Institute of Medical Microbiology and Epidemiology of Infectious Diseases, Leipzig University Hospital; Interdisciplinary Centre for Infectious Diseases (ZINF), Leipzig University Hospital; Department of Gastroenterology, Division of Infectious Diseases and Tropical Medicine, Leipzig University Hospital; Department of Gastroenterology, Leipzig University Hospital.
Dtsch Arztebl Int. 2019 Mar 29;116(13):213-219. doi: 10.3238/arztebl.2019.0213.
Symptomatic infection with pinworm (Enterobius vermicularis), a human pathogen, is clinically relevant in Germany, with an estimated prevalence in childhood of 2-20%. Enterobiasis can cause major mental distress. There is little systematically verified knowledge on the treatment of this condition, and there is no corresponding German guideline. This review is, therefore, intended as a summary of the current state of knowledge.
This review is based on pertinent publications retrieved by a selective search in PubMed for literature appearing from 1 January 1990 to 5 February 2019 and containing the search terms "enterobiasis," "oxyuriasis," "Enterobius vermicula- ris," "pinworm," and "threadworm."
More than one billion people worldwide are thought to be infected with pinworm. Estimates of its prevalence among kindergarten and primary-school pupils in Europe are generally near 20%. Infants (<2 years of age), adolescents (>14 years of age), and adults are only sporadically affected. The main risk factors are age 4-11 years, uncontrolled anus-finger-mouth contact, nail-biting (onychophagia/peri- onychophagia), unsupervised body hygiene, and poor compliance with basic hand hygiene. No large-scale, randomized, controlled trials of treatment are available. The approved antihelminthic agents are mebendazole, pyrantel embonate, and pyrvinium embonate (success rates up to >90%). For recurrent infections, prolonged treatment for up to 16 weeks (a "pulse scheme") is recommended.
In nearly all cases, antihelminthic treatment along with attention to hygienic measures can successfully eradicate pinworm infection and prevent recurrence and autoinfection. The involvement of all persons living in the patient's house- hold, including sexual partners, is a prerequisite to the lasting success of treatment.
蛲虫（人蛔虫）是一种人体病原体，其引起的症状性感染在德国具有临床相关性，儿童的估计患病率为 2%至 20%。蛲虫感染会引起严重的精神困扰。目前，对于这种疾病的治疗，几乎没有经过系统验证的知识，也没有相应的德国指南。因此，本文旨在对现有知识进行总结。
本综述基于在 PubMed 中进行的选择性搜索，检索了 1990 年 1 月 1 日至 2019 年 2 月 5 日期间发表的相关文献，并使用了“蛲虫病”、“蛲虫感染”、“人蛔虫”、“蛲虫”和“线虫”等搜索词。
据估计，全世界有超过 10 亿人感染了蛲虫。在欧洲的幼儿园和小学学生中，其患病率普遍接近 20%。婴儿（<2 岁）、青少年（>14 岁）和成年人则很少受到感染。主要的危险因素包括 4-11 岁年龄组、肛门-手指-口腔接触不受控制、咬指甲（咬甲癖/甲周病）、无人监督的身体卫生和基本手部卫生依从性差。目前尚无大规模、随机、对照试验来治疗蛲虫病。已批准的驱虫药包括甲苯达唑、双羟萘酸噻嘧啶和吡喹酮（成功率高达>90%）。对于复发性感染，建议延长治疗时间（“脉冲方案”）长达 16 周。
在几乎所有情况下，驱虫治疗结合卫生措施都可以成功根除蛲虫感染，并预防复发和自身感染。让所有居住在患者家中的人（包括性伴侣）参与治疗是治疗成功的前提条件。
