Shaken Baby Syndrome

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Amniotic fluid problems

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Choosing a pre-school

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Newborn reflexes

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Pelvic floor exercises

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Antenatal Classes

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  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52


Parasitic worms can live happily in the human body and affect millions of people worldwide. They range in size from that which can be seen with the naked eye to microscopic. For example, tapeworms measure between 3-30 feet long. Worms not only inhibit the digestive tract, but may be present in the bloodstream, muscle tissue, brain, heart and other organs. The ineffective removal of waste products from the body due to constipation provides a perfect living environment for worms in the bowel (, 2005).


Parasites enter the body in a number of ways, namely through food, water, mosquito bites, or through the nose and skin. The eggs of the pinworm in particular, can enter the mouth via the fingers, clothing or bed linen. Parasitic worms can be divided into 3 types: Trematoda, Cestoda, and Nematoda. Nematoda include roundworm, pinworm, heart worm, hookworm, whipworm, etc (, 2005).





The most common parasitic intestinal worm in temperate countries is the pinworm, also known as the thread worm or butt worm. These parasites get their name from their long pin-shaped posteriors and their resemblance to tiny white pieces of thread. The adult male pinworm is 1-4 mm in length and the lengthier female is 8-13 mm. Pinworms that infest humans have the clinical name Enterobius vermicularis. These worms are the most common childhood parasite, resulting in a mild but highly annoying infection. Preschool and school-going children are particularly vulnerable to pinworms, especially those who suck objects or eat food contaminated by worms’ eggs. These tiny parasites are the least harmful of parasitic worms, and constitute more of a nuisance than a serious health problem (, 2010; Collins, 2003; Leary, 1990).



In order to understand how these worms behave in your child’s body, it is important to understand the life cycle of the pinworm.

·         Pinworms reside in large numbers and mate in the lower bowel.

·                The pregnant female pinworm travels down the intestines at night and emerges through the rectum to deposit tiny eggs around the anus.

·                The female pinworm is able to produce as many as 10 000 eggs in her lifetime.

·                All this activity around the perianal area results in intense itching, causing the child to scratch the egg-infested area around their anus and buttocks.

·                The eggs are then picked up by the fingers and may become lodged beneath the fingernails.

·                Anything the child touches thereafter, such as bedding, clothes or toys, may spread the eggs.

·                If other children or family members accidentally ingest these eggs, they will also become infected.

·                The swallowed eggs hatch in the intestines, mature, mate and lay new eggs, thus repeating the full life cycle of the pinworm.

·                Adult females are able to survive for up to 3 months in their human hosts.

·                Their eggs are only able to survive for 1-2 days in a warm, dry environment, but can live for up to 2 weeks in cool, humid conditions (Collins, 2003; Leary, 1990; WebMD, 2010).



Approximately ⅔ of children who are infected with pinworm experience no symptoms. If symptoms do occur, they usually present themselves 1-3 days after the parasite has entered your child’s body and are generally worse at night.

·                The primary symptom of pinworm is an intense itching sensation around the anus and rectum.

·                Girls may experience an itchy vulva.

·                As a result your child may have difficulty getting a good night’s sleep.

·                Irritability and restlessness.

·                Possibly the inflammation of the anus due to constant scratching.

·                If the scratching is severe and the skin is broken, a secondary bacterial infection may develop.

·                Sometimes tiny white worms may be seen wriggling in the faeces.

·                Pinworms DO NOT cause abdominal pain, fever, poor appetite or bloody bowel movements. These symptoms are indicative of a more serious medical condition and require immediate medical attention.

·                Pinworms have been found during operations to remove inflamed appendices; however, it is controversial as to whether or not the pinworm was responsible for the infection (, 2010; Collins, 2003; NetMD, 2010).


How to detect a pinworm infection

If your child is showing symptoms of pinworm, one of the effective ways to make a diagnosis is the ‘tape test’. This test should be performed in the morning before your child uses the bathroom or takes a bath. Press or pat a piece of clear sticky tape on the skin around your child’s anus. The tape can then be taken to your doctor for examination under a microscope to check for the presence of pinworms or their eggs (, 2010; Collins, 2003).



