Intestinal worms affect millions of children worldwide. Older children can learn and share knowledge about the life cycle of intestinal worms, the available treatment for worms and what they can do to prevent the chances of worm infestation like good hygiene practices and wearing shoes. Scroll down to read our Top Ten messages on Intestinal Worms for children to learn and share, plus ideas on what children can do to understand, find out more, take action and reflect on this topic. CHILDREN SAY THAT WE CAN MAKE our own Intestinal Worms Messages using our own words in our own language! LEARN these messages so we never forget them! ADD these messages to our collection! SHARE these messages with other children and our families! Intestinal Worms ChildrenforHealth.org Page 1
Message 1 Millions of children have worms living inside their body, in a part called the intestines this is where the food we eat is digested by our bodies. Most worms live in a part of our body called the large intestine. This is where our bodies work hard to take the nutrients out of our food, leaving waste that comes out of our body as poo and water that comes out of our body as pee. Having worms is very common. As many as 1.5 billion people in the world have worms in their bodies right now. That is the same as one person in every four. How does the food we eat get used by our bodies? How long is our large intestine? How do worms take our food? How long can a tapeworm grow? Intestinal Worms ChildrenforHealth.org Page 2
Message 2 Different kinds of worms can live in our bodies like roundworm, whipworm, hookworm and bilharzia (schistosomiasis). There are others too! Roundworms are very common. The female can grow up to 40cm long and can make 2000 eggs every day. Pinworms live in our intestine. They make our bottoms itch because this is where they come out to lay eggs. Hookworms attach themselves to our intestines and drink our blood. Five hookworms can drink one spoonful of blood every day. Imagine how weak you would feel if you had 100 hookworms drinking your blood? Schistomaisis worms live in water snails. They burrow into our feet and legs if we drink or play in water where the snails live. How many types of worm do you know? What kind of worms are most common where you live? Watch the video about Schistomaisis and find out more about worms in dirty water. Make up a play about wicked worms and how children stop wicked worms stealing their family s food! Intestinal Worms ChildrenforHealth.org Page 3
Message 3 Worms can make us feel ill or weak and they can cause stomach aches, coughs, fever and sickness. When worms live in our bodies they eat our food and drink our blood. They can leave us feeling tired and unwell. They can stop us growing as quickly as we should and also make it hard for us to concentrate on our work at school. We might have worms if our bottom feels itchy, if our tummy hurts or if we have lost our appetite but most people don t even know they have worms. What are the signs you could have worms? Where you can get deworming medicine and who needs to take it? (Answer: Everyone in your family!) Write a story about worms explaining how we can stop worms spreading by washing our hands and remembering to wear our sandals. Intestinal Worms ChildrenforHealth.org Page 4
Message 4 Worms live inside your body so you might not know they are there but sometimes you can see worms in your poo. Sometimes you can see pinworms because they come out of your bottom at night and lay their eggs making your bottom itchy. You might see them in your poo. If you scratch your bottom you can spread the worm eggs to other people. Children who have a lot of worms in their bodies sometimes have big stomachs, but most children don t know they have worms. They may have tummy ache, or feel dizzy if they have hookworms, or lose their appetite. Another kind of worm called Guinea worm makes a lump on your leg and the worm has to be pulled out. It s very painful, but becoming rarer as people are working hard all over the world to get rid of Guinea worms forever. How many eggs can a worm make every day? Worms may take other nutrients like vitamin A from our bodies as well as food can you find out what we need Vitamin A for? Make a role play or puppet show about how we can stop worms spreading. Intestinal Worms ChildrenforHealth.org Page 5
