January 2003
5936.
Correa-Oliveira R, Golgher DB, Oliveira GC, Carvalho OS, Massara CL,
Caldas IR, Colley DG, Gazzinelli G. Infection with Schistosoma mansoni
correlates with altered immune responses to Ascaris lumbricoides and hookworm.
Acta Trop 2002 Aug;83(2):123-32
Studies
were performed on humoral and cellular immune responses of patients from areas
in Brazil endemic for hookworm and Ascaris lumbricoides, and either endemic or
non-endemic for Schistosoma mansoni. Humoral and cellular responses were
evaluated by enzyme-linked immunosorbant assay (ELISA) and peripheral blood
mononuclear cell (PBMC) proliferation assays against larval hookworm antigens,
A. lumbricoides egg antigens, and soluble egg antigens (SEA) or soluble whole
adult antigenic preparation (SWAP) from S. mansoni. Patients from S. mansoni-endemic
areas, who currently had only hookworm or Ascaris infections, expressed lower
humoral and cellular responses to hookworm or Ascaris antigens, respectively,
than did their counterparts from areas not endemic for S. mansoni. Individuals
from S. mansoni endemic area, although without detectable S. mansoni infection,
do mount humoral and cellular responses to SEA and SWAP. This group of
individuals has been probably in contact with S. mansoni antigens, since the
groups harboring A. lumbricoides or hookworm infections from non-S. mansoni
endemic areas do not have detectable anti-S. mansoni responses. PBMC
proliferative responses discriminated well between patients with active hookworm
infections versus ascariasis, if they were from areas not endemic for S. mansoni.
5937.
Nishiura H, Imai H, Nakao H, Tsukino H, Changazi MA, Hussain GA, Kuroda
Y, Katoh T. Ascaris lumbricoides among children in rural communities in the
Northern Area, Pakistan: prevalence, intensity, and associated socio-cultural
and behavioral risk factors. Acta Trop 2002
Sep;83(3):223-31
The
prevalence and intensity of Ascaris lumbricoides in 492 children from five rural
villages in the Northern Area of Pakistan was examined. The overall prevalence
of A. lumbricoides was 91% (95%CI 88.6-93.6) with geometric mean (GM) egg count
intensities of 3985 eggs per g (epg). The most intense A. lumbricoides
infections were found in children aged 5-8 years. We also investigated selected
socio-cultural and behavioral variables for A. lumbricoides infections that
might be relevant for the design of appropriate prevention and control programs.
Univariate analysis associated A. lumbricoides intensity with age (P=0.004),
location of household (P<0.01), defecation practices (P=0.02), soil eating
habit (P<0.01), hand washing after defecation (P<0.01), and living with
children under 5 years old (P=0.02). Multivariate analysis identified the
children's age 5-8 (P<0.01), location of household in Surngo, Askole, and
Stakchun where the pilot health care model activities were not done (P<0.01),
and living with children under 5 years old (P=0.03) as variables statistically
associated with the intensity of A. lumbricoides. The results indicated that
there were certain clear risk factors in A. lumbricoides transmission, and that
its intensity was influenced by age-related behavioral and environmental factors
that contribute to exposure.
Pathogenesis:
5938.
Howard SC, Donnelly CA, Kabatereine NB, Ratard RC, Brooker S. Spatial and
intensity-dependent variations in associations between multiple species helminth
infections. Acta Trop 2002
Aug;83(2):141-9
Estimated
associations between infections with different helminth species can be used to
predict the proportion of a population infected with multiple species
infections. This is an important measure of disease burden, as those with
multiple infections are often at an increased risk of morbidity. In this paper,
we investigate variation amongst the estimated associations between Ascaris
lumbricoides, Trichuris trichiura and hookworm, over a number of different
spatial levels among schoolchildren in Cameroon. Associations between species
were largely homogeneous within districts, provinces and ecological zones,
although variation between these regions was identified, implying that a single
measure of association may not be appropriate in different epidemiological
settings. Further data collected amongst school children in Kenya and Uganda
were analysed, to assess the dependence of the associations on the intensity of
infection. It was found that the strength of the association between A.
lumbricoides and T. trichiura increased with intensity, such that those with
more intense infections with one species are increasingly likely to harbour
concurrent intense infections with the other species. The implications of these
results are discussed in relation to the estimation of the disease burden due to
multiple helminth species.
5939.
Odigie
VI, Yusufu LM, Yakubu AA, Bello A. Nasogastric tube obstruction by Ascaris
lumbricoides. Trop Doct 2002
Jul;32(3):176-7 No abstract.
Therapy
5940.
Nishiura
H, Imai H, Nakao H, Tsukino H, Changazi MA, Hussain GA, Kuroda Y, Katoh Odigie
VI, Yusufu LM, Yakubu AA, Bello A. Nasogastric tube obstruction by Ascaris
lumbricoides. Trop Doct 2002
Jul;32(3):176-7 No abstract.
