China
Africa
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Communicable, infectious and parasitic conditions
Published in Jackie Musgrave, Health and Wellbeing for Babies and Children, 2022
In countries where there is clean water available, good sanitation, the resources that help to minimise the spread of infestations and a temperate climate, such worms are not likely to be present. However, threadworms are a common parasite and 40% of children are estimated to be affected by threadworms. Threadworms are spread easily on toilet seat, under finger nails and scan be difficult to eradicate. Threadworms are problematic because they can cause intense anal and vulval itching which can cause sleep disturbance. Prolonged presence of threadworms can cause lack of appetite and weight loss. Treatment is available via an oral preparation, but good hygiene measures are also required to break the cycle.
Answers
Published in Samar Razaq, Difficult Cases in Primary Care, 2021
Threadworm infections are common in young children. It may cause no symptoms whatsoever, although anal itching (due to deposition of eggs) is the most common presentation. In girls they may be a cause of vulval and vaginal irritation. Whether they are responsible for undiagnosed cases of abdominal pain or wrongly suspected appendicitis is unlikely. Eggs are picked up from anal scratching or from contaminated bedding, and ingested. The eggs hatch in the upper bowel and the larvae mature into adult worms in the caecum. Eggs are again laid on the perianal skin and the cycle continues. Eggs trapped in nails (which are then bitten) result in repetition of the life cycle of the worm. A single dose of mebendazole 100 mg has a greater than 90% success rate. The dose should be repeated after 2 weeks. Advise the parents to regularly wash the child’s hands before meals and after visits to the toilet. An early-morning bath or rinse of the anal area helps clear any eggs that may have been laid in the night.
Common problems in pregnancy
Published in Anne Lee, Sally Inch, David Finnigan, Therapeutics in Pregnancy and Lactation, 2019
Threadworm infestation is common in pregnancy. Women should be advised to try and eradicate infection through rigorous measures of hygiene, which will break the life cycle of the Enterobius parasite. With daily changing of bedlinen and nightwear, thorough scrubbing of hands and nails after going to the toilet and avoiding scratching the perianal area, the problem should clear up within a week or two. None of the available threadworm treatments have been proven safe in pregnancy and drug treatment is best avoided, particularly in the first trimester.43 Mebendazole is poorly absorbed from the gut so is unlikely to present a risk to the fetus, although toxicity in animal studies has been noted. Outwith the first trimester, mebendazole may be used if treatment is considered necessary.44,45 There is no evidence that piperazine exposure is harmful; women exposed inadvertently should be reassured.
Historical analysis of inverse correlation between soil-transmitted helminthiasis and pancreatic cancer
Published in Baylor University Medical Center Proceedings, 2021
Soil-transmitted helminths, which include Ancylostoma duodenale and Necator americanus (hookworms), Ascaris lumbricoides (roundworms), Trichuris trichiura (whipworms), and Strongyloides stercoralis (threadworms), are transmitted by eggs passed in the feces of infected humans. In regions that lack adequate sanitation (e.g., widespread open defecation, septic tank overflow), these eggs contaminate soil and freshwater sources. Larvae penetrate the skin of those walking barefoot on contaminated soil. Thus, areas lacking in hygiene and sanitation, proper sewage removal, and treatment systems are commonly endemic to STH.5