Skip to main content

Advertisement

SpringerLink
Log in

An update on the geohelminths: Ascaris lumbricoides, hookworms, Trichuris trichiura, and Strongyloides stercoralis

  • Published:
Current Infectious Disease Reports Aims and scope Submit manuscript

Abstract

Geohelminths remain prevalent throughout the developing world where levels of sanitation, personal hygiene, and maternal education are low. The five species of nematodes responsible for the bulk of disease are Ascaris lumbricoides, the hookworms Ancylostoma duodenale and Necator americanus, Trichuris trichiura, and Strongyloides stercoralis. Geohelminths are acquired through ingestion of fecally contaminated food or water or through contact with infected soil. In developing countries, infection with more than one nematode species and high worm burdens are common. The morbidity is substantial, particularly among children, and deaths occur. Geohelminthic infections are encountered in industrialized countries among immigrants and long-term travelers who have lived in endemic regions where sanitation is poor, and occasionally following autochthonous transmission.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Drake LJ, Bundy DA: Multiple helminth infections in children: impact and control. Parasitol 2001, 122(Suppl):S73-S81. This is an excellent review of the impact of intestinal helminths worldwide and the efficacy of control measures.

    Google Scholar 

  2. Guyatt HL: Mass chemotherapy and school-based anthelmintic delivery. Trans R Soc Trop Med Hyg 1999, 93:12–13.

    Article  PubMed  CAS  Google Scholar 

  3. de Silva NR, Chan MS, Bundy DA: Morbidity and mortality due to ascariasis: re-estimation and sensitivity analysis of global numbers at risk. Trop Med Int Health 1997, 2:519–528. It is estimated that 1300 million people globally are infected with A. lumbricoides, with 12 million cases of acute illness and 10,000 deaths per year. Children account for a disproportionate share of morbidity.

    PubMed  Google Scholar 

  4. Williams-Blangero S, Subedi J, Upadhayay RP, et al.: Genetic analysis of usceptibility to infection with Ascaris lumbricoides. Am J Trop Med Hyg 1999, 60:921–926.

    PubMed  CAS  Google Scholar 

  5. McSharry C, Xia Y, Holland CV, Kennedy MW: Natural immunity to Ascaris lumbricoides associated with immunoglobulin E antibody to ABA-1 allergen and inflammation indicators with children. Infect Immun 1999, 67:484–489.

    PubMed  CAS  Google Scholar 

  6. Lynch NR, Hagel IA, Palenque ME, et al.: Relationship between helminthic infection and IgE response in atopic and nonatopic children in a tropical environment. J Allergy Clin Immunol 1998, 101:217–221.

    Article  PubMed  CAS  Google Scholar 

  7. Sarinas PS, Chitkara RK: Ascariasis and hookworm. Semin Respir Infect 1997, 12:130–137.

    PubMed  CAS  Google Scholar 

  8. De Silva NR, Guyatt HL, Bundy DA: Worm burden in intestinal obstruction caused by Ascaris lumbricoides. Trop Med Int Health 1997, 2:189–190. This is an excellent review of intestinal obstruction due to A. lumbricoides. Of patients presenting to the hospital with intestinal obstruction, most were children. The worm burden was typically greater than 60 and approximately tenfold higher in fatal cases.

    Article  PubMed  Google Scholar 

  9. de Silva NR, Guyatt HL, Bundy DA: Morbidity and mortality due to Ascaris-induced intestinal obstruction. Trans R Soc Trop Med Hyg 1997, 91:31–36. In 12 studies of Ascaris-induced intestinal obstruction, the casefatality rate ranged from 0% to 8.6%, with a weighted mean of 5.7%. The mean age of obstruction was less than 5 years in six of seven studies in which the age was specified.

    Article  PubMed  Google Scholar 

  10. Mani S, Merchant H, Sachdev R, et al.: Sonographic evaluation of biliary ascariasis. Australas Radiol 1997, 41:204–206.

    PubMed  CAS  Google Scholar 

  11. Misra SP, Dwivedi M: Clinical features and management of biliary ascariasis in a non-endemic area. Postgrad Med J 2000, 76:29–32.

