Intervention 11: De-worming



Many children are likely to be infected with intestinal worms (i.e. helminths) from the time they stop breast-feeding, and they can be continually infected and re-infected for the rest of their lives. School-age children have the highest intensity of worm infections. Infants usually do not carry the burden of helminth infestations as long as they are not yet mobile. Once they begin crawling and walking, however, the risk of exposure increases. It is usually recommended that a child receive de-worming medication at 12 months of age. For children 12–24 months, treatment should be undertaken as prescribed by national guidelines. Due to the likelihood of re-infection, it is important to treat the whole family. In communities where intestinal worms are common, all children should be offered treatment. There is no need to screen or examine each child to confirm the presence of worms. Screening is much more expensive, and treatment is safe for uninfected children.

Besides accessing periodic treatment, caregivers need to ensure that the child’s surroundings are kept clean and sanitary, that proper hand-washing techniques are used by everyone in the family and that appropriate sanitary facilities are available and in use. All of these messages are included in 7-11 programming.


  • Child 12-24 months is given periodic de-worming tablets according to national guidelines

Target Behaviours/Results:

  • Caregiver ensures child takes de-worming medication by attending either mass de-worming campaigns or the local health facility
  • Caregiver ensures that when child begins to walk, he/she wears shoes


What are the symptoms of worms in children? 

Some symptoms include: stomach problems such as diarrhoea and abdominal pain, general tiredness and weakness, lowered immunity, malnutrition, stunted growth and delayed development, intestinal blockages which may require surgery and chronic intestinal blood loss that results in anaemia(caused by hookworms).

Why do we need to treat worms in children? 

Worm infections pose a serious threat to children’s health, education, and productivity. Globally, more than 500 million children are infected with intestinal worms which impacts their growth and development.

 Soil-transmitted helminthes infections in children can cause:

  • Decreased nutritional status (causing intestinal bleeding, loss of appetite, diarrhoea or dysentery, and reduced absorption of micronutrients – including Vitamin A)
  • Decreased appetite which can contribute to malnutrition
  •  Worsening of school performance and absenteeism
  •  Complications that require surgical intervention
  •  Decreased ability of the immune system to fight infections.

Worm infections often exist with other more severe infections such as HIV, Malaria and TB. They may therefore have additional negative effects on nutritional status, immune response and organ damage. 

Intestinal worms are associated with a significant loss of micronutrients among preschool-age children, and these deficiencies during childhood can cause poor learning and development, stunted growth, blindness, and problems with immune function.

STH’s can weaken the effectiveness of vaccines in children. The constant and lifelong immune suppression (weakening the body’s “soldiers”) due to worm infections can reduce the body’s lifelong capacity to resist other infections. 

Are there any side effects to deworming medication? 

Yes, but they are usually not severe and do not last long. Side effects of those who have worm infestation include abdominal discomfort/pain, headaches, and nausea. 



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