Characteristics seen in men who have sex with men with Enterobius vermicularis (threadworms): a systematic review

Objectives Enterobius vermicularis (threadworms) is a parasitic enteric helminth causing anal pruritus. This systematic review aimed to explore demographic, behavioural and biological characteristics seen in men who have sex with men (MSM) with E. vermicularis.

Methods Four databases (OVID, CINAHL, Web of Science and PubMed) were searched in January 2025. Articles that included MSM diagnosed with E. vermicularis and written in English were included. Following removal of duplicates, citation and abstract review, two independent researchers screened full texts for eligible articles and performed a risk of bias assessment using Joanna Briggs Institute critical appraisal tools. Data were synthesised narratively and the protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42024597731).

Results 11 articles were included in this review from the UK (n=4), the USA (n=3), Iraq (n=1), South Africa (n=1), Australia (n=1) and Cuba (n=1), which included 33 MSM with E. vermicularis published between 1972 and 2024. This review highlighted demographic (young age (median 27 years), living with HIV), behavioural (oral sex, oral-anal sex, anal sex, fisting, multiple/non-regular sexual partners, sex toys, group sex, recreational drug use) and coinfection (Neisseria gonorrhoeae, Treponema pallidum, hepatitis A, human papillomavirus, recurrent urethritis, Giardia duodenalis, Entamoeba histolytica, Endolimax nana, Iodamoeba buetschlii, Dientamoeba fragilis, Entamoeba coli, intestinal spirochaetosis) characteristics seen in MSM with E. vermicularis.

Conclusion Although limited, this review provides some useful insights into the possible sexual transmission of E. vermicularis in MSM for future public health control strategies, clinical guidelines and research.

PROSPERO registration number CRD42024597731.