Trichuris trichuria: background document for the WHO guidelines on sanitation and health

Abstract

Trichuris trichiura is a soil-transmitted helminth responsible for trichuriasis, a neglected tropical disease that affects millions of people worldwide, particularly in regions with inadequate sanitation and hygiene. Transmission occurs primarily through ingestion of embryonated eggs from contaminated soil, food, water, or hands. The parasite's eggs can persist for prolonged periods in environmental matrices including soil, wastewater, and sludge, contributing to sustained transmission in endemic communities. This WHO background document summarizes the biology, transmission pathways, environmental occurrence, detection methods, public health significance, prevention strategies, and sanitation-related control measures for T. trichiura. The document highlights the importance of safely managed sanitation systems, wastewater treatment, sludge management, and preventive chemotherapy programs to reduce transmission and reinfection. Long-term improvements in sanitation are emphasized as essential components of sustainable control and elimination efforts.