Trichuriasis

Trichuriasis

Trichuriasis is a helminthiasis (nematodosis) that occurs with a lesion of the gastrointestinal tract. Etiology. The causative agent is a roundworm (nematode) Trichuris trichiura (Trichocephalus trichiurus)

    • The anterior part of the helminth is hairy (hence the name of the helminth – whipworm), the posterior end is thickened. The male is 30-45 mm long, the tail is spirally curved, it contains the intestines. The female is 35-55 mm long, the caudal end is slightly curved, it contains the intestines and uterus. Life expectancy is 5 years. The eggs are yellowish-brown in color, reminiscent of a lemon with transparent and colorless plugs at the poles; dimensions 47-52×22-23 microns; the content is fine-grained, covered with a multi-layered smooth shell. Epidemiology. The final host and source of invasion is man. The route of infection is fecal-oral. The disease is common

everywhere in countries with a warm and humid climate, especially in the tropics (up to 80% of all cases). The incidence in the world is 1 billion cases per year. Most often, trichuriasis is observed when using agricultural products grown in the fields with a violation of the soil disinfection regime. Vlasoglav parasitizes in the caecum and appendix, with massive invasions (the number of individuals reaches 3,000 or more) – throughout the colon to the anus. Adult individuals are fixed on the wall of the intestine, penetrating it with a thin anterior end, the thick end of the body hangs down into the intestinal lumen. The female lays 3,000-10,000 eggs daily. With faeces, immature eggs enter the soil, where, at a humidity of 70–90% and a temperature of 15–35 ° C, they mature, and larvae are formed with a stylet-like formation at the anterior end. Depending on the temperature, maturation takes from 2 weeks to 3-4 months; eggs can be stored in the soil for 1-2 years. Invasive larvae emerge from eggs that have penetrated into the human intestine, which penetrate into the villi of the mucous membrane of the small intestine, where they remain for 3-10 days. Then the larvae slowly migrate through the intestinal lumen into the caecum and ascending colon. Here, having penetrated into the mucous membrane, they turn into sexually mature worms within 1-3 months and begin to lay eggs. The latter with faeces enter the soil, where, under favorable conditions, after 2-4 weeks they develop to invasive stages. where they stay for 3-10 days. Then the larvae slowly migrate through the intestinal lumen into the caecum and ascending colon. Here, having penetrated into the mucous membrane, they turn into sexually mature worms within 1-3 months and begin to lay eggs. The latter with faeces enter the soil, where, under favorable conditions, after 2-4 weeks they develop to invasive stages. where they stay for 3-10 days. Then the larvae slowly migrate through the intestinal lumen into the caecum and ascending colon. Here, having penetrated into the mucous membrane, they turn into sexually mature worms within 1-3 months and begin to lay eggs. The latter with faeces enter the soil, where, under favorable conditions, after 2-4 weeks they develop to invasive stages.

Clinical picture

    • In the majority of cases (with non-cordial infection), the disease is asymptomatic
    • Symptoms (with a large number of parasites): abdominal pain, fatigue, loss of appetite, increased salivation, constipation (sometimes alternating with diarrhea), hypo- or normochromic anemia
    • In places where parasites accumulate, infiltrates and erosion are formed.
    • In tropical regions, with intensive invasions, cases of hemocolitis are noted (in babies and women in labor with rectal prolapse).

The research method is the detection of parasite eggs in feces.

Treatment

    • Mebendazole 100 mg twice a day for 3 days. If necessary, the course is repeated at intervals of 1-1.5 months
    • With contraindications to mebendazole – oxygen therapy (introduction of oxygen through a tube into the intestine).

Prevention – see Ascariasis Synonyms

  • Trichuria
  • Trichiuriasis ICD. B79 Trichuria Literature. 129:262-263

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