    Article  PubMed  CAS  Google Scholar 

  12. Yamamoto H, Tamada K, Tomiyama T, et al.: Ascaris pancreatitis; early diagnosis by ultrasonography and endoscopic treatment. Endocopy 1998, 30:316.

    CAS  Google Scholar 

  13. Misra SP, Dwivedi M, Misra V, et al.: Preoperative sonographic diagnosis of acute appendicitis caused by Ascaris lumbricoides. J Clin Ultrasound 1999, 27:96–97.

    Article  PubMed  CAS  Google Scholar 

  14. Beitia AO, Haller JO, Kantor A: CT findings in pediatric gastrointestinal ascariasis. Comput Med Imaging Graph 1997, 21:47–49.

    Article  PubMed  CAS  Google Scholar 

  15. Nontasut P, Waitkagul J, Muennoo C, et al.: Minimum effective doses of mebendazole in treatment of soil-transmitted helminths. Southeast Asian J Trop Med Public Health 1997, 28:326–328.

    PubMed  CAS  Google Scholar 

  16. Gonzalez AH, Regalado VC, van den Ende J: Non-invasive management of Ascaris lumbricoides biliary tract migration: a prospective study in 69 patients from Ecuador. Trop Med Intern Health 2001, 6:146–150.

    Article  CAS  Google Scholar 

  17. Grencis RK, Cooper ES: Enterobius, trichuris, capillaria, and hookworm including Ancylostoma caninum. Gastroenterol Clin North Am 1996, 25:579–597.

    Article  PubMed  CAS  Google Scholar 

  18. Stoltzfus RJ, Dreyfuss ML, Chwaya HM, Albonico M: Hookworm control as a strategy to prevent iron deficiency. Nutr Rev 1997, 55:223–232. The prevalence of hookworm infection increases with age in children and typically plateaus in late adolescence. Intestinal blood loss is proportional to the number of adult worms in the gut. Hookworms are an important cause of anemia in women, who are often overlooked by current helminth control programs that target school-aged children.

    Article  PubMed  CAS  Google Scholar 

  19. Brown A, Girod N, Billett EE, Pritchard DI: Necator americanus (human hookworm) aspartyl proteinases and digestion of skin macromolecules during skin penetration. Am J Trop Med Hyg 1999, 60:840–847.

    PubMed  CAS  Google Scholar 

  20. Furmidge BA, Horn LA, Pritchard DI: The anti-haemostatic strategies of the human hookworm Necator americanus. Parasitology 1996, 112:81–87.

    Article  PubMed  Google Scholar 

  21. Chadderdon RC, Cappello M: The hookworm platelet inhibitor: functional blockade of integrins GPIIb/IIIa (alphaIIbbeta3) and GPIa/IIa (apha2beta1) inhibits platelet aggregation and adhesion in vitro. J Infect Dis 1999, 179:1235–1241.

    Article  PubMed  CAS  Google Scholar 

  22. Cappello M, Hawdon JM, Jones BF, et al.: Ancylostoma caninum anticoagulant peptide: cloning by PCR and expression of soluble, active protein E. coli. Mol Biochem Parasitol 1996, 80:113–117.

    Article  PubMed  CAS  Google Scholar 

  23. De Clercq D, Sacko M, Behnke J, et al.: Failure of mebendazole in treatment of human hookworm infections in the southern region of Mail. Am J Trop Med Hyg 1997, 57:25–30.

    PubMed  Google Scholar 

  24. Marti H, Haji HJ, Savioli L, et al.: A comparative trial of a single-dose ivermectin versus three days of albendazole for treatment of Strongyloides stercoralis and other soiltransmitted helminth infections in children. Am J Trop Med Hyg 1996, 55:477–481.

    PubMed  CAS  Google Scholar 

  25. Stephenson LS, Holland CV, Cooper ES: The public health significance of Trichuris trichiura. Parasitology 2000, 121(Suppl):S73-S95.

    Article  PubMed  Google Scholar 

  26. Faulkner H, Renauld J, Van Snick JC, Grencis RK: Interleukin-9 enhances resistance to the intestinal nematode Trichuris muris. Infect Immun 1998, 66:3832–3840.

