Ascariasis

Introduction  Roundworms are almost worldwide in distribution and are abundant in the surface layers of soils. Roundworm infections are common and frequently go unnoticed, but several species cause serious diseases. It is a helminthes infection of the small intestine. A person becomes infected by swallowing infective eggs. Symptoms are variable, often vague or absent. Live worms passed in stools or vomiting are frequently the first recognized sign of infection. Pulmonary signs too are present. Heavy parasite burdens may cause digestive and nutritional disturbance. Causative organism- Ascaris lumbricoides  Mode of transmission • By ingestion of infective eggs from soil contaminated with human faeces containing eggs, but not directly from man to man. Salads and other foods eaten raw are the common vehicles. Contaminated soil may be carried long distances on feet or footwear into house, transmission of infection by dust is also possible. • Children of 3-8 years whose fingers become contaminated while playing on open ground are also the source. The worms can live 1-2 years in their host.

Symptoms

Symptoms are ordinarily mild

1. Live worm passed in stools

2. Pulmonary signs
     
     • Loeffer’s syndrome with irregular respiration, spasms of coughing
     • Fever and pronounced blood eosinophilia

3. Digestive, nutritional disturbances

     • Abdominal pain
     • Vomiting
     • Restlessness
     • Disturbed sleep

4.Serious complications
      
     • Bowel obstruction
    

 • Occasional death due to migration of adult worms into liver, gall bladder, peritoneal and rarely from perforation of the intestine.

Diagnosis

Tests to diagnose this condition include:

     • Stool ova and parasites exam
     • Abdominal x-ray   
     • Complete blood count.

Treatment

Piperazine hexahydrate or piperazine salt (citrate, adipate, or phosphate) can be used for the treatment of Ascariasis. During pregnancy, unless infection is heavy and ladies health is at risk, treatment is generally postponed until after delivery of the baby. 

Prevention

• Provision of adequate facilities for proper disposal of faeces and prevention of soil contamination in areas immediately adjacent to houses, particularly in play areas of children.

• In rural areas contribution of privies should be done in such manner as to prevent dissemination of ascarid eggs through overflow, drainages. Treatment of night soil, such as composing, should be practiced where such facilities are lacking and in areas where human faeces are used as fertilizer.

• All persons (particularly children and food handlers) should be educated about the use of toilets facilities and washing hands after defecating. Encouragement of satisfactory hygienic habits on the part of children in particular, should be done. They should be trained to wash their hands before handling and not to eat food which has been drooped on the floor.