PEDIATRIC NURSING

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.