    PubMed  CAS  Google Scholar 

  27. Bancroft AJ, Else KJ, Sypek JP, Grencis RK: Interleukin-12 promotes a chronic intestinal nematode infection. Eur J Immunol 1997, 27:866–870.

    Article  PubMed  CAS  Google Scholar 

  28. Grencis RK, Entwistle GM: Production of an interferongamma homologue by an intestinal nematode: functionally significant or interesting artifact? Parasitolgy 1997, 115(Suppl):S101-S106.

    Article  Google Scholar 

  29. Bancroft AJ, Artis D, Donaldson DD, Sypek JP, Grencis RK: Gastrointestinal nematode expulsion in IL-4 knockout mice is IL-13 dependent. Eur J Immunol 2000, 30:2083–2091.

    Article  PubMed  CAS  Google Scholar 

  30. Mahmoud AA: Strongyloidiasis. Clin Infect Dis 1996, 23:949–952.

    PubMed  CAS  Google Scholar 

  31. Kitchen LW, Tu KK, Kerns FT: Strongyloides-infected patients at Charleston area medical center, West Virginia, 1997–1998. Clin Infect Dis 2000, 31:E5-E6.

    Article  PubMed  CAS  Google Scholar 

  32. Wehner JH, Kirsch CM: Pulmonary manifestations of strongyloidiasis. Sem Respir Infect 1997, 12:122–129.

    CAS  Google Scholar 

  33. Gotuzzo E, Terashima A, Alvaez H, et al.: Stronglyoides sterocoralis hyperinfection associated with human T cell lymphotropic virus type-1 in Peru. Am J Trop Med Hyg 1999, 60:146–149.

    PubMed  CAS  Google Scholar 

  34. Neva FA, Filho JO, Gam AA, et al.: Interferon-gamma and interleukin-4 responses in relation to serum IgE levels in persons infected with human T lymphotropic virus type I and Stronglyoides stercoralis. J Infect Dis 1998, 178:1856–1859.

    Article  PubMed  CAS  Google Scholar 

  35. Plumelle Y, Gonin C, Edouard A, et al.: Effect of Strongyloides stercoralis infection and eosinophilia on age at onset and prognosis of adult T-cell leukemia. Am J Clin Pathol 1997, 107:81–87.

    PubMed  CAS  Google Scholar 

  36. Rotman HL, Schnyder-Candrian S, Scott P, et al.: IL-12 eliminates the Th-2 dependent protective immune response of mice to larval Strongyloides stercoralis. Parasite Immunol 1997, 19:29–39.

    Article  PubMed  CAS  Google Scholar 

  37. Palau LA, Pankey GA: Strongyloides hyperinfection in a renal transplant recipient receiving cyclosporine: possible Strongyloides stercoralis transmission by kidney transplant. Am J Trop Med Hyg 1997, 57:413–415.

    PubMed  CAS  Google Scholar 

  38. Guerin JM, Leibinger F, Mofredji A: Stronglyoides stercoralis infection in patients infected with human immunodeficiency virus. Clin Infect Dis 1997, 24:95.

    PubMed  CAS  Google Scholar 

  39. Cahill KM, Shevchuk M: Fulminant, systemic strongyloidiasis in AIDS. Ann Trop Med Parasitol 1996, 90:313–318.

    PubMed  CAS  Google Scholar 

  40. Sarangarajan R, Belmonte AH, Tchertkoff V: Strongyloides stercoralis hyperinfection diagnosed by gastric cytology in an AIDS patient. AIDS 1997, 11:394–396.

    PubMed  CAS  Google Scholar 

  41. Sarangarajan R, Ranganathan A, Belmonte AH, Tchertkoff V: Strongyloides stercoralis infection in AIDS. AIDS Patient Care STD 1997, 11:407–414.

    Article  CAS  Google Scholar 

  42. Husni RN, Gordon SM, Longworth DL, Adal KA: Disseminated Stronglyoides stercoralis infection in an immunocompetent patient. Clin Infect Dis 1996, 23:663.