Message 5 Worms and their eggs get into our bodies in different ways: some get in from food or drink (like unsafe water). Others get in through bare feet. To protect ourselves from getting worms we must wash our hands with soap and water after using the toilet, before eating and after cleaning up after a younger child has had a poo. We must always wash vegetables before we eat them or cook them with clean water and only drink water we know is safe to drink. Some worms like to get into our bodies through our feet so we must remember to always wear our sandals when playing outside and especially when we use the toilet. Some worm eggs live in water and we get these worms when we play in or drink dirty water these worms live in snails and give us an illness called bilharzia which some people call Schistomaisis. Worm babies are called larvae. Which worm larvae get into our bodies through our skin? How using the toilet or latrine and getting rid of our poo safely helps stop worms spreading? Find out how food is prepared in our school and how our cook keeps food safe and free from worms. Make posters to show how to keep food safe and free from worms by washing it before eating raw vegetables, cooking meat properly and preparing food. Intestinal Worms ChildrenforHealth.org Page 6
Message 6 Killing worms with de worming treatment is easy and cheap. It s given by health workers every 6 or 12 months or more for some worms. It s hard to know if we have worms. That s why we get de worming medicine at school or go to the health clinic to treat them once or twice every year with our families. De worming medicine is safe. It kills any worms and their eggs that are in your body. It treats them once and it doesn t stop you getting them again, that is why it is important to wash your hands before eating and after using the toilet, wash vegetables before eating them raw or cooking them and only drinking water that is clean and safe to drink. When our school de worming days are? Why does everyone get de worming tablets on the same day? Why is it important that when we have de worming medicine everyone in our family has it too? Watch the video Dirty word of the day all about worms! Find out how to make a Tippy Tap and make a handwashing station for our class to use. Intestinal Worms ChildrenforHealth.org Page 7
Message 7 Worm eggs live in pee and poo. Use latrines or get rid of pee and poo safely. Wash your hands with soap after you pee or poo, and if you help someone younger, so worm eggs don t get on your hands. Worm eggs live in poo. If we always use a latrine worm eggs can t get into the soil and don t get onto our hands or onto our food. Animals have worms too, so we need to keep them and their poo away from the house and away from our drinking water. We need to wash our hands with soap and water after a pee or poo and help younger children to remember to wash their hands after having a pee or poo so they don t get worms. We must always use the toilet or latrine to stop worm eggs spreading from poo that gets into the soil and water. Washing our hands needs soap and water, find out how to wash our hands. Make a song about how to stop worms spreading. Take a quiz to find out if we know when to wash our hands before doing something and when to wash our hands after doing something. Intestinal Worms ChildrenforHealth.org Page 8
Message 8 Stop worms getting into your body by washing hands with soap after a pee or poo, washing fruit and vegetables, before preparing food, eating or drinking and by wearing shoes. If we remember to keep our hands clean we can protect ourselves from worms. Worms only live in poo, we can t catch them from someone else. So if we remember to wash fruit and vegetables before we eat them and remember to always wash our hands with soap and water after using the toilet, playing outside or touching animals and before eating, then we can stop worms getting into our body. If we remind each other to wash our hands and food and if we take de worming medicine once or twice a year, we can stop worms infecting us. How many children in the world have worms? Why is it important we stop worms spreading? Do a survey to find out what people in our family know about worms. Listen to a story about Meena or read the comic book about how Meena learns about worms. Intestinal Worms ChildrenforHealth.org Page 9
Message 9 Some worms live in the soil so always wash your hands with soap after touching soil. When someone has worms the worms make eggs and the eggs come out in their poo. The eggs are so tiny we can t see them. If we don t use a toilet but poo in the bush, worm eggs can get into the soil. The eggs in the soil get onto our hands and bare feet when we play outside and they get dirty. Eggs can get onto vegetables from the dirt they grow in. About our digestive system how does it work and what do worms do to stop it working? How small is a worm egg? What is the smallest thing you know? Watch the video about our digestive system. Make up a song about hand washing to remind us when and how to wash our hands. Intestinal Worms ChildrenforHealth.org Page 10
