Intestinal Parasites Are Feeding on Poor, Undernourished

Some of your biggest enemies in Cambodia are small, round and they wiggle, and can re­sult in long-lasting health problems if they’re not treated, doctors said.

For as long as they remain, intestinal parasites can cause a number of symptoms, in­cluding stomach pains, diarrhea, headaches and fatigue, said Dr Phanita Yos of the Naga Clinic in Phnom Penh.

For young children, worms of any type can be extremely dangerous, especially if the children are malnourished, he said.

“These parasites can compromise a child’s inability to grow,” Phanita Yos said, as they cause diarrhea and take nutrients from ingested food.

The five most common intestinal parasites are amoeba, roundworms, threadworms, pinworms, hookworms and tapeworms, said Dr Gavin Scott of the Tropical and Travelers Medical Clinic in Phnom Penh.

Amoeba, roundworms, threadworms, and pinworms are usually contracted through contaminated food and water and unclean vegetables, Scott said. Hookworms enter the body as larvae, which find their way in through tiny cuts, usually on the feet, he said.

“The symptoms depend on the amount of worms in the intestine,” Scott added. “The more worms you have, the more symptoms you will have as well.”

Tapeworms are most often contracted through two main sources—undercooked pork and beef, Phanita Yos said.

“Tapeworms can be a meter long, depending on its stage of maturity,” said Phanita Yos, but added it usually takes months before such worms grow to that size.

Giardia lamblia is yet another common parasite, according to Dr Reid Schaftell of the American Medical Center.

“This disease is…very hard to get rid of,” Schaftell said. A person can get sick from giardia lamblia after ingesting “trophozoites,” or nonbacterial organisms, also found in contaminated food and water, he said. Those trophozoites then hatch inside the intestine.

Doctors say they usually test for worms by conducting blood tests and taking stool samples from patients.

Blood tests don’t show what type of parasite a patient has, but can indicate the presence of worms, Scott said.

Stool samples, or excrement, meanwhile, can be inaccurate, and should be done for three consecutive days to best identify and treat the parasite, he said.

“Although a stool test is best to find out what worms you’ve got, most stool tests are negative for finding parasites,” Scott said. “It’s like looking for a needle in a haystack.”

Treatment depends on the variety of worms, Scott said. Most doctors prescribe general medicines, such as mebendazole and albendazole, also known by its trade name Zentel. But those medicines are not always 100 percent effective, he said.

“Some worms you need to take specific medications,” he said. “A general deworming medicine will get rid of most worms but not all types of worms.”

General medicines, such as Zentel or Py­ren­tel, cost about $1 for two pills and should be taken twice daily for three days to treat worms, said Toy Paradi, a pharmacist at Pharmacie de la Gare in Phnom Penh. Within 24 hours of taking the pills, parasites should be passed through the stool, clearing the intestines of them, Phanita Yos said.

Side effects may include drowsiness, nausea, fever and vomiting, Phanita Yos said.

Even if people do not feel ill, they should take a general deworming medicine like Zentel every three months as a preventative measure, Toy Paradi said.

“A healthy person should take Zentel anyway to prevent worms,” he said.

To avoid getting intestinal parasites, doctors recommend cooking meat thoroughly, washing hands before handling food, cleaning vegetables with boiled water, and boiling or drinking purified water.

People, particularly those in the countryside, should also wear shoes to prevent hookworms, according to Dr Chhim Sarath, health information officer for Medicam.

Intestinal parasites are particularly common among poor people, especially those living in remote areas that do not have access to clean, running water, Scott said.


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