3. OVERVIEW OF WHIPWORM
BIOLOGY
KEYWORDS: TRICHURIS TRICHIURA, LARGE INTESTINE, POOR HYGIENE, SOIL-CONTAMINATED HANDS OR FOODS
LIFE CYCLE FACTS
• Female worms in the cecum shed
between 3,000 and 20,000 eggs per day
• The life span of the adults is about 1 year
• Only patients with heavy parasite
burden become symptomatic
• Vitamin A deficiency has been seen in
patients with infection
• Small amounts of whipworms might not
cause any symptoms&
TRANSMISSION
4. OVERVIEW OF WHIPWORM
DIAGNOSIS • Microscopically identify whipworm eggs in a stool sample
SYMPTOMS
• Frequent, painful passage of stool that contains a mixture of mucus, water, and blood
• Bloody diarrhea has an acrid smell due to severe vitamin and iron loss
• In severe cases growth retardation can occur. Rectal prolapse can also occur
Left: Egg of T. trichiura in an iodine-stained wet mount
Right: Egg of T. trichiura in an unstained wet mount
Middle: Micrograph of an adult female Trichuris human whipworm
For Heavy Infection
5. OVERVIEW OF WHIPWORM
TREATMENT
ANTHELMINTHIC MEDICATIONS
(Drugs that rid the body of parasitic worms)
ALBENDAZOLE MEBENDAZOLE
Infections are generally treated for 3 days
The drugs appear to have few side effects
6. OVERVIEW OF WHIPWORM
EVALUATION OF ALBENDAZOLE
KEYWORDS: DEVELOPING COUNTRIES, SCHOOL AGE CHILDREN, GENERALLY LOW CURE RATE, MEDIUM EGG REDUCTION RATE
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
100.00%
Uganda Thailand Tanzania
(3)
South
Africa
Phillipines
(2)
Peru Panama Nigeria Nepal (3) Malaysia
(2)
Laos Kenya (2) Haiti (2) Ethiopia
(3)
China (2) Cameroon Average
Total
Efficacy of One Dosage of Albendazole (400 mg)
Cure Rate Egg Reduction Rate
Average CR: 36.99% Average ERR: 67.64%
7. OVERVIEW OF WHIPWORM
MEDICAL EXPERTS ON USAGE OF ALBENDAZOLE
STUDY: Efficacy of albendazole against the whipworm Trichuris Trichiura — a randomised, controlled trial
Conclusion:
“The results supported the hypothesis in that the 400 mg dose of Albendazole had an inferior
cure rate (range 16.1 - 25.8%), even when repeated regularly at intervals of approximately 4
months. On all the treatment occasions, the cure rates for the 800 and 1 200 mg doses were
not significantly different but were better than those for the 400 mg dose (p = 0.001).The
repeated treatments did not increase cure rates significantly after the initial differential effect
of each dose.”
8. OVERVIEW OF WHIPWORM
EVALUATION OF MEBENDAZOLE
0.00%
20.00%
40.00%
60.00%
80.00%
100.00%
Tanzania (1) Tanzania
(Pemba)
Tanzania
(Zanzibar)
Brazil,
Cambodia,
Cameroon,
Ethiopia, United
Republic of
Tanzania, and
Vietnam
Cameroon China Ethiopia Ethiopia (2) South Africa Tanzania (3) Tanzania (4) Viet Nam
Efficacy of One Dosage of Mebendazole (500 mg)
Cure Rate Egg Reduction Rate
Average CR: 45.10% Average ERR: 65.03%
KEYWORDS: MEDIUM CURE RATE & MEDIUM EGG REDUCTION RATE
9. OVERVIEW OF WHIPWORM
COMPARISON
Albendazole and Mebendazole Administered Alone or in Combination with
Ivermectin against Trichuris trichiura: A Randomized Controlled TrialSTUDY:
• The highest CR (55%) was achieved with a Mebendazole-Ivermectin combination, followed by
Albendazole-Ivermectin (38%).
• Particularly low CRs were achieved when administering Albendazole and Mebendazole alone
(10% and 19%, respectively)
“The addition of ivermectin to albendazole and mebendazole improves treatment outcomes against T. trichiura
and will have an extra beneficial effect against an often coendemic but neglected soil-transmitted helminth”
ADDITIONAL INTERPRETATION
11. OVERVIEW OF WHIPWORM
REFERENCES
Center for Disease
Control and Prevention
Medscape
MedlinePlus
Healthline
Global Health Impact Project
CONTRIBUTORS
Professor Nicole Hassoun
Sharon Cruz
Chelsea Gallay
Michael Fiechter
