Internal medicine

Tropical disease

Disease

Ascariasis

Helminthiasis

Biology

Zoology

Helminths

Trichuris trichiura

Immunology

Neglected tropical diseases

Mebendazole

Ascaris lumbricoides

Trichuriasis

Trichuris

Medicine

Nature Reviews Disease Primers

Trichuriasis and ascariasis are neglected tropical diseases caused by the gastrointestinal dwelling nematodes Trichuris trichiura (a whipworm) and Ascaris lumbricoides (a roundworm), respectively. Both parasites are staggeringly prevalent, particularly in tropical and subtropical areas, and are associated with substantial morbidity. Infection is initiated by ingestion of infective eggs, which hatch in the intestine. Thereafter, T. trichiura larvae moult within intestinal epithelial cells, with adult worms embedded in a partially intracellular niche in the large intestine, whereas A. lumbricoides larvae penetrate the gut mucosa and migrate through the liver and lungs before returning to the lumen of the small intestine, where adult worms dwell. Both species elicit type 2 anti-parasite immunity. Diagnosis is typically based on clinical presentation (gastrointestinal symptoms and inflammation) and the detection of eggs or parasite DNA in the faeces. Prevention and treatment strategies rely on periodic mass drug administration (generally with albendazole or mebendazole) to at-risk populations and improvements in water, sanitation and hygiene. The effectiveness of drug treatment is very high for A. lumbricoides infections, whereas cure rates for T. trichiura infections are low. Novel anthelminthic drugs are needed, together with vaccine development and tools for diagnosis and assessment of parasite control in the field. Whipworm and roundworm infections are neglected tropical diseases caused by the gastrointestinal nematode parasites Trichuris trichiura and Ascaris lumbricoides, respectively. These soil-transmitted helminths are prevalent in tropical areas and affect hundreds of millions of people, with substantial morbidity and disease burden.

Whipworm and roundworm infections