Trichuris trichiura, also known as the whipworm, inhabits the large intestine of humans. The female produces 2,000-10,000 eggs per day which are passed in stool and can develop into infective larvae in soil within 2-3 weeks. People can become infected by ingesting these infective eggs. Stool is suitable for diagnosis through direct wet examination or concentration techniques to detect eggs. The eggs are oval, brown, and thick-shelled measuring 60 x 40 μm. Treatment involves anthelmintic drugs such as albendazole or mebendazole. Prevention relies on proper sanitation including handwashing and avoiding use of untreated human waste as fertilizer.

1. Trichuris trichiura
The whipworm
Lecture by: Osman H. Ali

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Introduction
• Trichuris trichiura or Trichocephalus trichiuris is intestinal
nematode worm
• Inhabit a human large intestine (ceacum)
• Causing the disease known as trichiuriasis
• It is soil transmitted infection (eggs are infective stage found in soil)
• Is commonly known as the whipworm because it looks like the whip

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4. • The worms has thin anterior and thick posterior part
• They attach to intestinal mucosa by embedding their anterior part.
• They feed on tissue fluid (not blood).
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Geographical distribution:
• Worldwide distribution
• It is more common in Asia
• Less in Africa and South America.
• Rare in the United states.

6. Morphology (the worm)
Shape: round
• narrow long anterior part end and
shorter and thicker posterior.
Color: pinkish-white
Size:
♀ 35–50 mm long
♂ 30–45 mm, with a coiled
posterior end
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7. Eggs of Trichuris trichiura
•Shape: oval (barrel-shaped)
has polar hyaline mucoid
blugs
• Size: 60 x40 µm
• Color: honey brown
• Shell: Thick
• Contents:
• Mass of granules
(Unembryonated)
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8. T.trichura eggs
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9. Development of T.trichura eggs
1 Eggs are single celled when passed with human feces
2The develop into 2 cell, 4 cell, morula, egg contain larva (in soil ) 3-Thelarvated egg
(infective to human)
• The development of infective eggs in soil takes about 2-3weeks,
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How man become infected?
• Infection to man is by ingestion of the infective eggs (contain larva) that may be in
contaminated food or drink, hands with soil
• The larva hatch in the human small intestine then migrate to large intestine
• They attach to mucosa of the large intestine.
• Then develop into mature worms with in three months
• After mating female produce 2,000–10,000 single-celled eggs per day
• which come out with feces.
• Worms can live up to five years

11. Life cycle
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Pathology & Symptomatology
People with light infections usually have no symptoms.
 People with heavy infection show symptoms like:
• Frequent defecation
• Painful passage of stool
• Stool appearance: contains a mixture of mucus and blood (dysentery).
• The clinical feature is identical to amebic dysentery.

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Complications:
• Colonic obstruction because of the tangle of worms
• Ulceration of large intestine which result in blood loss.
• Iron deficiency anemia
• Rectal prolapse

14. Rectal prolapse
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Laboratory Diagnosis
1 what is /are suitable sample/s?
2what is are suitable diagnostic test/s or technique/s?
3- what is/are the diagnostic stage/s?

16. Summary:
• T. trichuria worm inhabit human large intestine
• The female produces large number of eggs 2,000–10,000 per day
• The worms are not found stool because they attach to the mucosa of
large intestine.
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1 Stool sample is suitable for the diagnosis.
2 suitable diagnostic technique:
A- direct wet examination for feces (heavy infection)
B-Concentration by sedimentation or by floatation to detect (very light
infection)
3 diagnostic stages:
eggs

18. Quality control
• Eggs of T. trichiura should be differentiated from
Capillaria philippensis eggs which may also found in stool.
C. Philippensis egg T.trichiura egg
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Treatment
Several anthelmintics drugs of choice:
• Albindazole
• Mebendozle
Prognosis
The prognosis is good in light infection Poor in heavy chronic
infection

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Prevention & control
• Prevent contamination of soil with human feces
• Construction of latrines
• Washing hands before eating (children, soil worker).
• Washing vegetables & fruits
• Do not use the night soil as fertilizer