Is deworming still necessary in the current world?

When we were younger, we used to be dewormed regularly but these days I don’t see that being done. Is it still being done and is it necessary in our current world? 
Concerned father

Dear concerned father,

Worms (or helminths) are the most common infectious organisms in the developing world. The majority of these infections are from soil transmitted helminths (STH), also known as intestinal worms, affecting about 24 per cent of the world population, mainly in sub-saharan Africa, East Asia, China and the Americas.  They are transmitted when eggs present in faeces are deposited in soil in areas with poor sanitation. Transmission can happen through:

• Children playing on contaminated soil put their hands in the mouth without washing their hands
• Eggs are attached to vegetables, which are eaten without being washed, peeled and/or cooked properly
• Eggs contaminating water sources
• Hookworm eggs hatch in the soil, producing larvae that can penetrate the soles of someone walking barefoot

Some worms are ingested from improperly cooked meat, and some penetrate the skin or membranes from infected water sources. Worm infection can cause abdominal pain, diarrhoea, itching, anaemia, malnutrition, weakness and impaired growth and development. If the worms are many, they can cause intestinal obstruction that requires surgical intervention. Because of the large number affected people  and the possible severe impact on nutrition, growth and development especially for children, there have been campaigns since 2001 to occasionally treat people in high burden areas regardless of whether someone has symptoms or not. Currently, the focus is on children, pregnant and breastfeeding women, and adults in high risk occupations like miners and tea pickers. In addition to the treatment, there is need for education on hygienic behaviours and provision of good sanitation.

Dear Doc

Leprosy has paralysed me and but I feel better now. How do I convince my relatives that I am well? I have been hit by the stigma and it affects my mental health

Dear reader,

Leprosy is a treatable infectious disease caused by the bacterium Mycobacterium leprae. These bacteria multiply very slowly, causing symptoms after an average of five years since infection. Symptoms may occur after within a year or may take up to 20 years to occur.

The illness affects the nerves, the skin, the eyes and the mucus membrane lining the nose. The symptoms depend on how severe the disease is and duration since the symptoms began, though in mild disease, the symptoms may regress naturally. It can cause skin lesions that are pale or reddish and do not have sensation, skin sores, lumps or swellings, hair loss, nasal congestion or nose bleeds, eye irritation, loss of feeling in the arms or legs, muscle weakness and disfigurement.

The disease is thought to be transmitted through droplets from coughing or sneezing, and spread happens after long-term close contact with an infected person. It does not spread by shaking hands, sitting next to, or hugging someone. It does not spread through sexual contact, or from a pregnant mother to an unborn baby.

It can be treated using a three-drug combination taken for six or 12 months, depending on the type of disease. The treatment is provided free of charge from the World Health Organization. The infection is completely cured with treatment, but any severe damage to the skin, nerves or disfigurement may not go back to normal. 

The BCG vaccine given to babies in Kenya offers some protection against leprosy. In addition, anyone who comes into contact with someone with leprosy can be given single dose rifampicin to prevent the disease.

Unfortunately, there is a lot of stigma for those with the disease or who have had it in the past. There are also a lot of myths surrounding the disease.

For your relatives, the best thing you can do is offer them proper information and refer them to sources of accurate information. For your mental health, it would be advisable to seek psychological support from a mental health professional and join a support group for those who have faced similar challenges.

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