5941.
Savage
AR. Providing nursing care for a Chagga client of Tanzania. J Transcult Nurs
2002 Jul;13(3):248-53 No abstract.
5942.
T.
Ascaris lumbricoides among children in rural communities in the Northern
Area,Pakistan: prevalence, intensity, and associated socio-cultural and
behavioral risk factors. Acta Trop 2002
Sep;83(3):223-31 No abstract.
6548.
Jain N ,Shrivastav U.K. Biliary stones and ascariasis . Gastroenterol
Today 2002,6(6),28-30. (ISA 016151,
Vol 38 No16 ,16Aug. 2002)
6549.
Sheikh KA, Khan AH, Altaf R, Khanday ZS; Bari S; Patnaik R.. Appendicular
perforation due to ascariasis in children of Kashmir. JK Practitioner. 2002
Jan-Mar; 9(1): 28-31
ABSTRACT:
In Kashmir the incidence of ascariasis is very high. Mainly the children from
low socio-economic group who are literate and whose standard of living is poor
are mostly affected. Dangerous complications may arise from the wanderlust of
the worms and their tendency to explore orifices, ducts and cavities.
Appendicular perforation though very rare is a grave problem. We are reporting
11 cases of appendicular perforation out of our series of 441 cases which were
admitted either as intestinal obstruction due to ascariasis or acute worm colic,
over a period of 10 years, with effect from January 1988 in the age group of
3-14 years. Patients which showed rising pulse rate in absence of any mass,
toxaemia out of proportion to severity of obstruction or fixity of mass for more
than 48 hours with increased abdominal distension were taken for surgical
intervention (Dayalan criteria). 121 patients taken for surgery as per above
criteria in our series. 11 cases which were having either appendicular
perforation alone or associated with other bowel lesions due to ascariasis were
our operative findings, as the diagnosis of appendicular perforation due to
ascariasis, preoperatively is very difficult are reported. All the cases
reported here were thoroughly studied. Clinical history, preoperative and
operative findings and results of various operative procedures and complications
are reviewed. Earliest surgical intervention is stressed to decrease the
morbidity or mortality. Mass deworming of the children is suggested.
6550.
Traub RJ, Robertson ID, Irwin P, Mencke N, Thompson RC. The role of dogs
in transmission of gastrointestinal parasites in a remote tea-growing community
in northeastern India. Am J Trop Med Hyg 2002
Nov;67(5):539-45
The
prevalence and risk factors associated with canine gastrointestinal parasitic
zoonoses and the role of dogs in the mechanical transmission of human Ascaris
infection was examined in three tea estates in Assam, India. Nearly all (99%)
dogs harbored one or more zoonotic species of gastrointestinal parasites, with
hookworm infection being most common (94%). Parasitic stages presumed to be
host-specific for humans such as Ascaris spp. (31%), Trichuris trichiura (25%),
and Isospora belli (2%) were also recovered from dog feces. A polymerase chain
reaction-linked restriction fragment length polymorphism technique was used to
differentiate the species of Ascaris eggs in dog feces. The results of this
study demonstrate the role of the dog as a significant disseminator and
environmental contaminator of Ascaris lumbricoides in communities where
promiscuous defecation by humans occurs.
July 2003
7097.
Belizario VY, Amarillo ME, de Leon WU, de los Reyes AE, Bugayong MG,
Macatangay BJ. A comparison of the efficacy of single doses of albendazole,
ivermectin, and diethylcarbamazine alone or in combinations against Ascaris and
Trichuris spp. Bull World Health Organ 2003;81(1):35-42
OBJECTIVE:
To determine the efficacy of single doses of albendazole, ivermectin and
diethylcarbamazine, and of the combinations albendazole + ivermectin and
albendazole + diethylcarbamazine against common intestinal helminthiases caused
by Ascaris and Trichuris spp. METHODS: In a randomized, placebo-controlled
trial, infected children were randomly assigned to treatment with albendazole +
placebo, ivermectin + placebo, diethylcarbamazine + placebo, albendazole +
ivermectin, or albendazole + diethylcarbamazine. The Kato-Katz method was used
for qualitative and quantitative parasitological diagnosis. The chi2 test was
used to determine the significance of cure rates, repeated measures analysis of
variance for the comparison of mean log egg counts, the Newman-Keuls procedure
for multiple comparison tests, and logistic regression for the comparison of
infection rates at days 180 and 360 after treatment. FINDINGS: Albendazole,
ivermectin and the drug combinations gave significantly higher cure and egg
reduction rates for ascariasis than diethylcarbamazine. For trichuriasis,
albendazole + ivermectin gave significantly higher cure and egg reduction rates
than the other treatments: the infection rates were lower 180 and 360 days after
treatment. CONCLUSION: Because of the superiority of albendazole + ivermectin
against both lymphatic filariasis and trichuriasis, this combination appears to
be a suitable tool for the integrated or combined control of both public health
problems. Publication Types: Clinical
Trial Randomized
Controlled TrialPMID: 12640474 [PubMed - indexed for MEDLINE]
7098.