Message 10 When watering plants to eat, make sure you use water that cannot have human pee or poo in it. When we grow vegetables we must keep the vegetable garden free from our poo. We need to use water that hasn t got our pee or poo in because this will put worm eggs into the soil. The worm eggs in the soil get onto the vegetables and when we harvest and eat them, the worm eggs can get into us. So keep the vegetable garden clear of pee and poo and use clean water to water produce. How can we tell if water is clean or dirty? What do plants need to grow? How can we make fertilizer that is safe to feed to plants? Watch a video about how to clean water so that it is safe using sunlight Make a poster to remind us to wash vegetables and fruit before we eat them or prepare them. Intestinal Worms ChildrenforHealth.org Page 11
All 10 Messages 1. Millions of children have worms living inside their body, in a part called the intestines this is where the food we eat is digested by our bodies. 2. Different kinds of worms can live in our bodies like roundworm, whipworm, hookworm and bilharzia (schistosomiasis). There are others too! 3. Worms can make us feel ill or weak and they can cause stomach aches, coughs, fever and sickness. 4. Worms live inside your body so you might not know they are there but sometimes you can see worms in your poo. 5. Worms and their eggs get into our bodies in different ways: some get in from food or drink (like unsafe water). Others get in through bare feet. 6. Killing worms with de worming treatment is easy and cheap. It s given by health workers every 6 or 12 months or more for some worms. 7. Worm eggs live in pee and poo. Use latrines or get rid of pee and poo safely. Wash your hands with soap after you pee or poo, and if you help someone younger, so worm eggs don t get on your hands. 8. Stop worms getting into your body by washing hands with soap after a pee or poo, washing fruit and vegetables, before preparing food, eating or drinking and by wearing shoes. 9. Some worms live in the soil so always wash your hands with soap after touching soil. 10. When watering plants to eat, make sure you use water that cannot have human pee or poo in it. Intestinal Worms ChildrenforHealth.org Page 12
Knowledge Worms are parasites that live in our bodies, eating nutrients that help us grow and drinking blood needed by our bodies. A parasite is an animal or organism that uses another animal or organism to provide its food. The animal or organism that feeds the parasite is called the host and some parasites cannot live or reproduce without a host. They are found all over the world. Children and adults can get worms from eating their eggs, walking on ground infected with baby worms (larvae) or by wading in water infected with worms from a snail. Worms are also called soil transmitted helminths where they live in the soil. The word helminth is another word for worms and is most often used to refer to parasitic worms in the soil that can infect humans. Worm infections are very common. They mostly affect people living in environments where sanitation is poor, but anyone can get them. The organisation Children without Worms estimate that as many as 1.5 billion people are at risk of getting infected with worms. And as many as 875 million of those are children. We get worms when we are infected by eggs or baby worms that get into our bodies. Most worms are transmitted by worm eggs that are found in poo. The poo and the eggs get into the soil and water and spread on hands and feet, and on vegetables grown in infected soil or watered with dirty water. Some worms spread through water, where their babies or larvae swim. These kinds of worms get into our bodies by burrowing into our skin when we are in contact with infected water. Intestinal Worms ChildrenforHealth.org Page 13
Types of Worm Roundworm (Ascaris lumbricoides) Roundworm, Ascariasis, is most prevalent in warm tropical and subtropical climates in Sub Saharan Africa and Southeast Asia, and it flourishes in areas with poor sanitation or where crops are irrigated by improperly treated waste water. Ascariasis is the most common human worm infection. More than 1 billion people worldwide are infected with ascariasis, and more than 60,000 die from the disease annually. Ascariasis is transmitted by accidental eating of ascaris eggs in contaminated food, water or soil. Once the eggs are swallowed, they move into the intestine and hatch into larvae. The larvae move through the body and into the blood where they can cause severe coughing and wheezing Coughing brings the larvae into the mouth and they are swallowed and go back to the small intestine where they mature and lay eggs sometimes up to 240,000 per day. Ascaris eggs are passed into poo and out into the soil, where they grow for about two weeks before the cycle begins again. Adult roundworms can live in the body for one to two years, and grow as long as twelve inches and as wide as a pencil. When a person is first infected with Ascariasis they may not have any symptoms. Later a person who is infected will have the symptoms of coughing and wheezing. When an infection with Ascariasis is very bad in children, it can