The Indian Journal of Pediatrics

, Volume 85, Issue 11, pp 1017–1024 | Cite as

Worm Infestation: Diagnosis, Treatment and Prevention

  • Bhavneet BhartiEmail author
  • Sahul Bharti
  • Sumeeta Khurana
Review Article


Worm infections continue to be among the most common diseases affecting children from low and middle income countries. Major worm infections of public health importance include Ascariasis, Trichuriasis, Hookworm, and Enterobiasis, which are transmitted through contaminated soil. In India, combined prevalence rates of worm infestation as per pooled data of 127 surveys is over 20%. Although most helminthic infections are mild and are often asymptomatic, but moderate to heavy worm infestations are generally associated with growth faltering, nutritional compromise, anemia and suboptimal academic performance among children from endemic regions. Migration of larval or adult worms also underpins pulmonary and gastrointestinal morbidity in affected children. Some of the distinctive life cycle and clinical features of various worms are discussed in the review. The gold standard diagnostic technique for evaluation of worm infestation includes stool microscopy for direct egg detection and species identification. Most of the community based surveys for detecting soil transmitted helminths (STH) use Kato-Katz technique. The drug armamentarium against worm infestation has evolved tremendously in last three to four decades with the availability of more efficacious and broad spectrum anthelminthics. The key strategies of a multi-component integrated management of worm infestation include individualized treatment, community management (mass drug administration) as well as preventive measures. Finally, barriers to diagnosis, treatment and prevention of worm infestations need to be identified and aggressively managed at individual, family and societal levels so that WHO’s 75% coverage target can be achieved to eliminate soil transmitted helminthiasis in children by 2020.


Worm infestation Helminthiasis Nematode infections Neglected tropical diseases (NTD) Soil transmitted helminthiasis (STH) Anthelminthics 



BB and SB drafted the article; SK contributed significantly in the diagnostic part of the article. BB will act as guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest


