A review: Updates on the treatment and integrated control strategies to eliminate Trichuris trichiura
Keywords:
Trichuris trichiura, treatment;, integrated control., soil-transmitted helminthsAbstract
Current treatment of Trichuris trichiura infection predominantly relies on benzimidazole derivatives, namely albendazole and mebendazole. However, emerging evidence of suboptimal efficacy and potential drug resistance has prompted the investigation of alternative therapeutic approaches. Recent clinical trials have demonstrated enhanced efficacy through novel drug combinations, including albendazole co-administered with ivermectin or oxantel pamoate. In parallel, integrated control strategies encompassing mass drug administration (MDA), water, sanitation, and hygiene (WASH) interventions, and vaccine development are gaining attention as sustainable solutions to reduce transmission and reinfection rates. This review synthesizes recent advances in pharmacological and public health interventions, highlighting the need for multifaceted approaches to effectively combat T. trichiura infections.
References
Welsche S, Mrimi EC, Hattendorf J, Hürlimann E, Ali SM, Keiser J. Efficacy and safety of moxidectin and albendazole compared with ivermectin and albendazole coadministration in adolescents infected with Trichuris trichiura in Tanzania: an open-label, non-inferiority, randomised, controlled, phase 2/3 trial. The Lancet Infectious Diseases 2023;23:331–40. https://doi.org/10.1016/S1473-3099(22)00589-8.
Matamoros G, Sánchez A, Gabrie JA, Juárez M, Ceballos L, Escalada A, et al. Efficacy and Safety of Albendazole and High-Dose Ivermectin Coadministration in School-Aged Children Infected With Trichuris trichiura in Honduras: A Randomized Controlled Trial. Clin Infect Dis 2021;73:1203–10. https://doi.org/10.1093/cid/ciab365.
Steinmann P, Utzinger J, Du Z-W, Jiang J-Y, Chen J-X, Hattendorf J, et al. Efficacy of single-dose and triple-dose albendazole and mebendazole against soil-transmitted helminths and Taenia spp.: a randomized controlled trial. PLoS One 2011;6:e25003. https://doi.org/10.1371/journal.pone.0025003.
Keiser J, Utzinger J. Efficacy of Current Drugs Against Soil-Transmitted Helminth Infections: Systematic Review and Meta-analysis. JAMA 2008;299:1937–48. https://doi.org/10.1001/jama.299.16.1937.
Lloyd AE, Honey BL, John BM, Condren M. Treatment Options and Considerations for Intestinal Helminthic Infections. J Pharm Technol 2014;30:130–9. https://doi.org/10.1177/8755122514533667.
Viswanath A, Yarrarapu SNS, Williams M. Trichuris trichiura Infection. StatPearls, Treasure Island (FL): StatPearls Publishing; 2025.
Buonfrate D. Alternative treatment strategies for trichuriasis. The Lancet Infectious Diseases 2023;23:266–7. https://doi.org/10.1016/S1473-3099(22)00653-3.
Moncayo AL, Vaca M, Amorim L, Rodriguez A, Erazo S, Oviedo G, et al. Impact of Long-Term Treatment with Ivermectin on the Prevalence and Intensity of Soil-Transmitted Helminth Infections. PLoS Negl Trop Dis 2008;2:e293. https://doi.org/10.1371/journal.pntd.0000293.
Moser W, Schindler C, Keiser J. Efficacy of recommended drugs against soil transmitted helminths: systematic review and network meta-analysis. BMJ (Clinical Research Ed) 2017;385:j4307. https://doi.org/10.1136/bmj.j4307.
Gebreyesus TD, Makonnen E, Tadele T, Mekete K, Gashaw H, Gerba H, et al. Reduced efficacy of single-dose albendazole against Ascaris lumbricoides, and Trichuris trichiura, and high reinfection rate after cure among school children in southern Ethiopia: a prospective cohort study. Infect Dis Poverty 2024;13:8. https://doi.org/10.1186/s40249-024-01176-6.
Elard L, Humbert JF. Importance of the mutation of amino acid 200 of the isotype 1 β- tubulin gene in the benzimidazole resistance of the small-ruminant parasite Teladorsagia circumcincta. Parasitology Research 1999;85:452–6. https://doi.org/10.1007/s004360050577.
Ghisi M, Kaminsky R, Mäser P. Phenotyping and genotyping of Haemonchus contortus isolates reveals a new putative candidate mutation for benzimidazole resistance in nematodes. Veterinary Parasitology 2007;144:313–20. https://doi.org/10.1016/j.vetpar.2006.10.003.
Su Q, Baker L, Emery S, Balan B, Ansell B, Tichkule S, et al. Transcriptomic analysis of albendazole resistance in human diarrheal parasite Giardia duodenalis. International Journal for Parasitology: Drugs and Drug Resistance 2023;22:9–19. https://doi.org/10.1016/j.ijpddr.2023.03.004.
Gandasegui J, Grau-Pujol B, Novela V, Muchisse O, Cambra-Pellejà M, Cossa A, et al. Deep-amplicon sequencing of the complete beta-tubulin gene in Trichuris trichiura before and after albendazole treatment. International Journal for Parasitology: Drugs and Drug Resistance 2024;26:100570. https://doi.org/10.1016/j.ijpddr.2024.100570.