block the intestines and stop them working. Ascariasis cannot be transmitted from person to person. Whipworm (Trichuris trichiura) Whipworms or Trichuriasis thrive in warm, humid tropical climates and infect 800 million people worldwide. Trichuriasis infects us when we accidentally eat eggs from contaminated soil or unwashed vegetables fertilized with human poo. Once inside our body, whipworm eggs move to the small intestine where they hatch into adult worms. These adult worms make themselves at home in the lining of the large intestine and colon where they feed on our blood. Adult whipworms can live in the body for up to a year, and female worms can make between 3,000 and 20,000 eggs per day. The eggs move out of the body in our poo, and if there aren t any toilets and the poo gets into the ground and we accidentally eat them, then the cycle begins again. Children are at high risk for whipworm, because they often play outside in the dirt or soil and put their hands in their mouths without washing them. Long or repeated infections with whipworm can cause serious health problems including malnutrition, anaemia (not enough iron in the blood), and slow Intestinal Worms ChildrenforHealth.org Page 14
growth. Hookworms Necator americanus and Ancylostoma duodenale) Hookworm is most commonly found in tropical and subtropical climates worldwide, particularly in Africa and Latin America. Hookworm and affects more than 700 million people across the world. Left untreated, hookworm causes internal blood loss and this can lead to iron deficiency anaemia and protein malnutrition, particularly in pregnant women and children. Chronic hookworm infection in children stops children s brains and bodies growing properly causing learning difficulties and poor school performance. How hookworms spread (their transmission) is a complex, repetitive cycle. Hookworm larvae are found in human poo and get into our bodies from the soil where poo has been. This is usually due to walking barefoot, or by accidentally eating contaminated soil by putting dirty hands into our mouths. Once inside the body, the larvae are carried through the blood to the lungs and mouth where they are swallowed, digested and passed to the small intestine. The larvae grow into half inch long worms and these attach themselves to the wall of our gut and feed on our blood. Adult worms mate and hatch thousands of eggs. These are passed into the poo of the human host. If the poo comes into contact with soil, the eggs hatch into larvae and can be re transmitted to humans, beginning the cycle all over again. There are two common species of hookworm, Necator americanus and Ancylostoma duodenale. Hookworm transmission requires the development of eggs into larvae in soil, and the infection cannot be spread from one person to another. Intestinal Worms ChildrenforHealth.org Page 15
Transmission Worms move from person to person from worm eggs that come out in the poo of infected children and adults. They spread from poo onto hands, feet, through the soil and onto vegetables when hand washing and hygiene practises are poor and there are no toilets or clean water. Adult worms live in our intestines and produce thousands of eggs every day. The eggs come out in our poo and when our poo gets into the ground or into our rivers and water, the worm eggs spread. Worm eggs can get into us in several ways: Eggs from poo get into the soil (when we don t use a toilet but pee and poo outside) and become attached to vegetables. When the vegetables are not carefully cooked, washed or peeled the worm eggs get into us. Eggs get inside us when we drink water from dirty water with poo in it. Eggs get into our mouths when we play outside and get soil or dirt on our hands and then put our hands into our mouths without washing them. As well as these ways, the eggs of the hookworm hatch in the soil, releasing babies (larvae) and when these larvae are big enough, they can burrow into our skin and get into our bodies and grow. We get hookworm when we walk barefoot on the soil. We can t catch worms from another person. This is because worm eggs need to grow and mature in the poo before they can infect us. Worms do not multiply when they are inside us, but make eggs that come out in our poo. Treatment We need to treat worms to kill them with special medicine that is cheap and safe called de worming medicine. The medicine kills the worms but it does not stop us getting them again. We are often given de worming tablets on special child health days at school, when everybody is given the medicine. This helps stop worms in our community. We are given these medicines every year. In 2012, de worming tablets were given to 285 million children for worms that live in the soil, which was equivalent to a third of all the children in the world who need de worming tablets (WHO). Intestinal Worms ChildrenforHealth.org Page 16