Tuesday, October 4, 2016
Vietnam - Don’t let worms wriggle in
Dr Cynthia Dacanay. — Photo courtesy of Family Medical Practice Hanoi
Expatriates moving to Hà Nội are often armed with basic knowledge of the city’s water, sanitation and common health problems. We are also fully aware that human parasites exist in this part of Southeast Asia.
Việt Nam is among the Asian countries with the highest rate of worm infections, according to the World Health Organization. Seventy-five percent of the Vietnamese population, including children 2 to 12 years old, was infected with worms in 2010.
Yet expats still engage in activities that make contracting parasites highly probable.
Trying a new restaurant, eating bún chả and nem cua on the street, drinking a night cap in a bia hơi, swimming in public pools, walking barefoot on the lawn, playing in a sandbox, wading in floodwater, getting licked by a pet, dipping our feet into a tub for a mát-xa (massage), planting rice during a field trip, eating undercooked meat and vegetables, drinking untreated drinking water and neglecting to wash our hands greatly increase our chances of getting hookworms, roundworms, ascaris and pinworms.
Such worms are transmitted via soil or water. For example, Ascaris, which can grow in the human brain, liver and other internal organs, is more common in urban areas. Habitual eating out in cities exposes people to foods contaminated by dust and insects, as well as to raw vegetables that may not be washed properly and which may carry worm eggs.
And while intestinal infection often causes digestive disorders resulting in weight loss and anemia, worms penetrating one’s bile duct, muscles, liver or brain can be fatal.
Meanwhile, Vietnamese parents focus a lot on feeding their children, fretting when they think the little ones have not eaten enough, rejoicing when they see a full meal taken. But most of these same parents shake their heads when asked if they ever dewormed their children.
Worm infestation in children can cause severe health problems, including anemia, vitamin A deficiency and intestinal obstruction. School performance may also be adversely affected. Studies show that regular deworming reverses malnutrition, increases school attendance and facilitates learning.
Checking to see if children are nurturing dangerous parasitic creatures, like round-worms, is a task that often slips parents’ minds. They do not think it is important.
Failing to check for parasites exposes children to risk of infections that can leave them too thin and cause severe complications, such as when roundworms cross the stomach to penetrate other organs like the liver, lungs or brain. Children are more vulnerable to worm infections. They can be exposed to parasites via food and also while crawling on the floor and playing with toys and pets.
So common myths - such as: “ It is not a problem in this day and age” or “Don’t bother to deworm unless you show symptoms” - need to be debunked.
The relevant question to ask is: “ How often should we deworm?”
Once every six months is sufficient. If symptoms are noted, consult your physician for a routine stool screening. Otherwise, deworm your whole family twice a year. Children can be dewormed from two years of age on.
Mebendazole or Albendazole (chewable) tablet is the drug of choice. Its side effects are rare, it helps the body to eliminate worms, and it is safe for pregnant women and unborn babies after the first trimester of pregnancy.
So, to all Hanoians - newcomers and old-timers alike - pop that deworming pill!
Worms can divert 1/3 of the food a child consumes
1.5 billion people in the world have roundworms
1 billion people in the world have whipworms
1.3 billion people carry hookworms in their gut
Sources: UNICEF, WSSCC and mtherald.com
*Fugacar is the brand name of the deworming pill available over-the-counter at Family Medical Practice Hanoi.
*Dr Cynthia Dacanay is a pediatrician at Family Medical Practice Hanoi. For more information or medical advice, please contact: firstname.lastname@example.org.