Parasites

Asymptomatic Treatment of High Prevalence Parasites in Cambodia* (Round Worm, Hook Worm, Whip Worm and Strongyloides)

Notes for Symptomatic patients: If chronic nonspecific GI symptoms, consider completing 5 total days of Albendazole to cover Giardia (bloating, chronic discomfort and alternating diarrhea/constipation) OR adding Tinidazole 2g QD for 3 days to cover Giardia and Amoeba (mucous/bloody stools). Also consider checking for H. Pylori, or even treating seronegative patients, if not responding to other treatments (and EGD if no response).

Azithromycin if suspect bacterial gastroenteritis (500mg QD x 3 days) or Typhoid fever (1g PO Day 1 then 500mg QD for days 5-7). If ingestion of raw or undercooked seafood/meat/snails, consider Praziquantel to cover liver flukes (25mg/kg/dose PO TID for 1-2 days) OR tapeworm (5-25mg/kg PO x 1 dose). Liver fluke = Opisthorcis, which occurs in all of Cambodia but especially in Kampong Cham and Takeo. If from Steung Treng, Kratie or Rattankiri, consider Praziquantel to cover Schistosomiasis (20mg/kg/dose TID for 1 day), especially if patient lives near Tonle Mekong or Tonle Sesan).