Human worm infections, often known as helminthiasis, are a form of parasitic illness caused by many parasitic worm species. These worms are a severe public health problem worldwide, particularly in communities with limited access to sanitary facilities and safe drinking water (World Health Organization, 2020).

Types.

Roundworms (nematodes), flatworms (platyhelminths), and thorny-headed worms (acanthocephalans) are three forms of parasitic worms that commonly infect humans. Once inside the body, these worms can settle in various organs, including the intestines, blood vessels, lymphatic system, lungs, and liver, producing a variety of health problems (Centers for Disease Control and Prevention, 2019).

Symptoms.

The symptoms of worm infection vary depending on the infecting organism and its location in the body. However, several shared and common symptoms may indicate a worm infestation. One typical sign of worm infections is stomach pain or distress.

 The pain can be generalized or localized, depending on the parasite's location and the disease's extent. Patients frequently experience bloating, gassiness, or unexplained abdominal pain.

Another typical symptom is digestive difficulties such as diarrhoea or constipation, which may alternate. Some people may also experience nausea, vomiting, or appetite problems. A considerable weight loss despite a normal or increased appetite may indicate the existence of intestinal worms that eat the host's nutrition.

Physical symptoms, such as weariness and skin problems, might indicate a worm infestation. Despite proper rest and a well-balanced diet, persistent weariness may be caused by the worm's resource-depletion effects on the body. Itching skin or rashes, particularly around the anal area for specific worms such as pinworms, may indicate a probable infection.

Worm infections can cause issues such as fever or the appearance of worms in the faeces in more severe instances. Children with severe infestations may experience reduced growth and developmental problems. Furthermore, a person with a worm infection may develop less apparent symptoms such as anaemia owing to iron depletion by some parasites such as hookworms. It is very typical for patients to have malnutrition signs.

The severity and duration of these signs vary significantly between people and depending on the type of worm. 

 As a result, if such symptoms are seen, it is essential to visit a doctor. Precise diagnostic procedures, such as stool examination and imaging methods, can establish the existence of worms, allowing the appropriate treatment plan to be chosen.

Transmission. 

Worms are often transmitted via the fecal-oral pathway. This implies that if someone unintentionally consumes tiny worm eggs discovered in contaminated food, drink, or soil, they may get ill (NHS, 2019). Consumption of these parasite eggs can result from insufficient sanitation, such as not thoroughly washing hands before eating or cooking.

Pinworms, roundworms, tapeworms, and hookworms are among the worms that often infect people, each with its transmission route. Pinworms, for example, are typically transmitted from one sick person's faeces to another via shared contaminated things. Roundworms and hookworms, on the other hand, are primarily transmitted by contact with soil contaminated with human faeces containing worm eggs or larvae (World Health Organization, 2020).

 Tapeworms may represent a concern in locations where livestock is abundant. These parasites are usually caught by eating raw or undercooked meat from infected animals, which allows the eggs or larvae to hatch within a human's gut and mature into adult worms (Centers for Disease Control and Prevention, 2019).

Furthermore, some worms, such as schistosomes, are contracted uniquely. Instead of being swallowed, these parasites enter the skin of people who come into touch with freshwater sources polluted with the larval stages of these worms, such as rivers or lakes (World Health Organization, 2021).

Infection diagnosis.

Accurate worm infection diagnosis frequently necessitates a combination of medical histories, meticulous clinical exams, and laboratory testing (Hotez et al., 2014). Evaluating a patient's medical history and probable exposure sources is the first step in the diagnosis process. Doctors ask about travel to locations with high parasite incidence, nutrition, particularly raw or undercooked foods, and contact with sick people or animals. Symptoms can also point doctors in the direction of worm infections. For example, loss of appetite, lethargy, gastrointestinal discomfort, diarrhoea, and unexplained weight loss may indicate an infestation (Mayo Clinic, 2020).

The following stage is a clinical examination that focuses on worm infection symptoms. Abdominal pain, an enlarged liver or spleen, rashes or skin lesions, and odd swellings or lumps may be present. Ascaris lumbricoides (roundworms), for example, leave apparent symptoms on the body, such as skin rashes or migratory footprints. However, laboratory testing is used to provide a definite diagnosis of worm infections. Stool testing, blood tests, imaging, and, on occasion, more specialist treatments are used (CDC, 2021).

Stool tests are commonly performed to detect worm infections, typically by detecting worm eggs or larvae. In these procedures, a stool sample is examined under a microscope for indications of uninvited guests. 

 However, certain worms may not produce eggs regularly or maybe in the early stages of infection, reducing the usefulness of this strategy (CDC, 2021).

Blood testing can reveal worm infestations indirectly. Certain worms cause an increase in white blood cell count, notably eosinophils, which can be seen on a complete blood count test. Serologic tests seek for antibodies against certain worms, which can indicate if an infection is ongoing or past (Mayo Clinic 2020).

More giant worms, such as tapeworms or flukes, can be detected via radiologic imaging, such as X-rays, ultrasounds, or CT scans. In some circumstances, endoscopy or colonoscopy may be required to view the worms directly in the intestines. A biopsy may be needed if a liver, lung, or other organ infection is suspected (Ashford & Crewe, 2003).

Treatment.

Following a worm diagnosis, the next step is to seek treatment from a certified doctor. The doctors will expose you to numerous therapy options based on your situation. The primary treatment procedure for worm infections is anthelmintic medication. This method comprises using medications to eliminate or reduce parasitic worms. Most worm infections are treated with one of four anthelmintic drugs: albendazole, mebendazole, pyrantel pamoate, and praziquantel.

Albendazole and mebendazole, both benzimidazoles, work by preventing the synthesis of microtubules in the parasite, resulting in energy loss and, eventually, death of the worm. They are frequently used to treat hookworms, roundworms, and whipworms. On the other hand, Pyrantel pamoate paralyzes the worm, enabling it to lose its hold on the intestinal wall and be evacuated naturally during bowel movements. It works against roundworms, hookworms, and pinworms.

Praziquantel works very well against flukes and tapeworms. It causes muscular contraction, paralysis, and death by increasing the permeability of the worm's cell membrane to calcium ions.

Prevention.

While anthelmintic medications help treat worm infestations, prevention is still the best option. Frequent hand washing can dramatically reduce the risk of disease, especially after using the restroom and before eating. 

Additional preventative actions include drinking clean, filtered water and properly preparing meals, particularly meat and fish.

While there are effective therapies for worm infections, such as anthelmintic medications, prevention is still the best defence. Continued research to create better therapeutic alternatives and implementing prophylactic measures are critical in the ongoing battle against parasitic worm infestations.

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 Photo: https://www.verywellhealth.com/parasite-primer-88231