Do you usually check out the places your children play from? Do you monitor the hygiene of their nails, hair, other parts of the body, clothing and beddings? If not, you should start doing so because health experts advise that ensuring proper hygiene is the best way to prevent pinworms (threadworms) in kids. Pinworms are small, thin, pin-shaped worms that sometimes live in the human colon and rectum which leave the intestines through the anus and deposit their eggs on the surrounding skin.

According to Dr Raymond Awazi, a pediatrician at Hôpital La Croix du Sud in Kigali, pinworms are a common intestinal infection caused by enterobius vermicularis, which is a white small worm about 1cm long.

Causes

"A child can pick up pinworms by touching an object or cloth that has pinworm eggs, and then putting their fingers in the mouth,” says Dr Edgar Kalimba, a pediatrician at King Faisal Hospital in Kigali.

He further says the child can pick pinworm eggs by eating food contaminated by someone with pinworms.

Awazi explains that eggs of pinworms are commonly spread by the hands, and are normally under nails.

Kalimba explains that the cycle starts when eggs travel to a child’s large intestine where they hatch; after hatching the female pinworms travel to the child’s intestines to lay their eggs around their anus.

"As the worms move, they cause intense itching that can interrupt sleep. When the child scratches their itchy anus, the eggs get under the fingernails and another cycle starts when they put their hands or fingers in the mouth,” he says.

Signs and Symptoms

Kalimba says the infection is often asymptomatic (without symptoms) but the patient can present with itching around the anus, especially at night, or experience irritation of the skin around the anus, and sometimes vulvar itching in girls.

According to online health portal BabyCenter, pinworms occasionally cause nausea and vomiting irritability, stomach pain, diarrhea and sleep disturbance.

Kalimba adds that kids with pinworms usually have abdominal pain, diarrhoea with mucus or blood, especially those with many worms.

He says pinworms are most common in school-age children and those in pre-school.

Diagnosis

Awazi says stool analysis needs to be done when someone is suspected to have pinworms. (A stool analysis is a series of tests done on a stool sample to help analyse certain conditions affecting the digestive tract).These conditions can include infection like those from parasites, viruses or bacteria.

"You can take a tape test especially at night when the child is sleeping. This test consists of taking a piece of cellophane tape and pressing the sticky side around the anus of the child, since the pinworms depart from the anus, the tape can be taken to the doctor to test in the microscope if it contains pinworm eggs,” he says.

BabyCenter also says one can use a flashlight to check for worms on the child’s buttocks at night or first thing in the morning since worms appear and deposit eggs on the skin mostly at night.

Treatment

Awazi recommends a dose of albendazol, mebedazole, though he says the dose must be repeated 2 weeks later in order to kill any pinworms that have hatched from the eggs since the last treatment. After treatment, worms can appear in the child’s stool, it is normal because they are getting out of the body.

Prevention

Kalimba calls upon parents to wash vegetables before cooking them, fruits to be cleaned thoroughly before they are eaten and the food to be well-cooked before being served.

"Hygiene is very essential; cut nails, avoid finger and nail biting, hand-wash frequently, avoiding anal scratching, change and wash under wears and night dresses daily and take a birth daily,” Awazi says.

Kalimba says kids should be showered more often, especially in the morning, to get rid of the eggs that could have been laid over the night.

"Avoid finger sucking or nail biting. Toilet seats, household utensils and towels should be well-cleaned and beddings ought to be washed regularly,” Kalimba notes.

He recommends parents not to mix up kids, especially those with pinworms and those that are not infected, because they will always share edibles or playing toys which results in spreading the infection.