 2-5 inches long. •Roundworms are very commonly found in pets and animals such as dogs and cats and can be easily passed on to humans.

6. Round Worms: Etiology •Fecal contamination of water •Unsanitary conditions •Eating raw or undercooked meats or fish •Keeping animals in close unsanitary conditions •Rat or insect infestations •Malnourished or diseased persons

7. Round Worms: Etiology •Heavy mosquito or fly infestations •Playgrounds where children can eat or come in contact with soil •Raw fish and meat •Contaminated food •Contaminated water •Unhygienic life-style

8. Roundworm Infestation: Clinical Manifestations

9. Hookworm Infestation (Ancylostomiasis) : Human hookworm disease is common helminth infection caused by nematode parasites Necator Americanus and Ancylostomiasis duodenale. Hookworm infestation is acquired through skin exposure to larvae in soil contaminated by human feces. Soil become infectious about 9 days after contamination and remains so for weeks. Pathophysiology- Each day in the intestine, a mature female A duodenale worm produces about 10,000-30,000 eggs, and a mature female N americanus worm produces 5000-10,000 eggs. •After deposition onto soil and under appropriate conditions, each egg develops into an infective larva.

10. Hookworm Infestation: Clinical Manifestations •Hookworms causing lumps and streaks beneath the skin. •Ground or dew itch-An erythematous, pruritic, papulovesicular rash develops at the site of initial infection on the palms or soles and may persist for 1-2 weeks after initial infection; intense scratching may lead to a secondary bacterial infection, which is quite common. •Pulmonary symptoms-When the worms break through from the venous circulation into the pulmonary air spaces, cough, fever, and a reactive bronchoconstriction may be observed, with wheezing heard on auscultation.

11. Hookworm Infestation: Clinical Manifestations •GI symptoms- Migration of the worms into the gastrointestinal (GI) tract may cause GI discomfort secondary to irritation; as the worms mature in the jejunum, patients may experience diarrhea, vague abdominal pain, colic, flatulence, nausea, or anorexia. •Symptoms of anemia-Signs of iron-deficiency anemia are often insensitive.; patients may exhibit pallor, chlorosis(greenish-yellow skin discoloration),hypothermia, spooning nails, tachycardia, or signs of high-output cardiac failure.

12. Pinworm Infestation (Enterobiasis): Enterobiasis (also called pinworm, seatworm, threadworm infection) is a benign intestinal disease caused by nematode Enterobius Vermicularis. It is a white threadlike worm that invades the cecum and may enter the appendix. Fecal-oral contamination via hand-mouth contact or via fomites (toys, clothes) are most common methods of infestation.

13. Pinworm Infestation (Clinical Manifestations)

14. Tapeworm infestation (Taeniasis): A tapeworm is a parasite that can live and feed in human intestines. This is called a tapeworm infection. Three parasite species cause taeniasis in humans, Taenia solium , Taenia saginata and Taenia asiatica. Only T. solium causes major health problems. Humans are the definitive hosts for some species of tapeworms. They may get a tapeworm infection after eating raw or undercooked: Beef. Pork. Fish. A tapeworm in the intestines often causes mild symptoms. Moderate to severe symptoms may include stomach pain and diarrhea. Larval cysts can cause serious disease if they are in a person's brain, liver, lungs, heart or eyes.

15. Tapeworm infestation: Clinical Manifestation Upset stomach, or feeling like you could throw up. Stomachache or stomach pain. Not wanting to eat. Loose stools. Diarrhea. Weight loss. Gas. Hunger pains. Cravings for salty food.

16. Liver Fluke Infestation: Liver flukes are parasites that can infect humans and cause liver and bile duct disease. Liver flukes are parasitic worms that live in the bile ducts and the liver of infected animals. These parasites cause a disease called fascioliasis in people, cattle, and sheep. Although liver flukes can infect people in all parts of the world, they are most prevalent in developing countries. It is not possible to spread liver flukes from person to person, and some infected people may not even realize they have them. Once contracted, liver flukes may live in a person’s body for 20 to 30 years if left untreated.

17. Liver Fluke Infestation: Etiology

18. Liver Fluke Infestation: Clinical Manifestations Abdominal pain Nausea Diarrhoea Vomiting Weight loss Hives Fever Malaise

19. WHO Recommendations for Worm Infestations Preventive chemotherapy (deworming), using annual or biannual a single-dose albendazole (400 mg) or mebendazole (500 mg)b is recommended as a public health intervention for all young children 12–23 months of age, preschool children 1–4 years of age, and school-age children 5–12 years of age (in some settings up to 14 years of age) living in areas where the baseline prevalence of any soil-transmitted infection is 20% or more among children, in order to reduce the worm burden of soil-transmitted helminth infection. a Biannual administration is recommended where the baseline prevalence is more than 50%. b A half-dose of albendazole (i.e. 200 mg) is recommended for children younger than 24 months of age.

20. Nursing Management

21. Nursing Assessment •History-Patients with worm infestations are often asymptomatic. Worms may be incidentally discovered when they are seen in the perineal region; if patients are symptomatic, pruritus ani and pruritus vulvae are common presenting symptoms. Subjective Data: Patient may tell common clinical manifestations of ROUND WORMS: pin worms, hook worms FLAT WORMS: tape worm FLUKES: liver fluke •Physical exam-Worms can be found in stools or on the patient’s perineum before bathing in the morning.

22. Nursing Diagnosis •Risk for impaired skin integrity related to intense perianal scratching. •Acute pain related to smooth muscle spasm secondary to migration of parasites in the stomach. •Imbalanced Nutrition: less than body requirements related to anorexia and vomiting. •Hyperthermia related to decrease in circulation secondary to dehydration.

23. Nursing Interventions • Diminish pain. An anti-helminthic medication should be prescribed to patients with worm infestations. •Improve hygienic status. Avoid scratching the area and nail-biting because this is a cause of autoinfection; thorough handwashing should be done before and after meals. Tell family not to shake bed linens to avoid aerosolization of eggs that may be found on linens. • Diminish increase in temperature. Administer antipyretics as prescribed; tepid sponge baths may also be given

24. Nursing Interventions •Administer medications as ordered. Drug therapy with pyrantel, mebendazole, or albendazole to destroy the causative parasites. Effective eradication requires treatment of the patient’s family or members of the household. •Improve skin integrity. Application of an antipruritic ointment or albendazole may help control scratching; keeping the patient’s fingernails trimmed to prevent excoriations is helpful.

25. Thank you.