·                The treatment for pinworms is safe and simple.

·                Your child will be given 5 ml of mebendazole (Vermox) syrup or 100 mg mebendazole tablets, morning and evening for 3 consecutive days.

·                Treatment of the whole family is advisable, to prevent reinfection.

·                Because eggs are able to survive for a few weeks, treatment may be repeated after 2 weeks to minimise the chance of recurrence (Collins, 2003; Leary, 1990; WebMD, 2010).



·                If  your child presents with symptoms, get him medical treatment as early as possible.

·                It is essential that the entire family receives treatment in order to prevent any recurrence of the infection.

·                Good hygiene is key in preventing pinworm infections. Ensure that your house and outdoor areas are clean. Educate your children about the importance of keeping their hands clean, especially after using the toilet and before and after eating, and encourage them not to touch their mouths frequently.

·                Thoroughly wash all bedding, clothes and toys in order to destroy any lingering eggs.

·                Wash the underwear and pyjamas of infected persons daily for 2 weeks (, 2010; WebMD, 2010).





The clinical name for the roundworm is Ascaris lumbricoides. Roundworms are reddish-brown in colour, approximately 6 inches in length and have rounded bodies with pointed ends. These parasites primarily infest the intestines of children and animals, but can also affect other organs.  Roundworms occur most frequently in moist, warm, tropical environments. Roundworms in children should be taken seriously because if left untreated, they can cause serious health ailments (, 2010; Leary, 1990).



·                In humans, roundworms are primarily contracted through contaminated food and polluted water.

·                They may also make their way into food and drinking water from contaminated soil and infected pets.

·                The adult female roundworm which resides in the intestines can lay more than 25               million eggs during her lifetime.

·                Some of these eggs may be retained in the infested site, while the majority are expelled from the body in the faeces.

·                In warm soil and under favourable conditions, the eggs are able to survive for up to 7 years (, 2010).



Children have a much higher risk than adults of being infected with roundworms because they play  outdoors in the grass and soil, and often ingest food without washing their hands. Symptoms may include:

·         Fever.

·         Tiredness.

·         Urticaria.

·         Abdominal pain.

·         Nausea and vomiting.

·         Diarrhoea.

·         Nerve problems.

·                The presence of larvae in the lungs can produce symptoms such as coughing, wheezing, shortness of breath and asthma.

·                A serious roundworm infestation can cause nutritional deficiencies in children, resulting in an inability to thrive and general ill health.

·                Roundworms can result vision problems if they migrate to the eye, causing inflammation and scarring of the retina.

·                Occasionally a roundworm infestation can result in severe illness. For example, a large number of worms can cause a blockage in the intestines, the liver or pancreas may become infected, or serious allergy symptoms may develop (BBCHealth, 2010; PatientUK, 2010).



If a child is malnourished despite having a well-balanced diet, or presents with some of the above symptoms, it is highly likely that he is infected with roundworms and requires medical treatment. There are several diagnostic tools that your doctor can use, in order to make a roundworm diagnosis:

·         Obtaining information about your child’s symptoms.

·         Performing a stool analysis to check for the presence of eggs or live roundworms.

·                A roundworm infection can also be identified by swabbing the anal area and viewing the sample under the microscope.

·                The use of ultrasound imaging is effective in locating roundworms in the intestinal tract (, 2010).



The treatment for roundworm is usually simple and effective. A special prescription medication kills or paralyses the worms, which then pass out of the body with the stools (PatientUK, 2010).



In areas where roundworm is common, infection can be prevented by eating only cooked foods. Children should be discouraged from playing in areas with poor sanitary conditions or where faeces are used as fertiliser. Maintain high hygienic standards; wash hands before preparing or eating food, and after using the bathroom or changing nappies (, 2010).





