Nail clipping and hand washing in school going children does it reduce the risk of intestinal parasites?

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The small intestine is prone to attack by bacteria that make it their home as intestinal parasites. It is even worse when the intestine suffers from food poisoning, nutritional neglect, and antibiotic use or self-sabotage. The over 30 feet small intestine should be almost sterile, unlike the shorter large intestine which holds most of the microbial biomass. An intestine parasite lives in the gut and often reproduces to cause much damage. It might also spread to other body parts. Drinking unsafe water and poor sanitation habits increase the risk of getting intestinal parasites. The best form of defense against these parasites is to maintain good hygiene.

Intestinal parasites prefer living in the guts (intestines) because they find it a comfortable shelter when they can reproduce. They are usually worms such as tape or pinworm or Protozoa like Giardia. The parasites can sometimes stay for long in the intestines without causing infection or showing any symptoms.

Worms are tiny thread-like organisms that find shelter in the rectum. At night they crawl out through the anus to lay eggs on the nearby skin which causes terrible itching. Worms are unpleasant, but they do not cause disease. Eggs from pinworm are very persistent living for up to 14 days outside the body on clothes, bedding or any other objects that come into contact. It is not always that the adult worm becomes visible. Other common types of intestinal parasites are:

  • Amebiasis
  • Dientamoeba
  • Blastocystis hominis
  • Ascariasis

Parasites are in plenty in many places around the world. Much transmission takes place in crowded places such as daycares where some children are carriers of some form of the parasite with unsafe water and poor sanitation increases the risk of spread. These were the best ways to prevent the spread of intestinal parasites:

Nail clipping

Parasites especially roundworms transmit much among school going children when they get into contact with contamination on the soil or feces. The parasite travels to the intestine after getting into contact and consumption of a contaminated substance. They will quickly grow and reproduce in the gut. Symptoms may appear when they become bigger and increase after reproduction.

Intestinal parasites (IP) spread much through fingernails in primary school environments. We all know that nails accumulate dirt and contribute more to spreading infections. Most people take care of their bodies but neglect the small areas like the finger and toenails which are also essential parts of the body. It is imperative to keep them clean, clean by cleaning, cutting and trimming. Most people forget and neglect the system as they consider it as less critical hence let them grow and get infections.

The World Health Organization (WHO) places the number of people with intestinal worms at 10% of the population. Children are more susceptible to the intestinal worms because they usually play in an environment with contaminated soils such as school playgrounds and sandboxes. Older adults with a weakened immune system are also at high risk.

A study to assess the prevalence of intestinal parasites in school going children took place in primary schools of Lahore District. The researchers collected 300 nail samples from primary school children of both genders but at different ages. They found the prevalence of IP from fingernail dirt of both boys and girls. The dirt collected from nails spreads other infections as well thus keeping them clean, and trim is essential.

Appropriate hand hygiene includes thorough cleaning and trimming of fingernails as they can harbor and germs contributing to spread of parasites and worms. In addition to cutting the fingernails short, it is essential to clean the undersides frequently with soap and water. Longer fingernails can harbor more dirt, parasites, and bacteria than shorter nails thus have more potential contributing to spreading of infection.

It is essential to thoroughly clean all the tools for the task such as a nail clipper and file before grooming nails or clipping. Sterilizing equipment before use is especially crucial when using nail tools after someone else especially in commercial salons where many people share them. It helps to prevent infections of the nails which cause swelling on the surrounding skin, pain in surrounding areas and thickening of a finger or the toenail. Some of the diseases might be too serious to heal without medicine or medication by a physician.

These measures help to prevent the spread of intestinal parasites, nail infections, and germs among the children.

  • Trimming the nails often to keep them short
  • Scrubbing the underside of nails with water and soap or a nail brush at every hand wash.
  • Training children not to bite or chew their nail
  • Avoiding cutting of cuticles because they are barriers that prevent infection

According to the U.S Centers for Disease Control and Prevention, clipping the nails weekly reduces the number re-infections by 49 percent.

Hand washing

Regular cleaning of hands with soap reduces rates of intestinal parasite and other infections from occurring by 68 percent. Intestinal parasites and infectious diseases can spread from one person to another by contaminated hands. These diseases include gastrointestinal infections such as those occurring due to Salmonella. Proper washing of hands can help to prevent the spreading of germs like viruses and bacteria that cause the disease.

Some forms of gastrointestinal infections are likely to cause serious infections more so to children or adults with weakened immune systems. When school going children should wash hands to reduce the risk of intestinal parasites It is essential that kids wash their hands thoroughly at these times:

  • After using the toilet
  • Before eating
  • After using a handkerchief or tissue to clean the nose
  • Before and after touching a sick person or child
  • After playing with solid or handling other dirt
  • After treating animals

How do intestinal parasites and other germs spread by hand?