    PubMed  CAS  Google Scholar 

  43. Upadhyay D, Corbridge T, Jain M, Shah R: Pulmonary hyperinfection syndrome with Strongyloides stercoralis. Am J Med 2001, 111:167–169.

    Article  PubMed  CAS  Google Scholar 

  44. Weight SC, Barrie WW: Colonic Strongyloides stercoralis infection masquerading as ulcerative colitis. J R Coll Surg Edinburgh 1997, 42:202–203.

    CAS  Google Scholar 

  45. Gutierrez Y, Bhatia P, Garbadawala ST, et al.: Strongyloides stercoralis eosinophilic granulomatous enterocolitis. Am J Surg Pathol 1996, 20:603–612.

    Article  PubMed  CAS  Google Scholar 

  46. Beeching NJ, Gill GV: Sub-acute intestinal obstruction by Strongyloides stercoralis. J Infect 1996, 32:170.

    Article  PubMed  CAS  Google Scholar 

  47. Friedenberg F, Wongpraparut N, Fischer RA, et al.: Duodenal obstruction caused by Stronglyoides stercoralis in an HTLV-1-infected host. Dig Dis Sci 1999, 44:1184–1188.

    Article  PubMed  CAS  Google Scholar 

  48. Iwamoto T, Kitoh M, Kayashima K, Ono T: Larva currens: the usefulness of the agar plate method. Dermatology 1998, 196:343–345.

    Article  PubMed  CAS  Google Scholar 

  49. Jongwutiwes S, Charoenkorn M, Sitthichareoncahai P, et al.: Increased sensitivity of routine laboratory detection of Strongyloides stercoralis and hookworm by agar-plate culture. Trans R Soc Trop Med Hyg 1999, 93:398–400.

    Article  PubMed  CAS  Google Scholar 

  50. Adenusi AA: Cure by ivermectin of a chronic, persistent, intestinal strongyloidiasis. Acta Trop 1997, 66:163–167.

    Article  PubMed  CAS  Google Scholar 

  51. Ashraf M, Gue CL, Baddour LM: Case report: strongyloidiasis refractory to treatment with ivermectin. Am J Med Sci 1996, 311:178–179.

    Article  PubMed  CAS  Google Scholar 

  52. Albonico M, Stoltzfus RL, Savioli L, et al.: A controlled evaluation of two school-based anthelminthic chemotherapy regimens on intensity of intestinal helminth infections. Int J Epidemiol 1999, 28:591–596.

    Article  PubMed  CAS  Google Scholar 

  53. Stephenson LS, Latham MC, Adams EJ, et al.: Physical fitness, growth and appetite in Kenyan school boys with hookworm, Trichuris trichiura and Ascaris lumbricoides infections are improved four months after a single dose of albendazole. J Nutr 1993, 123:1036–1046.

    PubMed  CAS  Google Scholar 

  54. Stephenson LS, Latham MC, Adams EJ, et al.: Weight gain of Kenyan school children infected with hookworm, Trichuris trichiura and Ascaris lumbricoides is improved after once- or twice-yearly treatment with albendazole. J Nutr 1993, 123:656–665.

    PubMed  CAS  Google Scholar 

  55. Stoltzfus RJ, Albonico M, Tielsch JM, et al.: School-based deworming program yields small improvement in growth of Zanzibari children after one year. J Nutr 1997, 127:2187–2193.

    PubMed  CAS  Google Scholar 

  56. Watkins WE, Pollitt E: Effect of removing Ascaris on the growth of Guatemalan schoolchildren. Pediatrics 1996, 97:871–876.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Geographic and International Medicine, Department of Medicine, University of Virginia Health System, Box 800379, 22908, Charlottesville, VA, USA

    Richard D. Pearson MD

Authors
  1. Richard D. Pearson MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pearson, R.D. An update on the geohelminths: Ascaris lumbricoides, hookworms, Trichuris trichiura, and Strongyloides stercoralis . Curr Infect Dis Rep 4, 59–64 (2002). https://doi.org/10.1007/s11908-002-0068-1

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11908-002-0068-1

Keywords

Search

Navigation