Deworming in a 1 Year and 3 Month Old Baby
Recommended Treatment
For a 15-month-old child at high risk of intestinal worm infestation, administer albendazole 400 mg as a single oral dose, with a repeat dose in 2 weeks. 1, 2
Medication Dosing
- Albendazole 400 mg is the standardized dose across all age groups for deworming, including children as young as 12 months 1, 3
- Alternative option: Mebendazole 100 mg as a single dose, repeated in 2 weeks 1, 2
- Both medications are equally effective and safe for young children in this age group 1
Administration Guidelines
Critical Safety Considerations
- Crush the tablet and mix with water for children under 3 years to reduce choking risk, as recommended by WHO 4
- Administer with food to enhance absorption 3
- Avoid administration if the child is fussy, fearful, combative, or struggling, as this increases choking risk 20-fold 4
- If the child is non-cooperative, delay administration until the child is calm—this single intervention could reduce choking risk by 79.5% 4
Practical Administration Tips
- Whole tablets carry only 3.6% risk of adverse swallowing events compared to 25.4% with crushed tablets 4
- However, for safety in this age group (15 months), crushing remains recommended despite higher rates of spitting or gagging 4
- Male children and those aged 1-2 years have higher risk of adverse swallowing events 4
Treatment Rationale for High-Risk Populations
- In endemic areas, prevalence of intestinal worms in children 6-23 months can reach 50% 5
- The most common worm is Ascaris lumbricoides (roundworm), affecting up to 68% of infected children 6
- Other common parasites include hookworm, whipworm, and Giardia intestinalis 6, 5
- Treatment should be given regardless of whether symptoms are present, as 30-40% of infected children are asymptomatic 1
Expected Outcomes and Limitations
- Single-dose albendazole provides temporary clearance but reinfection rates are high—infections can return to baseline levels within 12-16 weeks 6
- Treatment failure is rare; persistent symptoms usually indicate reinfection rather than drug resistance 1
- Symptoms such as abdominal pain, diarrhea, and irritability typically improve within 2-4 weeks of treatment 6
Follow-Up Protocol
- Repeat stool examination 2-3 weeks after treatment if symptoms persist 2
- Consider retreatment at 6-month intervals in high-risk endemic areas, as recommended by WHO for regions where soil-transmitted helminths are prevalent 6, 7
- Monitor for signs of reinfection: nocturnal perianal itching (pinworm), abdominal pain, diarrhea, or visible worms in stool 1, 2
Prevention of Reinfection
Hygiene measures are essential as medication alone provides only short-term benefit 7:
- Wash hands and fingernails with soap frequently, especially before eating and after toilet use 2, 7
- Ensure the child wears shoes when outdoors in endemic areas 8
- Wash fruits and vegetables thoroughly or cook them well 8
- Clean living areas by vacuuming or damp mopping rather than dry sweeping 9
- Consider screening and treating household contacts in endemic settings 8
Monitoring for Adverse Effects
- For treatment courses longer than 14 days (not applicable for single-dose deworming), monitor for hepatotoxicity and leukopenia 1
- For standard single-dose treatment at 15 months of age, routine laboratory monitoring is not required 3
Common Pitfalls to Avoid
- Do not skip the repeat dose at 2 weeks—this is essential to eliminate newly hatched worms 1, 2
- Do not rely solely on medication—without hygiene interventions, reinfection occurs rapidly 6, 7
- Do not force medication on a distressed child—wait until the child is calm to dramatically reduce choking risk 4
- Do not assume negative stool tests rule out infection in high-risk populations—sensitivity of standard stool microscopy is limited 8