About Ascariasis

Overview

Ascariasis is a disease caused by a type of parasitic worm called Ascaris. It is a common infection that affects over one billion people worldwide. Ascariasis is classified as a Neglected Tropical Disease (NTD) and is most prevalent in low- and middle-income regions, such as sub-Saharan Africa, South America, and South- and South-east Asia. The infection can occur when a person ingests Ascaris eggs from contaminated soil, food, or water. Once inside the body, the eggs hatch into larvae and migrate through the digestive system, potentially causing symptoms such as abdominal pain, diarrhea, and nutritional deficiencies. Ascariasis can have negative effects on growth, cognitive development, and nutritional status, particularly in children.

Causes and Risk Factors

Ascariasis is a parasitic infection caused by the roundworm Ascaris lumbricoides. Ascariasis is caused by eating or drinking contaminated food or water. The eggs of Ascaris lumbricoides are present in soil contaminated with human feces. When ingested, the eggs hatch in the small intestine. The larvae (newly hatched roundworms) can move through the bloodstream and lymphatic system to reach the lungs. From there, they are coughed up and swallowed, returning to the small intestine where they mature into adult worms that can grow to several inches long. The adult worms can live in the small intestine for 1-2 years and reproduce. The eggs then are passed into the stool, which may repeat the cycle of contaminating soil if sanitation facilities are not available.

Risk factors of ascariasis include:

Age: Children are more susceptible to ascariasis due to their tendency to play in contaminated soil and their less developed immune systems.
Geographic location: Ascariasis is more common in warm climates and areas with lack of access to clean water and lack of proper sanitation facilities. Lack of proper sanitation increases chances that soil may be contaminated with human feces and Ascaris eggs.
Poor personal hygiene: Failure to wash hands properly before eating or preparing food can lead to ingestion of Ascaris eggs.

To reduce the risk of Ascariasis, it is important to promote good hygiene practices such as regular handwashing with soap, proper sanitation facilities, and safe handling and preparation of food.

Symptoms

Some people ascariasis do not have noticeable symptoms.

Symptoms of ascariasis include:

Persistent cough
Wheezing
Shortness of breath
Abdominal discomfort or pain
Nausea and vomiting
Diarrhea or bloody stools

Ascariasis may become more severe, especially if there are a large number of worms infecting the intestine. Additional symptoms may occur, such as:

Severe abdominal pain
Weight loss
Being very tired (fatigue)
A worm in vomit or stool

It's important to note that these symptoms can vary in severity and speed of onset from person to person. If you experience any of these symptoms or suspect you may have ascariasis, it is recommended to consult with a healthcare professional for proper diagnosis and treatment.

Diagnosis

The symptoms of ascariasis may also be caused by other conditions. To exclude (rule out) other conditions and diagnose ascariasis, doctors may perform the following examinations, tests, and procedures:

Medical history and physical examination: The doctor will ask about your symptoms and medical history, and conduct a physical examination that includes checking your lungs and abdomen.

Stool analysis: Stool samples are collected and examined under a microscope to detect the presence of Ascaris lumbricoides eggs or adult worms.

Imaging tests: X-rays, ultrasound, or other scans may be used to look for signs of larvae and adult worms in parts of the body, such as the lungs, small intestine, live, or pancreas.

Blood tests: Blood tests may be done to check for an increase in eosinophils, which can indicate the body’s response to the parasites. Blood tests may also be used to look for effects of the ascaris infection on other parts of the body, such as the liver.

It's important to note that these examinations, tests, and procedures are commonly used for diagnosing Ascariasis, but the specific approach may vary depending on individual circumstances. It's always best to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan.

Treatment Options

The goals of treatment for ascariasis are to eliminate the parasitic infection, relieve symptoms, and prevent complications.

The main treatment for ascariasis is anthelmintic (anti-worm) drugs. Medications like albendazole and mebendazole are commonly used to kill the worms in the intestines, helping to eliminate the infection.
In cases of infection with many worms, a surgery procedure may be needed to remove the worms that may block the intestines.
In addition, treatment includes health education to help prevent re-infection.
- Educating individuals about proper hygiene practices, including handwashing and proper waste disposal.
- Encouraging individuals to adopt personal hygiene practices that includes washing hands regularly, especially before eating or preparing food; and washing or cooking raw foods that may be grown in contaminated soil.

It's important to consult with a healthcare professional for personalized advice on medication dosing and potential side effects.