Light infections are usually asymptomatic. Occasionally, there
may be anorexia or vague abdominal discomfort. In moderate infections, abdominal
pain (often in the right lower quadrant), low-grade fever, nausea,
vomiting, weight loss, and pruritus are the most frequent complaints.
Heavy infections may be accompanied by diarrhea, tenesmus, blood-streaked
stools, and rectal prolapse, often with worms visibly imbedded in
the rectal mucosa. Trichuriasis is difficult to differentiate clinically
from other intestinal nematode infections or from intestinal amebiasis. Chronic
infection can lead to impaired growth, physical fitness, and cognitive
function.
Diagnosis is made by examining the stool for the characteristic
ova. Concentration techniques may increase the yield in light infections. Mebendazole
(Vermox) is commonly used for treating trichuriasis in both adults
and children.4,5 The dose is the same for adults and
children (100 mg by mouth twice daily for 3 days or 500 mg once),
although single-dose mebendazole therapy for trichuriasis is not
reliably effective. Albendazole is an excellent alternative, and according
to some studies is significantly better than mebendazole. The dose
is 400 mg daily for 3 days. Studies of mass chemotherapy have found
that 800 mg once is equally if not more effective in decreasing
the prevalence of trichuriasis.6 Problems with
rectal prolapse subside with treatment.