Helminthiasis, Intestinal
Description Diagnostic criteria General and supportive measure Medicine treatment Referral ICD-10 code: B82.0 DESCRIPTION Infestation of the intestine with adult worms. The following species are commonly encountered: Ascaris lumbricoides (round worm). Enterobius vermicularis (pin worm). Trichuris trichiura (whipworm). Ancylostoma duodenale and Necator americanus (hookworm). Taenia saginatum
General and supportive measure
ICD-10 code: B82.0
DESCRIPTION
Infestation of the intestine with adult worms. The following species are commonly encountered:
- Ascaris lumbricoides (round worm).
- Enterobius vermicularis (pin worm).
- Trichuris trichiura (whipworm).
- Ancylostoma duodenale and Necator americanus (hookworm).
- Taenia saginatum and Taenia solium (beef and pork tapeworms).
DIAGNOSTIC CRITERIA
Clinical
- Most infestations are asymptomatic and become apparent with the passage of a worm rectally or orally.
- Signs and symptoms include:
- vague abdominal pains,
- perianal itch,
- diarrhoea,
- vaginitis,
- rectal prolapse,
- iron deficiency anaemia, and
- protein losing enteropathy.
- Surgical complications are secondary to mechanical obstruction in the bowel, pancreatic duct or biliary tree.
- Migration of worm larvae may cause cutaneous, pulmonary or cerebral symptoms. See: Neurocysticercosis.
Investigations
- Identification of the adult worm from stool or vomitus.
- Stool microscopy (fresh sample): Recognition of the worm or identification of worm eggs or proglottids in stool.
GENERAL AND SUPPORTIVE MEASURES
Prevent infestation by:
- Hand washing.
- Careful preparation of foods by adequate washing and cooking.
- Wearing shoes (hookworm).
- Improved sanitation will protect the environment from contamination.
Deworming for all children between 12–60 months is performed 6 monthly as part of routine child health care.
MEDICINE TREATMENT
All helminths excluding Taenia and Enterobius:
Children 1–2 years of age:
- Mebendazole, oral, 100 mg 12 hourly for 3 days.
Children > 2 years:
- Mebendazole, oral, 500 mg as a single dose immediately.
Enterobius
- Mebendazole, oral, 100 mg immediately as a single dose.
- Repeat after 2 weeks.
Taenia
- Albendazole, oral, daily for three days.
- If 1–2 years of age: 200 mg.
- If > 2 years of age: 400 mg.
REFERRAL
- All patients with mechanical obstruction and complications related to migration of worm larvae.
Standard Treatment Guidelines and Essential Medicines List for South Africa Paediatric Hospital _2023, 5th edition_Updated July 2024
Chapter 8: Infective/Infectious Diseases, 8.1 Helminthiasis, Intestinal