NEMATODA INTESTINAL

Trichuris trichiura
( Whipworm)
= cacing cambuk
-Disease: Trichuriasis trichiura
-DH : Humans
- Epidemiology
Whipworm is a soil-transmitted
helminth (STH) and is the third most
common roundworm of humans
Often occurs in areas where human feces is
used as fertilizer or where defecation onto soil
happens.
fecal-oral transmission or
through feces-contaminated food.
Geographic Distribution
Worldwide, infection occurs more
frequently in areas with tropical
weather and poor sanitation
practices, and among children. In
2002, the estimated number of
persons infected with whipworm was
1 billion. Trichuriasis also occurs in
the southern United States.
Morphology:
Adult:
the worm looks like a buggy whip, the anterior 3/5 is
slender and the posterior 2/5 is thick. It is pinkish gray
in color. The female worm is 3-5 cm in length and has a
long slender esophageal region. The male is smaller
than the female and has a curved tail. The reproductive
organs of male and female are all double tubule.
Egg:
it is barrel or spindle in shape and 50 x 20m in size. It is
brownish and has a translucent polar plug at either
ends. The content of the egg is an undeveloped cell
Adults of T. trichiura
 Eggs of
T. trichiura
The unembryonated eggs are passed with the stool .
In the soil, the eggs develop into a 2-cell stage , an
advanced cleavage stage , and then they embryonate
; eggs become infective in 15 to 30 days. After
ingestion (soil-contaminated hands or food), the eggs
hatch in the small intestine and quickly burrow into
the cells of intestinal viili, undergoing two molts in
about 3 to 10 days, mature, migrate to the caecum
region and develop to sexual maturity. The adult
worms (approximately 4 cm in length) live in the
cecum and ascending colon. The adult worms are
fixed in that location, with the anterior portions
threaded into the mucosa. The females begin to
oviposit 60 to 70 days after infection. 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.
Pathogenesis:
1. Light infection: Asymptomatic
2. Middle infection: Clinical manifestations are
usually abdominal pain, anorexia, diarrhea,
constipation .
3. Heavy infection: Bloody diarrhea, emaciation,
prolapse rectum may occur.

Diagnosis:
Discover the eggs in feces by saturated brine
flotation method or direct fecal smear.
Treatment and prevention:

-Same as those of Ascariasis

-Mebendazole 3 days for a treatment course
and repeat next week