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AnuKantele

Trichuriasis

Common throughout tropical and subtropical regions. Globally, nearly 800 million individuals carry the parasite.

Adult worms live in the large intestine. The eggs land in the soil through faeces. Transmission occurs by eating or drinking infective eggs. Eggs need an extracorporeal maturation period of 2-3 weeks, and transmission therefore occurs most commonly through vegetables fertilised with human faeces or faecally contaminated surface water.

The infection usually remains asymptomatic. In heavily infected individuals, particularly in children, abdominal complaints, anaemia and weight loss may occur.
Diagnosis is based on the detection of worm eggs in the faeces (investigation: stool ova and parasites, O&P).

Treatment consists of mebendazole; the dose for adults and children over two years of age is 100 mg twice daily for 3 days.
Alternatives: albendazole 400 mg once daily for 3 days (the dose is 200 mg for children 1-2 years of age) or mebendazole + ivermectin (200 µg/kg once daily for 3 days; not recommended for children weighing less than 15 kg).
Mebendazole or albendazole should not be used during pregnancy, or at least not during the first trimester, even though teratogenicity has not been established. They may be used whilst breastfeeding. There is a limited amount of information on the use of ivermectin during pregnancy, and it should only be used with compelling indications.
To ensure a parasitologic cure, the stool examination should be repeated after 3 weeks.
Drug therapy is effective. Recurring infections are common in people living in endemic regions.
Trichuriasis is prevented by taking care of good toilet hygiene, washing of vegetables and root vegetables, as well as by treating infected individuals.