Brandon Butera, 26, says he gave up on restaurant food two years ago. He used to suffer stomach upset, occasional diarrhea, and body weakness, and always tested positive for parasitic worms after eating from the restaurant.

According to medics, up to two-thirds of children are at risk of getting intestinal parasitic worms. The most common include roundworms, hookworms and whipworms.

The highest prevalence occurs where there is inadequate sanitation, low levels of education and lack of access to healthcare.

Pascal Kasereka, a medical practitioner at Kabaya Hospital in Ngororero District, Western Province, says children under the age of five are the most susceptible, with ascariasis and amoeba the most common abdominal worms.

"The high prevalence is attributed to poor hygiene. Some people have not mustered the use of boiling drinking water despite sensitisation,” Kasereka says.

Infestations can impair physical growth, brain development and are major causes of nutrient deficiencies such as iron deficiency anaemia. Hookworm induced iron deficiency anaemia has been associated with decreased physical activity, worker productivity and adverse pregnancy outcomes in adults.

Roundworms, hookworms and whipworms have all been associated with impaired development, poor school performance and absenteeism in school-age children.

"Infestation is associated with malnutrition through appetite suppression, increased nutrient loss and decreased nutrient absorption and utilization,” says Dr Cory Couillard, who works in collaboration with the World Health Organisation’s Goals of Disease Prevention and Control, and a regular columnist with The New Times newspaper.

Roundworms get their nutrition from the contents of one’s digestive tract. They have been associated with impaired fat digestion, temporary lactose intolerance and reduced vitamin absorption, especially vitamin A.

Dietary vitamin A, in the form of beta-carotene, is a strong antioxidant that helps the body fight off infection and sustains the strength of one’s immune system.

"Infected people excrete the eggs of the worms in their faeces, which then contaminate the soil. Walking barefoot, trying to grow food and allowing children to play in contaminated areas are important mechanisms of infestation,” Dr Couillard says.

Signs and symptoms

Some of the symptoms include,  diarrhoea, abdominal pain, weakness and generally not feeling well. Hookworms cause chronic intestinal blood loss that result in anaemia. The most common symptoms of anaemia include fatigue and loss of energy, shortness of breath, headache and dizziness.

People with iron deficiency anaemia can also experience symptoms of soreness of the mouth and experience cracks at the corners, an upward curvature of the fingernails and a strange hunger for substances such as paper, ice or dirt. Eating contaminated dirt can cause further infestation.

Dealing with it

The control of intestinal worms is often based on anthelminthic drug treatment, improved sanitation and health education. The medicine kills and facilitates the expulsion of worms from the body. Benzimidazoles (albendazole and mebendazole) are the most common deworming drugs used to treat infestations in children.

"Research has shown that deworming during pregnancy (after the first trimester) and iron supplementation significantly reduces maternal anaemia, increases the weight of the newborn and reduces infant mortality rates,” says Alfred Gatabarwa, a general    practitioner with Abbey Family Clinic, Remera.

He adds that practicing good hygiene habits is imperative to the prevention of intestinal worms. Eating a healthy diet with fresh fruits and vegetables as well as drinking purified water will naturally boost the strength of one’s immune system and prevent intestinal worms.