IPs and other pathogens get to the hands and fingernails of school-age children if they touch:

  • Dirty hands of other children
  • Contaminated items or surfaces
  • A cough, sneeze or others body fluids by an infected person

When children touch these unhygienic items and surfaces, they touch their mouth, nose, eyes and it is only a matter of time before they spread to their school and playing mates.

Promoting hand washing with soap together with clipping nails are successful strategies for decreasing intestinal parasite infection or re-infection rates in school-age children. A study published by Mekelle University, Ethiopia in PLOS Medicine concludes as much. To reach this conclusion, researchers did a cluster randomized controlled trial on 367 parasite-negative school going children in Northern Ethiopia after a random assignment to a hand washing or nail clipping intervention. Some of the pupils were in the interventions and others in the non-intervention group for six months.

Field workers in the hand washing intervention visited a household that was part of the study each week encouraging the children in the group and other family members to clean their hands

with water and soap. They insisted on hand washing after visiting a toilet, and before meals. They checked on the use of soap by each household.

Field workers in nail intervention clipped nails of the children in the group each week. After adjustment for factors that are likely to cause infection such as the source of drinking water and latrine use, it is only 14% of children in the hand washing with soap groups get re-infection with intestinal parasites compared to the 29% of those who were not in a hand washing group. These are kids in nail clipping or none of the interventions. The number of children nails clipping groups who got re-infection was 17% while 26% of those who were not in this intervention got re-infection.

A noteworthy finding is that hand washing without nail clipping significantly reduces the rate of anemia in children.

These findings support the importance of implementing of proper hand washing and weekly nail clipping as a measure to maintain public health as a way of reducing parasite infection rates in the resource-limited regions. Although these interventions were efficient under the trail conditions that included intensive monitoring, the researchers did not follow up how hand washing and nail clipping works under the real-life situations.

Why is it important to use water and soap?

Washing hands with water get rid of most of the bacteria. Use of running water is safer than stagnant water in a basin because it gets contamination through use.

There is a debate on whether to use cold, warm or hot water to wash hands. The assumption has been that the hot water can link parasites, bacteria and other contaminants from the hands but there is no evidence to show this and other benefits. Hot temperature of water to wash hands could increase the irritant capacity of soap or damage the natural oils to cause contact dermatitis over time.

Soap is important in hand washing because using it together with water will remove more disease-causing organisms tan just water. People who avoid using soap because it causes their skin to irritate should find a brand that has a different pH. It can be neutral, alkaline or slightly acidic. Some of the perfumes found in soap might also irritate. Replacing soaps that irritate with hand-friendly type will help those who are uncomfortable when washing hands with soap.

Liquid soap is better for hand washing that a bar soap particularly at school or other places where many people use the same one. Bar soap is still better in cleaning hands if there is no liquid soap. There is no proof that antibacterial soap will provide more advantage in clearing intestinal parasite from the hands. If a child follows all the hand cleaning steps, any type will provide the benefits.

Antibacterial soap

When following the hand washing steps outlined above, all soaps are equally effective at removing disease-causing germs.Antibacterial soap is not a necessity and does not offer an advantage over regular soap. The way of storing the soap can affect its cleanliness and by extension the efficiency in cleaning the hands. Keeping the soap for long in areas such as closed sections, or puddle of water can cause the development of bacteria that spread to the hands when someone touches the soap. The hands may smell clean, but in reality, they are not any cleaner. Proper hand washing techniques to reduce the risk of intestinal parasites Proper hand washing takes these steps:

  • Wet the hands clean and running water then turn the tap off
  • Apply soap to the hands and lather it well for about 20 seconds or longer when the dirt is ingrained.
  • Rub the hands together in a rapid movement across all hand surfaces
  • Cleaning the hand surface should include the back of the hands, space between the fingers, wrists and under the fingernails.
  • If possible, it is crucial to remove items such as watches and rings before washing the hands or move to clean under them as microorganisms or parasites might exist under them.
  • Rinse the hands thoroughly under running water to ensure complete removal of all traces of soap
  • Air dries the hands and uses a clean towel to wipe them. Hot air dryers are also good for during the hand.
  • Dry under the skin under any rings as accumulating moisture can cause infection in future.

It is more hygienic for a household with school going children to have a towel for each. They should carry a handkerchief or smaller towel drying their hands at school. These towels and handkerchiefs require frequent washing.

Nail clipping and hand washing are an essential step in reducing the risk of intestinal parasites to school going children, but it is necessary to keep the surfaces, items, and toys they touch clean. The beddings and clothing should also be clean. It is also essential to keep reminding the children about washing their hands after touching dirt and before eating anything. They should even know about the importance of avoiding filthy surfaces as intestinal parasites might spread before they wash their hands.

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