TRICHURIASIS

Trichuriasis is a parasitic infection primarily in the tissue of the cecum, appendix, colon and rectum
that is caused by Trichuris trichiura(whipworm), an intestinal parasitic nematode.

Trichuris trichiura

Morphology:

 Adult: the worm looks like a buggy whip, the anterior 3/5 is slender and the posterior
2/5 is thick. It is pinkish gray in color. The female worm is 3-5 cm in length and has a long
slender esophageal region. The male is smaller than the female and has a curved tail.
The reproductive organs of male and female are all double tubule.

 Egg: it is barrel or spindle in shape and 50 x 20µm in size. It is brownish and has a
translucent polar plug at either ends. The content of the egg is an undeveloped cell.

Epidemiology:

 The third most common whip worm of humans. 

 Worldwide, with infections more frequent in areas with tropical weather and poor sanitation
practices, and among children. 

  It is estimated that 600-800 million people are infected worldwide with 3.2 billion individuals
at risk

Transmission:

 Transmitted primarily through the ingestion of embryonated eggs from infected foods such
as fruits and vegetables 
Life cycle:

Clinical features and symptoms:

 Light infection: Asymptomatic.

 Middle infection: Clinical manifestations are usually abdominal pain, anorexia, diarrhea and
constipation.
 Heavy infection: Bloody diarrhea, emaciation and prolapse rectum may occur (in
malnourished children).

Diagnosis:

 Discover the eggs and charcot-leyden crystals in feces by floatation method.

 By direct fecal smear.
  Sigmoidoscopy may show worms attached to the mucus membrane or sometimes intact
worms may be passed out in the feces.


Treatment:

 Mebendazole: 90% effective in the first dose. 3 days for a treatment course and repeat if
necessary.
 Albendazole: can be offered as an anti-parasitic agent.
 Oxantel plus pyrantel pamoate: dosage is 10 to 12mg/kg body weight as a single dose.
Heavy infections, treatment may be repeated for 2-3 times.
 Iron addition in blood stream helps to solve iron deficiency and rectal prolapse.

Prevention and control:

 Training adults and children in proper sanitary disposal of feces and washing of hands is
necessary.
 Treating water sources before use.
 Avoid living in overcrowded places and using human feces as fertilizer on farms.