Speich B, Ali SM, Ame SM, Bogoch II, Alles R, Huwyler J, et al. Efficacy and safety of albendazole plus ivermectin, albendazole plus mebendazole, albendazole plus oxantel pamoate, and mebendazole alone against Trichuris trichiura and concomitant soil-transmitted helminth infections: a four-arm, randomised controlled trial. The Lancet Infectious Diseases 2015;15:277–84. https://doi.org/10.1016/S1473-3099(14)71050-3.
Speich B, Ame S, Ali S, Alles R, Huwyler J, Hattendorf J, et al. Oxantel pamoate-albendazole for Trichuris trichiura infection. The New England Journal of Medicine 2014. https://doi.org/10.1056/NEJMoa1301956.
Palmeirim MS, Hürlimann E, Beinamaryo P, Kyarisiima H, Nabatte B, Hattendorf J, et al. Efficacy and safety of albendazole alone versus albendazole in combination with ivermectin for the treatment of Trichuris trichiura infections: An open-label, randomized controlled superiority trial in south-western Uganda. PLOS Neglected Tropical Diseases 2024;18:e0012687. https://doi.org/10.1371/journal.pntd.0012687.
Krolewiecki A, Kepha S, Fleitas PE, van Lieshout L, Gelaye W, Messa A, et al. Albendazole–ivermectin co-formulation for the treatment of Trichuris trichiura and other soil-transmitted helminths: a randomised phase 2/3 trial. The Lancet Infectious Diseases 2025;25:548–59. https://doi.org/10.1016/S1473-3099(24)00669-8.
Abene S. CHMP Approves Ivermectin/Albendazole Combination for Parasitic Worm Infections. ContagionLive 2025.
Vaz Nery S, Pickering AJ, Abate E, Asmare A, Barrett L, Benjamin-Chung J, et al. The role of water, sanitation and hygiene interventions in reducing soil-transmitted helminths: interpreting the evidence and identifying next steps. Parasit Vectors 2019;12:273. https://doi.org/10.1186/s13071-019-3532-6.
Makaula P, Kayuni SA, Mamba KC, Bongololo G, Funsanani M, Musaya J, et al. An assessment of implementation and effectiveness of mass drug administration for prevention and control of schistosomiasis and soil-transmitted helminths in selected southern Malawi districts. BMC Health Serv Res 2022;22:517. https://doi.org/10.1186/s12913-022-07925-3.
Sahimin N, Abu Bakar N, Lim YAL, Behnke JM, Lewis J, Kamaruddin N, et al. Entry of Migrant Workers to Malaysia: Consideration to Implement Mass Drug Administration Against Intestinal Parasitic Infections. Int J Health Policy Manag 2024;13:7842. https://doi.org/10.34172/ijhpm.2024.7842.
Else KJ, Keiser J, Holland CV, Grencis RK, Sattelle DB, Fujiwara RT, et al. Whipworm and roundworm infections. Nat Rev Dis Primers 2020;6:1–23. https://doi.org/10.1038/s41572-020-0171-3.
Ali J, Polland A, Adlerstein D, Gziabher YG, Sabar G, Liss Y, et al. Deworming school children in Ethiopia: The importance of a comprehensive approach. Open Journal of Tropical Medicine 2018;3:001–6. https://doi.org/10.17352/ojtm.000008.
Hayon J, Weatherhead J, Hotez PJ, Bottazzi ME, Zhan B. Advances in vaccine development for human trichuriasis. Parasitology 2021;148:1783–94. https://doi.org/10.1017/S0031182021000500.
Wei J, Hegde VL, Yanamandra AV, O’Hara MP, Keegan B, Jones KM, et al. Mucosal Vaccination With Recombinant Tm-WAP49 Protein Induces Protective Humoral and Cellular Immunity Against Experimental Trichuriasis in AKR Mice. Front Immunol 2022;13. https://doi.org/10.3389/fimmu.2022.800295.
Welsche S, Mrimi E, Hattendorf J, Hürlimann E, Ali SM, Keiser J. Efficacy and Safety of Moxidectin and Albendazole Compared to Ivermectin and Albendazole Co-Administration in Adolescents Infected with Trichuris Trichiura: A Randomized Controlled Non-Inferiority Phase II/III Trial 2022. https://doi.org/10.2139/ssrn.4168899.
Barda B, Ame SM, Ali SM, Albonico M, Puchkov M, Huwyler J, et al. Efficacy and tolerability of moxidectin alone and in co-administration with albendazole and tribendimidine versus albendazole plus oxantel pamoate against Trichuris trichiura infections: a randomised, non-inferiority, single-blind trial. The Lancet Infectious Diseases 2018;18:864–73. https://doi.org/10.1016/S1473-3099(18)30233-0.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Journal of Biomedical and Clinical Sciences (JBCS)

This work is licensed under a Creative Commons Attribution 4.0 International License.