Source of Funding



  1. 1.
    Chan MS. The global burden of intestinal nematode infections--fifty years on. Parasitol Today. 1997;13:438–43.CrossRefGoogle Scholar
  2. 2.
    de Silva NR, Brooker S, Hotez PJ, Montresor A, Engels D, Savioli L. Soil-transmitted helminth infections: updating the global picture. Trends Parasitol. 2003;19:547–51.CrossRefGoogle Scholar
  3. 3.
    WHO. Soil-transmitted helminthiases: eliminating soil-transmitted helminthiases as a public health problem in children: progress report 2001–2010 and strategic plan 2011–2020. 2012.Google Scholar
  4. 4.
    Kattula D, Sarkar R, Rao Ajjampur SS, et al. Prevalence & risk factors for soil transmitted helminth infection among school children in south India. Indian J Med Res. 2014;139:76–82.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Greenland K, Dixon R, Khan SA, et al. The epidemiology of soil-transmitted helminths in Bihar State, India. PLoS Negl Trop Dis. 2015;9:e0003790.CrossRefGoogle Scholar
  6. 6.
    Stephenson LS, Latham MC, Ottesen EA. Malnutrition and parasitic helminth infections. Parasitology. 2000;121:S23–38.CrossRefGoogle Scholar
  7. 7.
    Gonzalez-Moreno O, Domingo L, Teixidor J, Gracenea M. Prevalence and associated factors of intestinal parasitisation: a cross-sectional study among outpatients with gastrointestinal symptoms in Catalonia, Spain. Parasitol Res. 2011;108:87–93.CrossRefGoogle Scholar
  8. 8.
    Horton J. Global anthelmintic chemotherapy programs: learning from history. Trends Parasitol. 2003;19:405–9.CrossRefGoogle Scholar
  9. 9.
    Savioli L, Montresor A, Albonico M. Control Strategies. Netherlands: Kluwer Academic Publishers; 2002.CrossRefGoogle Scholar
  10. 10.
    Stephenson LS, Holland CV, Cooper ES. The public health significance of Trichuris trichiura. Parasitology. 2000;121:S73–95.CrossRefGoogle Scholar
  11. 11.
    Albonico M, Allen H, Chitsulo L, Engels D, Gabrielli AF, Savioli L. Controlling soil-transmitted helminthiasis in pre-school-age children through preventive chemotherapy. PLoS Negl Trop Dis. 2008;2:e126.CrossRefGoogle Scholar
  12. 12.
    Jardim-Botelho A, Raff S, Rodrigues Rde A, et al. Hookworm, Ascaris lumbricoides infection and polyparasitism associated with poor cognitive performance in Brazilian schoolchildren. Tropical Med Int Health. 2008;13:994–1004.CrossRefGoogle Scholar
  13. 13.
    Thein-Hlaing, Myat-Lay-Kyin, Hlaing-Mya, Maung-Maung. Role of ascariasis in surgical abdominal emergencies in the Rangoon Children's Hospital, Burma. Ann Trop Paediatr. 1990;10:53–60.CrossRefGoogle Scholar
  14. 14.
    Dent A, Kazura J. Nelson Textbook of Pediatrics. 20th ed. New Delhi: Elsevier; 2016.Google Scholar
  15. 15.
    Katz N, Chaves A, Pellegrino J. A simple device for quantitative stool thick-smear technique in Schistosomiasis mansoni. Rev Inst Med Trop Sao Paulo. 1972;14:397–400.PubMedGoogle Scholar
  16. 16.
    Chatterjee K. Parasitology. New Delhi: CBS Publishers & Distributors; 2009.Google Scholar
  17. 17.
    Pilotte N, Papaiakovou M, Grant JR, et al. Improved PCR-based detection of soil transmitted helminth infections using a next-generation sequencing approach to assay design. PLoS Negl Trop Dis. 2016;10:e0004578.CrossRefGoogle Scholar
  18. 18.
    Mishra PK, Agrawal A, Joshi M, Sanghvi B, Shah H, Parelkar SV. Intestinal obstruction in children due to ascariasis: a tertiary health centre experience. Afr J Paediatr Surg. 2008;5:65–70.CrossRefGoogle Scholar
  19. 19.
    Keiser J, Utzinger J. Efficacy of current drugs against soil-transmitted helminth infections: systematic review and meta-analysis. JAMA. 2008;299:1937–48.CrossRefGoogle Scholar
  20. 20.
    Adegnika AA, Zinsou JF, Issifou S, et al. Randomized, controlled, assessor-blind clinical trial to assess the efficacy of single- versus repeated-dose albendazole to treat ascaris lumbricoides, trichuris trichiura, and hookworm infection. Antimicrob Agents Chemother. 2014;58:2535–40.CrossRefGoogle Scholar
  21. 21.
    Keiser J, Speich B, Utzinger J. Oxantel pamoate-albendazole for Trichuris trichiura infection. N Engl J Med. 2014;370:1953–4.PubMedGoogle Scholar
  22. 22.
    Anderson VR, Curran MP. Nitazoxanide: a review of its use in the treatment of gastrointestinal infections. Drugs. 2007;67:1947–67.CrossRefGoogle Scholar
  23. 23.
    Strunz EC, Addiss DG, Stocks ME, Ogden S, Utzinger J, Freeman MC. Water, sanitation, hygiene, and soil-transmitted helminth infection: a systematic review and meta-analysis. PLoS Med. 2014;11:e1001620.CrossRefGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2017

Authors and Affiliations

  • Bhavneet Bharti
    • 1
    Email author
  • Sahul Bharti
    • 2
  • Sumeeta Khurana
    • 3
  1. 1.Department of Pediatrics, Advanced Pediatrics CenterPostgraduate Institute of Medical Education and ResearchChandigarhIndia
  2. 2.Build Healthy India Movement, NGOChandigarhIndia
  3. 3.Department of ParasitologyPostgraduate Institute of Medical Education and ResearchChandigarhIndia

Personalised recommendations