Hymenolepiasis

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Symptoms

It is not clear that hymenolepiasis necessarily have any symptoms. The symptoms of hymenolepiasis are traditionally described as abdominal pain, loss of appetite (anorexia), itching around the anus, irritability and diarrhea. However, in one study of 25 patients conducted in Peru, successful treatment of the infection made no significant difference to symptoms.[1] Some authorities report that heavily infected cases are more likely to be symptomatic.[2][3]

Signs and tests

Examination of the stool for eggs and parasites confirms the diagnosis. The eggs and proglottids of H. nana are smaller than H. diminuta. Proglottids of both are relatively wide and have three testes. Identifying the parasites to the species level is often unnecessary from a medical perspective, as the treatment is the same for both.

Treatment

Praziquantel as a single dose (25 mg/kg) is the current treatment of choice for hymenolepiasis and has an efficacy of 96%. Single dose albendazole (400 mg) is also very efficacious (>95%). Niclosamide has also been used.

A three-day course of nitazoxanide is 75–93% efficacious. The dose is 1g daily for adults and children over 12; 400mg daily for children aged 4 to 11 years; and 200mg daily for children aged 3 years or younger.[1][4][5]


Prognosis

Cure rates are extremely good with modern treatments, but it is unclear that successful cure results in any symptomatic benefit to patients.[1]

Complications

Prevention

Good hygiene, public health and sanitation programs, and elimination of rats help prevent the spread of hymenolepiasis.

Source

References

  1. 1.0 1.1 1.2 Chero JC, Saito M, Bustos JA; et al. (2007). "Hymenolepis nana infection: symptoms and response to nitazoxanide in field conditions". Trans R Soc Trop Med Hyg. 101 (2): 203&ndash, 5. doi:10.1016/j.trstmh.2006.04.004.
  2. Chitchang S, Plamjinda T, Yodmani B, Radomyos P. (1985). "Relationship between severity of the symptom and the number of Hymenolepis nana after treatment". J Med Assoc Thai. 68: 423&ndash, 26.
  3. Schantz PM. (1996). "Tapeworm (cestodiasis)". Gastroenterol Clin North Am. 25: 637&ndash, 53.
  4. Ortiz JJ, Favennec L, Chegne NL, Gargala G. (2002). "Comparative clinical studis of nitazoxanide, albendazole and praziquantel in the treatment of ascariasis, trichuriasis, and hymenolepiasis in children from Peru". Trans R Soc Trop med Hyg. 96: 193&ndash, 96. PMID 12055813.
  5. Reomero-Cabello R, Guerro LR, Munez-Gracia MR, Geyne Cruz A. (1997). "Nitazoxanide for the treatment of intestinal protozoan and helminthic infections in México". Trans R Soc Trop Med Hyg. 91: 701&ndash, 3.

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