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WHO Essential Medicines Library - EMLib

Nematodes - strongyloidiasis

Introduction, etiology

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Infection is transmitted by eggs or larvae which begin their cycle of development within the human host when, depending on the species, they either actively penetrate intact skin or are ingested or, very rarely, inhaled. The larvae of the most widely prevalent species remain dormant but potentially infective for long periods in contaminated soil; the larvae or cysts of other species are ingested when the flesh of reservoir hosts is eaten either raw or undercooked.

Some 50 to 100 million people are estimated to be infected with Strongyloides stercoralis. It is widespread, not only in moist rainy areas of the tropics and subtropics, but also in some areas of southern and eastern Europe and of the United States of America.

Recommended treatments

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Treatment of choice
ivermectin .html scored tablet, 3 mg, 6 mg	.html Adults: 200 micrograms/kg as a single dose or 200 micrograms/kg/day on 2 consecutive days

When ivermectin is not available
albendazole .html chewable tablet, 400 mg	.html Adults and children over 2 years: 400 mg for 3 consecutive days
.html Mebendazole has also been used but, to be effective, it must be administered for longer periods as it has a limited effect on larvae and hence the prevention of auto-infection.

References

1. .html
Model Formulary search, enter 'strongyloidiasis' and see Intestinal nematode infections

http://mednet3.who.int/eml/modelFormulary.asp

2. .html
Intestinal nematodes; WHO link page

http://www.who.int/health-topics/intestinal.htm

3. .html
Parasites and Health, Stongyloidiasis, Centers for Disease Control and Prevention, USA

http://www.dpd.cdc.gov/dpdx/HTML/Strongyloidiasis.htm

4. .html
WHO Model Prescribing Information. Drugs used in parasitic diseases second edition, 1995. 146 pages [E, F, S] ISBN 92 4 140104 4 Sw.fr. 35.-/US $31.50. In developing countries Sw.fr.24.50.
Note: Where there is discrepancy between this book and the WHO Model Formulary, the Formulary should be considered to be the more authoritative.

Sales Information: http://www.who.int/bookorders/index.htm

5. .html
Report of the WHO Informal Consultation on the use of praziquantel during pregnancy/lactation and albendazole/mebendazole in children under 24 months, Geneva, 8-9 April, 2002, WHO/CDS/CPE/PVC/2002.4

http://www.who.int/wormcontrol/documents/en/pvc_20024full.pdf

6. .html
Benzimidazoles: use in children, Essential Medicines, WHO Drug Information, Vol 17, No. 1, 2003

http://www.who.int/druginformation/vol17num1_2003/vol17-1.pdf

1.	.html Model Formulary search, enter 'strongyloidiasis' and see Intestinal nematode infections
	http://mednet3.who.int/eml/modelFormulary.asp
2.	.html Intestinal nematodes; WHO link page
	http://www.who.int/health-topics/intestinal.htm
3.	.html Parasites and Health, Stongyloidiasis, Centers for Disease Control and Prevention, USA
	http://www.dpd.cdc.gov/dpdx/HTML/Strongyloidiasis.htm
4.	.html WHO Model Prescribing Information. Drugs used in parasitic diseases second edition, 1995. 146 pages [E, F, S] ISBN 92 4 140104 4 Sw.fr. 35.-/US $31.50. In developing countries Sw.fr.24.50. Note: Where there is discrepancy between this book and the WHO Model Formulary, the Formulary should be considered to be the more authoritative.
	Sales Information: http://www.who.int/bookorders/index.htm
5.	.html Report of the WHO Informal Consultation on the use of praziquantel during pregnancy/lactation and albendazole/mebendazole in children under 24 months, Geneva, 8-9 April, 2002, WHO/CDS/CPE/PVC/2002.4
	http://www.who.int/wormcontrol/documents/en/pvc_20024full.pdf
6.	.html Benzimidazoles: use in children, Essential Medicines, WHO Drug Information, Vol 17, No. 1, 2003
	http://www.who.int/druginformation/vol17num1_2003/vol17-1.pdf