Tapeworms are worm-like parasites that may affect humans after eating undercooked beef (Taenia saginata) or pork (Taenia solium), which contains cysts or ‘measles’. Two other common types of tapeworm are the dwarf tapeworm and the fish tapeworm.  Tapeworms range in size from 1 cm-30 m and have a long, flat appearance, that has been likened to a roll of stamps. Most children with a tapeworm infection show few or no symptoms. These parasites can affect people of all ages, but occur more commonly where meat is not cooked properly or processed (, 2010; MFMER, 1998-2010).




Ingestion of larvae cysts in meat or muscle tissue

·                Tapeworms grow in the muscles of animals (cows and pigs) and are consumed by humans in meat.

·                The immature form of the parasite is released into the small intestine, where it attaches Itself to the intestinal wall and grows for months or years. This may result in irritation or mild inflammation of the intestine.

·                The tapeworm reproduces by extending its length with new worm segments, known as proglottids.

·                These segments have thousands of eggs that are passed in the stool.

·                The eggs are highly infectious and can transmit the infection to other adults and children, particularly when there are poor standards of hygiene (, 2010; Leary, 1990).


Ingestion of eggs

·                Alternatively, if you eat food or drink water that has been contaminated by the faeces of a person or animal with a tapeworm infection, you are ingesting microscopic tapeworm eggs.

·                Once the eggs enter the intestine, they develop into larvae, which then become mobile.

·                The larvae may migrate from the intestines to other tissues, such as the lungs or liver, where they form cysts.

·                This is known as an invasive tapeworm infection and is most commonly the result of the pork tapeworm (MFMER, 1998-2010).



·                Tapeworm infestations are most commonly diagnosed with the passage of worm segments (proglottids) into the stool.

·                Tapeworm eggs are released into the stool by the thousand but are only visible under a microscope.

·                The microscopic evaluation of a stool sample is termed an ‘ova & parasite’ or ‘O&P’ stool test.

·                If an entire tapeworm or several proglottids are present, they resemble a roll of stamps.

·                A single worm segment looks like a flat, tan, rubbery, square piece of tissue.

·                In the case of an invasive tapeworm infection, cysts on the tissues or organs may be seen by means of a CT or MRI scan.

·                Blood tests indicating antibodies to the pork tapeworm may also be helpful in reaching a diagnosis (Drtummy, 2010; Merck & co, inc, 2009-2010).



·         Specific symptoms are seldom evident.

·                People who do have symptoms may experience, nausea, vomiting, diarrhoea, weakness, dizziness, loss of appetite and abdominal pain.

·                Young children who have a severe tapeworm infection may develop a headache, itchy bottom, or have sleeping difficulties. The presentation of these symptoms can be misleading and sometimes a misdiagnosis of pinworm infection is made.

·                In the case of an invasive tapeworm infection, cysts may form on other parts of the body, including the organs. In some cases, you may be able to see or feel the cysts. Depending on the site of these masses, potentially serious or life-threatening symptoms may ensue, including seizures or neurological impairments.

·                The fish tapeworm can cause anaemia, because it absorbs vitamin B which is essential for red blood cell maturation.

·                Contrary to popular belief, you cannot feel the tapeworm inside your body (, 2005;, 2010;




Medications for intestinal tapeworms

·                Some tapeworm infections never require treatment because they exit the body on their own.

·                Several effective prescription drugs are available for the treatment of tapeworm infections, depending on the species of tapeworm involved and the site of the infection.  The most commonly used are oral medications that are toxic to the adult tapeworm, such as praziquantel or albendazole, as well as the antimicrobial drug nitazoxanide.

·                Since these medications attack the adult tapeworm and not the eggs, caution must be taken against reinfection. Always wash your hands after using the toilet and before preparing or eating food.

·                Your doctor may check your child’s stool sample 1-3 months after he has completed the course of medication.

·                The success rate for people who receive appropriate treatment is high and it should render your child’s stools free of tapeworm eggs, larvae and proglottids (; MFMER, 1998-2010).


Treatments for invasive tapeworms

Treatment varies according to the location and effects of the infection.

·                Medication may be used to shrink tapeworm cysts. Your doctor may periodically order imaging studies, such as ultrasound or X-ray, to check the drugs’ effectiveness.

·                Anti-inflammatories may assist in reducing any swelling or inflammation in the tissues or organs.

