Worms in Nicaragua

Pediatric Blogs

Intestinal worms are common in Nicaragua. 

Children Without Worms (CWW), an organization dedicated to the worldwide control of worm disease, performed a survey in five Nicaragua communities in 2005, and documented a prevalence rate for worms of 49%!

Worms are soil-transmitted helminths (STH). Eggs are ingested by individuals through food that is not carefully washed or on dirty hands. Larvae penetrate the skin directly. The eggs or larvae develop into adult worms, which produce eggs. Infected individuals contaminate the soil with their feces. Eggs develop in the soil. The cycle continues. 

Once infected the child can develop abdominal pain and distension, intestinal obstruction, iron-deficiency anemia, malnutrition and poor growth, allergic reactions, and lung disease.

CWW in partnership with Johnson & Johnson and local government, targets school-aged children to receive a 500 mg dose of mebendazole and the families to be educated on hygiene.  In Nicaragua the drug is administered by the Ministry of Immunization. 

CWW advocates four key components to break the cycle of worm disease.

1. Water - access to potable water for handwashing and cleaning of foodstuffs. 
2. Sanitation - latrines to keep infected feces away from individuals.
3. Hygiene Education - personal and environmental hygiene (handwashing).
4. Deworming. 

I emailed Ms. Kim Koporc, Director of Children Without Worms. to inquire if there is a way for me to help in the clinic where I will work.  

At the very least, I will prepare my own handout on how to disinfect water and on the need to wash all fruits and vegetables prior to food preparation, and the importance of regular hand washing.  

While in Nicaragua, I will find out if the Ministry of Immunization campaign in 2010 included the clinic region where I work and how often the dosing is administered. Without intervention to prevent re-infestation, the worms will return. I will bring enough 500 mg tablets of mebendazole for every child I see and handouts in Spanish on hygiene and how to prevent re-infestation.   

I've traveled extensively in my life and I only developed a gastrointestinal problem once. While on a family vacation to snorkel in the Cayman Islands, I developed shellfish toxin poisoning after eating at a fancy restaurant, which could just as easily have happened in Calgary. I've never been ill, touch wood, with any of my trips into rougher country. I've visited Haiti once and Nicaragua three times in the last twenty months and stool tests performed on my return from each trip have been negative. I set high standards and my compulsive nature helps. I was very strict about hand washing and all the fruits and vegetables were carefully washed in a dilute bleach solution before use.  

DISCLAIMER: This blog was originally posted on Help Nicaraguan Children. Please note, Dr Robson is not accepting donations at this time. However, he would greatly appreciate your comments and suggestions in support of his efforts.