Maintaining hand hygiene is a way of harm reduction

12:11 pm Health Care, Heart Care Foundation of India, Medicine

Infections such as soil-transmitted helminth and dysentery can be avoided in children with hand washing

New Delhi, 21st February 2019: Statistics from the WHO indicate that last year, about 1.5 billion people globally were at risk of contracting soil-transmitted helminth (STH) infections — or roundworms. About 270 million pre-school children and 600 million children of school-age live in areas where these parasites are intensively transmitted. India accounts for a quarter of the world’s STH-infected children; 64% of them are younger than 14 years.

Open defecation, contaminated soil and water, uncooked food, and not following basic hygiene are the main reasons for transmission (worm larvae and eggs). If undiagnosed, the worms persist in the body and lay thousands of eggs every day. These cause a decline in iron, protein and vitamin A levels, leading to anemia, a lower appetite, malnutrition, and diarrhea.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Adult worms live in the lumen of small intestine. The female worm produces fertilized eggs much faster in the stool. These eggs prefer warm, shady, moist conditions where they can survive for five years. They hatch in the small intestine within days of consumption of contaminated food or water and release larvae every minute in the next 10 days. Most worms are asymptomatic. During migration in the lung, a patient may have asthma-like attack. A high burden of worms in the intestine can cause nutritional deficiency and heavy infection can also cause nutritional obstruction. Eggs do not appear in the stool for at least 40 days after infection.”

The Ministry of Health and Family Welfare launched the National Deworming Programme in 2015. This is one of the largest fixed-day, mass drug administration public health programmes in the world, and aims to reach out to over 230 million children by 2020. Deworming tablets (Albendazole) are administered under this initiative which has garnered many accolades globally, especially from public health advocates of neglected tropical diseases.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “Maintaining good hygiene and sanitation through hand washing and other techniques is a way of harm reduction in children and adults alike. Proper hand washing can prevent several fatal diseases as well. Some other points to be considered to prevent STH include provision of clean drinking water, safe fecal sludge management, and safe disposal of waste and recycling.”

Some tips from HCFI

Respiratory hygiene This is important to prevent cross infection, specifically, from flu and related respiratory illness. One should keep a minimum distance of 3 feet, from a person who is coughing, sneezing or singing.

Hand hygiene This is the fundamental principle for any disease prevention and the catch phrase is “before and after”, that is, one should wash hands before and after eating food, touching any infected material, seeing a patient or after normal evacuation of stool in the morning.

Food hygiene This means maintaining hygiene at home while cutting, serving and eating food. While cutting a vegetable, the surface or the cutting board should be clean and hygienic including the knife, hands, water, utensils etc. If that hygiene is not possible, follow the formula of ‘boil it, heat it, peel it, cook it or forget it’.

Water hygiene This involves drinking safe water, safe drinking glass, proper washing of glass, not washing multiple glasses in the same utensil and picking up glasses properly.

Sexual hygiene This involves washing local areas before and after sexual contact.

Nail hygiene This is very important especially for food handlers, because they are responsible for water and food disease. It is important that they be given typhoid vaccines and de-worming tablets every three months.

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