·                Anti-epileptic medications may form part of the treatment regime, if the disease is causing seizures.

·                An invasive infection may cause hydrocephalus, where too much fluid accumulates around the brain. A permanent shunt or tube may need to be placed in the skull in order to remove the excess fluid.

·                Sometimes cysts may require surgical removal, depending on the site and the symptoms they produce. Cysts on the liver, lungs or eyes are generally removed because they can eventually affect organ functioning (MFMER, 1998-2010).



·                Maintain healthy hygiene.

·                Only give your child meat and pork obtained from a reputable abattoir, to ensure that all carcasses have been carefully inspected for cysts.

·                Ensure that all meat and fish are thoroughly cooked.

·                Prolonged freezing can also kill cysts.

·                Freshwater fish can be eaten if it is cured in brine.

·                Smoking and drying do not kill cysts.

·                The adequate treatment of human waste disrupts the life cycle of the tapeworm and assists in the prevention of infections (Merck & co., inc., 2009-2010).





Whip-worm intestinal infections are caused by the roundworm Trichuris trichiura and they may affect people worldwide, particularly those living in tropical, warm areas and/or where there are primitive sanitary conditions. Infection may also occur due to the consumption of shaded, moist soil, or from the ingestion of food that has been faecally contaminated. Children are especially vulnerable to infection due to their high risk of exposure, e.g. playing outdoors in the soil or putting food in their mouths without washing their hands. Whip-worm eggs are infectious 2-3 weeks after they have been deposited in favourable conditions, namely warm, moist soil (Health Grades Inc., 2010; Wikipedia, 2010).



·                Eggs are deposited from human faeces to soil, where they embryonate and become infective after 2-3 weeks.

·                The infective larvae are ingested and hatch in the small intestine before migrating to the large intestine, where they embed their heads in the intestinal lining and feed on tissue secretions.

·                Each larva grows into an adult worm, with the larger female reaching a length of 35-50 mm compared to the smaller male which measures 30-45 mm in length.

·                The females have a bluntly rounded posterior end, while the males have a more coiled posterior appearance.

·                The life cycle of Trichuris trichiura, from the time of ingesting the eggs to the development of mature worms, takes 3 months on average.

·                The female worm begins to lay eggs after 3 months of maturity and can produce 2000-10 000 single-celled eggs per day. 

·                Worms are able to survive for up to 5 years, during which time the amount of eggs the female is able to lay increases to 20 000.

·                These eggs are passed either in the stools or through vomiting, which may be the first sign that your child has a whip-worm infection (Leary, 1990; Merck & co., inc, 2009-2010; Wikipedia, 2010).



·                A diagnosis of trichuriasis can be made if your doctor finds under the microscope the typical barrel-shaped eggs of the whip-worm in a stool sample obtained from your child.

·                In the case of a rectal prolapse, a diagnosis can be made by means of a defecating proctogram, which is a means of imaging the parasitic infection  (Merck & co., inc, 2009-2010).



·                In mild cases, your child may be asymptomatic.

·                Symptoms of intestinal infestation may include intermittent abdominal pain, diarrhoea and blood stained stools.

·                Long-term blood loss, may result in anaemia, an iron deficiency.

·                Vitamin A deficiencies may also occur due to the infection.

·                In extreme cases, some of the rectal lining may prolapse through the anus (Health Grade Inc., 2010; Leary, 1990; Wikipedia, 2010).



·                Prescription anti-parasitic drugs such as mebendazole or albendazole may be offered in order to eradicate the worms.

·                In some cases, iron may be added to the bloodstream to help solve the iron deficiency (Leary, 1990; Wikipedia, 2010).



·                Prevention is reliant on adequate sanitation and good personal hygiene, particularly sanitary toilet facilities and the thorough washing of hands after using the toilet. Hands should always be washed before preparing or eating food, and unwashed fruits or vegetables should be avoided.

·                Infection can also be avoided through the proper disposal of human faeces, not eating dirt, and avoiding crops fertilised with night soil (Merck & co., inc, 2009-2010; Wikipedia, 2010).