The distribution and abundance of Enterobius vermicularis in a South Indian fishing community

The distribution and abundance of Enterobius vermicularis in a fishing community in South India, as determined by counting worms expelled following mass anthelmintic chemotherapy, was examined in samples of patients stratified by age, sex and family grouping. The results of a worm expulsion study in January 1984 are compared with those of a second expulsion programme in November 1984, following an 11-month period of reinfection. The prevalence of Enterobius infection was consistently high in all age groups of both males and females. A comparison of the overall prevalence and intensity of infection in the January and November surveys revealed significant increases in both the percent infected and the mean number of worms harboured in November relative to the initial level. No significant trends in the intensity of Enterobius according to host age or sex were detected in either survey. The frequency distribution of Enterobius was found to be highly aggregated in the population as a whole and within age groups. At both sampling dates, the most heavily infected 25% of the community harboured over 90% of the total pinworms recovered. There was a significant pattern within most age groups for individuals to re-acquire worm burdens of a similar magnitude to their initial pre-treatment burdens. Heavy infections were found to be associated with household. A selective or targetted approach to treatment of heavily infected individuals or households is likely to be an efficient means of reducing parasite abundance on a community-wide basis. It must be stressed, however, that treatment must be applied at frequent intervals in order to achieve a long-term reduction in pinworm abundance and to avoid the possibility of increasing the intensity of infection, as was observed in this community.