Update on Treatment and Resistance of Human Trichuriasis

Abstract

Trichuris trichiura is a common soil-transmitted helminthic pathogen with considerable impact on human health. To achieve appropriate control of trichuriasis from a public health perspective, effective treatments and regular education of populations most at risk such as children and pregnant women are essential. Currently available drugs show however only unsatisfying cure rates when used in short-course regimens, and egg reduction rates are disappointingly low. An improvement in efficacy of drug therapy has been demonstrated for a prolonged 3-day dosing regimen of albendazole as well as for a combination therapy of albendazole and oxantel pamoate or mebendazole and albendazole. However, even these regimens do not reach the widely accepted threshold for a satisfactory cure rate of at least 90 %. While this lack of efficacy of current anthelminthic drugs may be explained by specific single nucleotide polymorphisms in the β-tubulin gene of T. trichiura, these findings highlight the need for further research to develop highly efficacious short-course treatments for human trichuriasis.