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\begin{document}

\title{Rare Tapeworm segments in 12 years old age girl Case report}



\author[1]{Ahmed Gaffer}%
\affil[1]{Alzaiem Alazhari University}%


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  \date{May 18, 2024}


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\begin{abstract}
ABSTRACT Intestinal cestode(tapeworm ) is characterized by
multisegmented, scolex, and absence of digestive tracts as appears in
our segments, we reported nine segments of tape worm
with,scolex,neck,13-17 uterus branch, and scorpion like tail.%
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\textbf{1. Introduction and literature review}

Intestinal trematode is associated with poor sanitation (freshwater,
soil-transmitted helminth, the prevalence is predominated in Sub-Saharan
African countries, Asia followed by Latin America AND Caribbean
counties(2) (3). It is estimated that in 2006 181 million school-age
children are infected with one or more worms(4).A recent survey in Sudan
estimated the prevalence of intestinal helminth as 5.47\% out of 105,176
students screened.

\textbf{Case report}

A 12-year-old Sudanese girl come to our clinic at 2022 presented with
chronic diarrhea (4-5) times per day for more than one year she doesn't
diagnose as she has intestinal trematodes, On physical examination, she
has a good appetite, abdominal pain, after meals quick needs a bath for
defecation, she appears pale and underweight. Laboratory investigation
showed normal white cell count of 4500/cmm, and mild anemia Hb 9g/dl the
stool was requested for examination, the stool loose contains large
particles seen macroscopically as undigested food. Two separate
techniques as available in our lab, direct saline wet preparation and
formal ether concentration technique was performed. on direct wet
preparation examined firstly with low power field a nine trematode
segments with scolex, neck, (13-17) uterus branch, scorpion- like tails,
were seen accidentally in one field figure (1). On formal ether
concentration technique there is no eggs of any parasite but many starch
cells were showed, and yeasts over growth. The patient was treated with
400 mg mebendazole immediately and after one week, and come for
follow-up after one month and there is no segments nor eggs, she appears
well and she start tonics for anaemia.

\textbf{Discussion}

Intestinal cestode(tapeworm ) is characterized by multisegmented, scolex
, and absence of digestive tracts (1)as appears in our segments, but
there is no feature of eggs which all times the feature of proglottid
segments, In our case the patient had to get daily fresh water without
treatment, she had eaten uncooked intestinal parts of cows as rituals in
the village (at the wedding) all these factors predisposing to infection
.but we didn't identify the exact type of helminth because there is no
staining and we exclude the Tanea spp which the segment is large and
contain eggs. These segments were first shown and not common in
parasitology atlas. Our finding needs further genetic testing to
identify specific parasite .

\textbf{Conclusion}

Intestinal tapeworm is associated with poor sanitary conditions
treatment of fresh water and avoid undercooked meat to protect the
children from helminths infections

\textbf{Ethical approval}

Written informed consent was taken from the father of the girls to
publish this report.

\textbf{Conflicts of interest}

There is no conflict of interest

\emph{Figure (1) Nine segments of intestinal trematode with low power
field object 10}\selectlanguage{english}
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\textbf{References}

1. GA C. Helminths: Structure, Classification, Growth, and Development.
In: S B, editor. Medical Microbiology {[}Internet{]}. 4th editio.
University of Texas Medical Branch at Galveston: Galveston; 1996.
Available from: https://www.ncbi.nlm.nih.gov/books/NBK8282

2. Brooker S, Clements AC B DA. Global epidemiology, ecology and control
of soil-transmitted helminth infections. Adv Parasitol.
2006;62:221--261.

3. . de Silva NR, Brooker S, Hotez PJ, Montresor A, Engels D SL.
Soil-transmitted helminth infections: updating the global picture.
Trends Parasitol. 2003;19:547--551.

4. Hotez PJ KA. Neglected tropical diseases in sub-saharan Africa:
review of their prevalence, distribution, and disease burden. PLoS Negl
Trop Dis. 2009;3:e412.

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