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Intestinal parasites are one of the primary childhood health problems in developing countries. According to the WHO, over 270 million pre-school and 600 million school children live in areas where intestinal parasites like pinworm are transmitted intensively. 
Pinworm or threadworm infection in babies usually occur in crowded environments and spread within families. It is highly prevalent in children under the age of five; those that belong to lower social groups, and whose parents are farmers or have occupations that are likely to have close contact with contaminated soil.
Let's know in detail about pinworm infection in children.
What Is Pinworm Infection?
Pinworm (Enterobius vermicularis), commonly known as threadworm and seatworm is a small, thread-like and white parasitic worm of length between 9-12 mm (female) and 2-5 mm (male). It belongs to the category of nematode or roundworms.
Studies say that humans are the only natural hosts of pinworms. The worm has a pin-like tail on the back part of female worms, while males have posterior shaped like a fish hook and complete with a barb, hence the name pinworm.
Causes Of Pinworm Infection
Some of the common causes of pinworm infection include:
- Biting or sucking unhygienic fingers after scratching the peri-anal areas
- Poor handwashing practices.
- Poor education
- Low socioeconomic status of parents
- Unawareness of personal hygiene.
- Polluted environments such as gutters and sewage.
- Handling contaminated clothes, bed sheets or linens.
- Touching contaminated surfaces or objects and then touching the mouth. 
- Inhaling the dust infected with eggs while sweeping or bed making.
- Through hairs of pets like dogs and cats.
How Does It Spread?
Pinworm infection, as aforementioned, is spread through unhygienic habits. When the eggs of pinworms or pinworms themselves are ingested by mouth, larvae from eggs are released in the small intestine, while the adult pinworms get settled in the colon. Later, coupling between adult pinworms takes place in the colon.
Just before the delivery of the eggs by the pregnant worms, they migrate to the perianal area due to the suitable environment and lay eggs, especially when the host is asleep.
Studies say that each pinworm lay around 1000 eggs. The time period between ingestion of infected eggs and laying of eggs is approx one month. Also, adult pinworms can stay in the colon for around two months and keep reinfecting.
When the eggs are laid, they are usually in the embryo stage. Sometimes, the female pinworms get confused and lay eggs far from the anus or even in the terminal of the intestinal tract. When laid in these areas, the eggs usually die as they fail to develop in the environment. 
Near the anus, the atmosphere is humid and the temperature is not less than 30-degree Celcius. This environment helps transform the embryo into a vermiform embryo (resembling a worm in shape) within a few hours. Also, the embryo can survive up to 10 days in favourable conditions.
When people scratch the peri-anal areas, they pick up the embryos or vermiform embryos, which then, probably, spread to objects or clothes nearby through infected fingers and nails. The cycle of pinworm infection is then continued when the eggs get transmitted to the mouth again through the aforementioned ways.
Symptoms Of Pinworm Infection
In many cases, pinworm infection is asymptomatic, however, when symptomatic, it causes symptoms like: 
- Itching of the anal.vaginal areas.
- Inflammation of the anal.vaginal areas.
- Mild nausea
- Intestinal inflammation
- Reduced appetite
- Stomach pain
- Secondary bacterial infection
- Skin rash
- Low immunity
Risk Factors For Pinworm Infection
- Age, especially children between ages 3-4 years.
- Living in crowded and unhygienic areas.
Complications Of Pinworm Infection
Untreated pinworm infection for longer can cause complications like:
- Invasion of vital organs like gall bladder, vagina (vulvovaginitis) and uterus.
- Urinary tract infection.
- Malnutrition in children due to reduced absorption of digested foods. 
- Watery diarrhoea. 
- Weight loss in babies.
- Peridontitis and salpingitis are rare.
Diagnosis Of Pinworm Infection
Pinworms are invisible to the naked eyes. Microscopic detection of pinworms is mainly preferred to confirm the diagnosis. Some of the methods include: 
- Scotch tape test: Here, the tape is pressed against the anal and perianal areas, especially in the morning before washing the genitals to take the sample of pinworms. The tapes are then viewed under a microscope to confirm the worms.
- Readymade diagnostic kits: Here, with the help of a swab provided in the kit, the sample is taken from the anal area and placed into a physiological saline solution to detect the presence of worms. It is mainly carried out on three different days.
Treatments Of Pinworm Infection
Some of the treatment methods include:
- Anthelminthic drugs: It includes drugs like albendazole and mebendazole. 
- Herbal treatments: It includes the consumption of blueberries and garlic.
- Proper hygiene practices: It includes hygienic practices to keep the surroundings clean and prevent infestation of pinworms.
How To Prevent Pinworm Infection In Babies?
- Change the clothes of babies daily.
- Change their bedding regularly.
- Wash their clothes and bed sheets in hot water
- Disinfect the floors and their toys regularly.
- Keep their nails short and clean.
- Teach them good hygiene practices.
- Keep their toilet seat clean.
- Give them boiled water, if possible.
Parents must keep a watch on their children's habits. If you notice that your child is scratching the perianal areas, consult a medical expert for speedy treatment of pinworm infection.
Pinworm infection in babies is mainly treated by anthelminthic or anti-parasitic drugs like albendazole. Also, proper hygiene practices are suggested to keep the baby and the surroundings clean and prevent the spread of infection.
When female pinworms travel to anal regions, their movement causes a strong itching sensation in the area. This can make your children uncomfortable and make them cry. If left untreated, pinworm infection can cause complications and may affect your baby in many ways.
When the hygiene of the baby and the environment is well-maintained, the eggs of pinworms present in the surrounding may reduce, thus affecting their life cycle. Pinworms can also go on their own with certain home remedies like garlic and blueberry. Consult a medical expert if the symptoms prevail for more than 3-4 days and before using any home remedies.