Worm Infections in Children: Signs, Deworming Schedule and Prevention

Ask any school teacher or village health worker in Bangladesh and they will tell you the same thing: worm infections are among the most common childhood health problems in the country. Intestinal worms — roundworm, hookworm, pinworm and whipworm — quietly steal nutrition from growing children, causing poor appetite, weak growth, low energy in class and anaemia. The good news is that worms are easy to treat with a simple tablet and largely preventable with everyday habits, which is why Bangladesh runs a free national deworming program for school children.

How do children get worms?

Most worms spread through soil and stool contamination. Worm eggs passed in an infected person's stool reach soil, water, vegetables and hands — and then enter another person's mouth through unwashed hands, raw or poorly washed vegetables and unsafe water. Hookworm larvae can even enter directly through the bare feet of children walking on contaminated soil. Open defecation, crowded living and playing in dirt all raise the risk, which is why almost every child here is exposed at some point.

What are the signs of a worm infection?

Many infected children look completely fine, which is exactly why routine deworming matters. When signs do appear, the most common are stomach ache around the navel, itching around the anus at night (typical of pinworm), poor appetite and slow weight gain. Heavy infections can cause anaemia, with pale skin, tiredness and poor concentration at school.

• Recurrent tummy ache, bloating or on-and-off loose stools
• An itchy bottom, especially at night, with disturbed sleep
• Poor appetite, weight loss or failure to grow as expected
• Paleness and easy tiredness — see our guide on anaemia and iron-rich foods for what to feed a pale, weak child
• Sometimes worms are actually visible in the stool or vomit

How often should children take deworming medicine?

In Bangladesh, routine deworming every six months is recommended for children, and the national school deworming program gives free tablets twice a year for exactly this reason. The tablets used are safe, effective and taken as a single dose, generally from one to two years of age onwards as a doctor or health worker advises. Just as important: treat the whole family at the same time, including adults, because family members otherwise keep passing the eggs back to each other.

Do not give repeated extra doses on your own, and always ask first before deworming a child under one year or a pregnant family member. A registered physician can guide you — you can find a child specialist on ChamberBD — and information on commonly used deworming medicines is available in our medicine directory.

How can you prevent worm infections?

Prevention means breaking the soil-to-mouth cycle at every step. A deworming tablet clears today's worms, but only clean habits stop tomorrow's re-infection.

• Wash hands with soap after using the toilet, after playing outside and before eating or preparing food
• Keep children's nails short and clean — eggs hide under long nails and reach the mouth with food
• Make sandals or shoes a habit, especially around soil, fields and toilets
• Wash raw vegetables and fruits thoroughly in safe water; cook vegetables well when possible
• Drink safe water — boiled, filtered or from a tested tube well
• Always use a sanitary latrine, keep it clean, and never allow open defecation around the home

When should you see a doctor?

Routine deworming can happen through the school program or a quick consultation, but some situations need a proper medical check rather than just another tablet. See a doctor if you actually see worms in your child's stool or vomit, if tummy pain is severe or keeps returning, or if the child keeps losing weight despite eating. A child who looks very pale, swollen or weak needs examination and blood tests, because untreated heavy infections can lead to serious anaemia and malnutrition.

• Visible worms in stool or vomit, or a worm coming out of the nose or mouth
• Severe or persistent abdominal pain, or a swollen, tender tummy
• Blood in the stool, ongoing diarrhoea or repeated vomiting
• Weight loss, poor growth, or marked paleness and weakness
• Night-time itching with broken, infected skin around the bottom that is not settling

This article is for general health education and is not a substitute for professional medical advice.