JBCS Publication Ethics
JBCS is committed to ensure the publication process follows specific academic ethics. Hence, Authors, Reviewers and Editors are required to conform to standards of ethical guidelines.
Authors
Authors should discuss objectively the significance of research work, technical detail and relevant references to enable others to replicate the experiments. JBCS do not accept fraudulent or inaccurate statements that may constitute towards unethical conduct.
Authors should ensure the originality of their works. In cases where the work and/or words of others have been used, appropriate acknowledgements should be made. JBCS do not accept plagiarism in all forms that constitute towards unethical publishing of an article.
This includes simultaneous submission of the same manuscript to more than one journal. Corresponding author is responsible for the full consensus of all co-authors in approving the final version of the paper and its submission for publication.
Reviewers
Reviewers of JBCS treat manuscripts received for review as confidential documents. Therefore, Reviewers must ensure the confidentiality and should not use privileged information and/or ideas obtained through peer review for personal advantage.
Reviews should be conducted based on academic merit and observations should be formulated clearly with supporting arguments. In cases where selected Reviewer feels unqualified to review a manuscript, Reviewer should notify the editor and excuse himself from the review process in TWO (2) weeks time from the review offer is made.
In any reasonable circumstances, Reviewers should not consider to evaluate manuscripts if they have conflicts of interest (i.e: competitive, collaborative and/or other connections with any of the authors, companies, or institutions affiliated to the papers).
Editors
Editors should evaluate manuscripts exclusively based on their academic merit. JBCS strictly do not allow editors to use unpublished information of authors without the written consent of the author. Editors are required to take appropriate responsive actions if ethical complaints have been presented concerning a submitted manuscript or published paper.
CONFLICT OF INTEREST
Journal of Biomedical and Clinical Sciences requires authors to declare all competing interests in relation to their work. All submitted manuscripts must include a ‘competing interests section at the end of the manuscript listing all competing interests (financial and non-financial). Where authors have no competing interests, the statement should read ,The authors have declared that no competing interests exist. Editors may ask for further information relating to competing interests.
Editors and reviewers are also required to declare any competing interests and will be excluded from the peer review process if a competing interest exists. Competing interests may be financial or non-financial. A competing interest exists when the authors interpretation of data or presentation of information may be influenced by their personal or financial relationship with other people or organizations. Authors should disclose any financial competing interests but also any non-financial competing interests that may cause them embarrassment if they were to become public after the publication of the article.
HUMAN AND ANIMAL RIGHTS
All research must have been carried out within an appropriate ethical framework. If there is suspicion that work has not taken place within an appropriate ethical framework, Editors will follow the Misconduct policy and may reject the manuscript, and/or contact the author(s) institution or ethics committee. On rare occasions, if the Editor has serious concerns about the ethics of a study, the manuscript may be rejected on ethical grounds, even if approval from an ethics committee has been obtained.
Research involving human subjects, human material, or human data, must have been performed in accordance with the Declaration of Helsinki and must have been approved by an appropriate ethics committee. A statement detailing this, including the name of the ethics committee and the reference number where appropriate, must appear in all manuscripts reporting such research. Further information and documentation to support this should be made available to Editors on request.
Experimental research on vertebrates or any regulated invertebrates must comply with institutional, national, or international guidelines, and where available should have been approved by an appropriate ethics committee. The Basel Declaration outlines fundamental principles to adhere to when conducting research in animals and the International Council for Laboratory Animal Science (ICLAS) has also published ethical guidelines.
A statement detailing compliance with relevant guidelines (e.g. the revised Animals (Scientific Procedures) Act 1986 in the UK and Directive 2010/63/EU in Europe) and/or ethical approval (including the name of the ethics committee and the reference number where appropriate) must be included in the manuscript. The Editor will take account of animal welfare issues and reserves the right to reject a manuscript, especially if the research involves protocols that are inconsistent with commonly accepted norms of animal research. In rare cases, Editors may contact the ethics committee for further information.
INFORMED CONSENT
For all research involving human subjects, informed consent to participate in the study should be obtained from participants (or their parent or guardian in the case of children under 16) and a statement to this effect should appear in the manuscript, this includes to all manuscripts that include details, images, or videos relating to individual participants.
DATA SHARING POLICY
JBCS strongly encourages that all datasets on which the conclusions of the paper rely should be available to readers. We encourage authors to ensure that their datasets are either deposited in publicly available repositories (where available and appropriate) or presented in the main manuscript or additional supporting files, in machine-readable format (such as spreadsheets rather than PDFs) whenever possible
Authors who do not wish to share their data must state that data will not be shared, and give the reason.
COPYRIGHT NOTICE
The JBCS retains the copyright of published manuscripts under the terms of the Copyright Transfer Agreement. However, the journal permits unrestricted use, distribution, and reproduction in any medium, provided permission to reuse, distribute and reproduce is obtained from the Journal's Editor and the original work is properly cited.
While the advice and information in this journal are believed to be true and accurate on the date of its going to press, neither the authors, the editors, nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
Copyright (c) 2023 Journal of Biomedical and Clinical Sciences (JBCS)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.





