Neobook — clinical reference

ICD-10 code: B76.0-1/B76.8-9/B77.0/B77.8/B77.9/B79/B80/B81.4/B82.0

Note:
Soil-transmitted helminth infections are notifiable conditions (i.e. Ascaris Lumbricoides, Trichuris trichiura, Ancylostoma duodenale, Necator americanus).

DESCRIPTION

Types of worm infestation and the characteristics are shown in the table below. Infestations are often asymptomatic:

Table 2.2: Types of helminthic infestations (excluding taenia) and their signs and symptoms

Type of Worm	Description	Signs and Symptoms
Common Roundworm Ascaris lumbricoides	- Long pink/white worms with sharp ends - Up to 25–30 cm long - Often seen in the stools and vomitus	- Cough - If there is vomiting consider intestinal obstruction
Pinworm Enterobius vermicularis	- White and thread-like - Up to 10 mm long - Often seen in the stools - Self-infection common	- Anal itching; worse at night - Sleeplessness
Hookworm Ancylostoma duodenale Necator americanus	- Up to 8 mm long	- No symptoms or pain - Anaemia
Whipworm Trichuris trichiura	- Up to 5 cm long - Anterior half thinner than posterior half	- No symptoms - Abdominal pain - Diarrhoea - Possible anaemia and rectal prolapse - Abdominal discomfort - Weight loss

GENERAL MEASURES

Many children with worms who have pica may have iron deficiency. Check for anaemia and failure to thrive (growth faltering).
Patient counselling and education.
Wash hands with soap and water, especially:
- after passing stool(s)
- before working with food or eating
Keep fingernails short.
Wash fruit and vegetables well before eating or cooking.
Keep toilet seats clean.
Teach children how to use toilets and wash hands.
Do not pollute the soil with sewage or sludge.
Dispose of faeces properly.
De-worm all children between 1–5 years of age every 6 months as part of routine child health care.

MEDICINE TREATMENT

Taenia (tapeworm):

See: Helminthic infestation, tapeworm.

Enterobius (pinworm):

Mebendazole, oral,
Children >1 year and adults:
100 mg as a single dose and repeated after 2 weeks.

Albendazole, oral
Children 1-2 years of age:
200mg as a single dose

Children ≥ 2 years and adults
400 mg as a single dose.

All other helminths excluding Enterobius (pinworm) and Taenia (tapeworm):

Mebendazole, oral,
Children 1–2 years:
100 mg 12 hourly for 3 days.
Children ≥ 2 years and adults:
500 mg as a single dose.

LoE:IIIb¹⁵

Albendazole, oral,
Children 1–2 years:
200 mg as a single dose.
Children ≥ 2 years and adults:
400 mg as a single dose.

If patient has iron deficiency:

See: Anaemia, iron deficiency.

REFERRAL

Signs of intestinal obstruction.
Abdominal tenderness.
Pain.
Persistent vomiting.
Complications related to migration of worm larvae.

Click here to access the pdf.

Click here for the NEMLC Recommendations for medicine amendments (2020-4 review cycle).

Standard Treatment Guidelines And Essential Medicines List For South Africa, Primary Healthcare, 2020-4_Version 1_June 2024

Chapter 2: Gastro-Intestinal Conditions, 2.11Helminthic Infestation, 2.11.2 Helminthic Infestation, Excluding Tapeworm

Helminthic Infestation, Excluding Tapeworm

DESCRIPTION

GENERAL MEASURES

MEDICINE TREATMENT

REFERRAL

Drugs mentioned

ICD-10 codes