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Trichuris trichiura
- 1. Trichuris trichiura (Whipworm) īˇ Known as the whipworm is also a soil transmitted helminth. īˇ Ascaris and Trichuris are frequently observed as occuring together. īˇ Trichuris is also notable for its small size compared with Ascaris lumbricoides. īˇ It is a very common intestinal helminthic infection, and about one quarter of the world's population is thought to carry the parasite. īˇ Tropical Asia & to a lesser degree, in Africa and South America. īˇ Only patients with heavy parasite burden become symptomatic īˇ Poor hygiene is associated with trichuriasis transmission, and children are especially vulnerable because of their high exposure risk. īˇ Prevalence of helminth infection was higher in the schools where hygiene conditions (i.e., tap water, hand washing soap) are lacking. Morphology: Adult: īˇ The worm looks like a buggy whip, the anterior 3/5 is slender and the posterior 2/5 is thick. īˇ It is pinkish gray in color. īˇ The female worm is 3-5 cm in length and has a long slender esophageal region. īˇ The male is smaller than the female and has a curved tail. īˇ The reproductive organs of male and female are all double tubule. Egg: īˇ It is barrel or spindle in shape and 50 x 20Âĩm in size. īˇ It is brownish and has a translucent polar plug at either ends. īˇ The content of the egg is an undeveloped cell
- 3. Life Cycle īˇ Site of inhabitation: cecum īˇ Infective stage: embryonic egg īˇ Infectve mode and route: passively swallowed by the mouth īˇ Without intermediate host and reservoir host īˇ The life span of the adult is about 3-5years īˇ The female T. trichiura produces 2,000â10,000 single-celled eggs per day. īˇ Eggs are deposited from human feces to soil where, after two to three weeks, they become embryonated and enter the "infective" stage. īˇ These embryonated infective eggs are ingested and hatch in the human small intestine exploiting the intestinal microflora as hatching stimulus.[3] īˇ This is the location of growth and molting. īˇ The infective larvae penetrate the villi and continue to develop in the small intestine. īˇ The young worms move to the caecum and penetrate the mucosa, and there they complete development to adult worms in the large intestine.
- 4. īˇ The life cycle from the time of ingestion of eggs to the development of mature worms takes approximately three months. īˇ During this time, there may be limited signs of infection in stool samples due to lack of egg production and shedding. īˇ The female T. trichiura begin to lay eggs after three months of maturity. Worms commonly live about 1 year during which time females can lay up to 20,000 eggs per day.
- 5. Pathogenesis: 1. Light infection: Asymptomatic 2. Middle infection: Clinical manifestations are usually abdominal pain, anorexia, diarrhea, constipation . 3. Heavy infection: Bloody diarrhea, emaciation, prolapse of the anus may occur.
- 6. Laboratory Diagnosis īˇ Direct fecal smear (DFS) with a drop of saline. īˇ Kato-Katz technique â used for egg counting to determine cure rate (CR), egg reduction rate (ERR), and intensity of infection. īˇ Formalin ether and acid ether concentration techniques īˇ CBC for Eosinophilia īˇ Histopathology of Intestinal mucosa īˇ Antibody Test īˇ PCR Treatment īˇ Mebendazole īˇ Alternatively, albendazole or ivermectin īˇ Mebendazole 100 mg orally twice a day for 3 days is recommended. īˇ A single dose of mebendazole 500 mg has been used in mass treatment programs. Alternatives are albendazole 400 mg orally once a day for 3 days or ivermectin 200 mcg/kg orally once a day for 3 days. īˇ These drugs should usually not be used during pregnancy.