SOIL HELMINTH

INFECTION/SOIL
TRANSMITTED
INFECTION

EPIDEMIOLOGY

Soil-transmitted helminths
Roundworms (Ascaris lumbricoides)
Whipworms (Trichuris trichiura)
Hookworms (Necator americanus and
Ancylostoma duodenale)
are among the most common causes of infection
in people who live in the developing world.
WHO estimates that over 270 million preschool
(PSC) children and over 600 million school-age
children (SAC) are living in areas where these
parasites are intensively transmitted, and are in
need of treatment and preventive interventions

MODE OF TRANSMISSION

eggs in human faeces------soil----- lack of

sanitation (food, hands, utensils)----ingestion
of infective eggs or larvae
penetration of the skin---- infective larvae
STH DO NOT multiply in the human host,
reinfection occurs only as a result of contact
with infective stages in the environment.

HOW THE DISTURB HUMAN

HOST?

Feeding on host tissues, including blood,

which leads to a loss of iron and protein (2,
3)
Increasing malabsorption of nutrients. In
addition, roundworm may possibly compete
for vitamin A in the intestine (4).
Loss of appetite and therefore a reduction of
nutrition intake and physical fitness
(5) Causing diarrhoea and dysentery (6).

IMPACT

Growth and physical development (7).

impair cognitive development (8, 9),
limit educational advancement
hinder economic development (10).

PREVENTION AND CONTROL

Drug should be administered to children without

previous individual diagnosis in endemic area (11).
Periodic drug treatment (deworming) to all
children living in endemic areas
(once a year when the prevalence of soiltransmitted helminth infections in the community
is over 20%,
and twice a year when the prevalence of soiltransmitted helminth infections in the community
is over 50%).
This intervention reduces morbidity by reducing
the worm burden (12).

Health and hygiene education reduces

transmission and reinfection by encouraging
healthy behaviours (13).
Provision of adequate sanitation is also
important but not always possible in
resource-poor settings.

The recommended drugs (albendazole 400

mg and mebendazole 500 mg) are effective,
inexpensive and easy to administer by nonmedical personnel (e.g. teachers) (14).
They have been through extensive safety
testing and have been used in millions of
people with few and minor side-effects.

A recent meta-analysis indicates that if the

prevalence of soil-transmitted helminths is 50% or
more, deworming leads to significant extra gains in
weight, height, mid-upper arm circumference and
skinfold thickness in comparison with untreated
controls; there was no evidence of an immediate
effect on haemoglobin concentration (15). However,
it is important to note that improvements in
anthropometry do not occur as a result of deworming
alone, and if the extra nutrients required for catchup growth are not available, growth rates are likely
to remain unchanged (15). Deworming has also been
linked to improvements in appetite (16), which may
contribute to increased growth.

Periodic deworming can be easily integrated with

child health days or supplementation programmes
for preschool children, or integrated with school
health programmes. In 2009, over 300 million
preschool and school-age children were dewormed
in endemic countries, corresponding to 35% of the
children at risk (17). The global target is to cover
at least 75% of these at-risk children (18). Schools
provide a particularly good entry point for
deworming activities, as they allow easy provision
of the health and hygiene education component
such as the promotion of hand washing and
improved sanitation.

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