Zargar SA, Javid G, Khan BA, Yattoo GN, Shah AH, Gulzar GM, Singh J,
Rehman BU, ud-din Z. Endoscopic sphincterotomy in the management of bile duct
stones in children. Am J Gastroenterol 2003
Mar;98(3):586-9
OBJECTIVE:
Endoscopic sphincterotomy (ES) is a widely accepted method of extracting bile
duct stones (BDS) in young as well as in elderly patients. The present study was
undertaken to assess the safety and efficacy of ES for the treatment of BDS in
children, seven of whom were critically sick because of suppurative cholangitis
or pancreatitis. METHOD: Over a period of 33 months, ES was performed in 16
consecutive children aged 7-16 yr with BDS. Nine patients had gallbladder in
situ, and seven had previously undergone cholecystectomy. The coexisting
abnormalities were gallstones and hepatic duct stones in one patient each and
dead fragmented roundworms in 11 patients. Seven (five with an intact
gallbladder and two cholecystectomized) patients presented with severe
complications of BDS such as severe cholangitis in six and acute severe
pancreatitis in one. RESULTS: ES was technically successful in all patients, and
complete stone extraction was achieved in 15 (93.8%) patients. Complications
were minor bleeding in one (6.3%) patient without mortality. One patient with
coexisting gallstones underwent cholecystectomy at a later date. During a mean
follow-up period of 4-32 months, one patient developed recurrent biliary
symptoms because of biliary ascariasis. CONCLUSIONS: We conclude ES is a safe
and an effective method of treating BDS in children with previous
cholecystectomy, and in those presenting with severe complications of BDS, such
as pyogenic cholangitis or acute pancreatitis regardless of the presence of
gallbladder.
Pathogenesis:
7099.
Ash LR. Ascaris lumbricoides? South Med J
2003 Jan;96(1):101-2. No abstract availbale.
October 2003
7800.
Araki
T, Tada S, Ueno N, Suko H, Yoneda Y, Matsumoto T. Gastric ascariasis.
Gastrointest Endosc. 2003 Apr;57(4):565. No abstract
7801.
Chawla A, Patwardhan V, Maheshwari M, Wasnik A. Primary ascaridial
perforation of the small intestine: Sonographic diagnosis. J Clin Ultrasound.
2003 May;31(4):211-3.
Ascaris
lumbricoides is the most common helminth affecting humans. Ascariasis can result
in serious complications, including intestinal obstruction and perforation.
Early diagnosis and treatment of such complications reduces the risk of
mortality. We present a case of sonographically diagnosed ascaridial perforation
in a 5-year-old girl. On sonography, each ascarid appeared as 2 pairs of
parallel lines, representing the worm's outer margins, flanking a central
sonolucent line, representing its digestive tract. Sonography revealed ascarides
in the peritoneal cavity and in some loops of the small bowel.Emergent
laparotomy was performed to remove ascarides from the peritoneal cavity and
terminal ileum, and the patient recovered well and was asymptomatic at a 3-month
follow-up. Knowledge of the sonographic features described herein may aid in the
evaluation of patients, especially children, in tropical countries who have
clinical symptoms of ascariasis.
7802.
de Silva NR. Impact of mass chemotherapy on the morbidity due to
soil-transmitted nematodes. Acta Trop. 2003 May;86(2-3):197-214.
This
review summarises current knowledge of the ill-effects of soil-transmitted
helminthiasis and takes a detailed look at studies that have been published over
the past decade describing the effect of mass anthelminthic use on the health of
endemic communities. Mass chemotherapy appears to give maximal returns in terms
of improved health in areas where hookworm is a major problem and albendazole is
used regularly, along with iron supplements; in children it improves physical
growth and iron stores, and in pregnant women it reduces the prevalence of
iron-deficiency anaemia. In areas where ascariasis is common, the directly
attributable benefits of chemotherapy may be minimal, but it can facilitate the
entry of other health care programmes in children, because deworming for
ascariasis is often much desired and appreciated by the community. In areas with
Vitamin A deficiency and endemic ascariasis, Vitamin A supplementation can be
combined with deworming: anthelminthics do not impair Vitamin A absorption but
the worms may interfere with Vitamin A uptake by reducing fat absorption. Where
trichuriasis is a major problem, single dose chemotherapy may take some time to
reduce prevalence, but reduction of heavy infections will reduce the incidence
of Trichuris Dysentery Syndrome, probably benefit the learning abilities of
affected schoolchildren, and may reduce anaemia and stunting. In general,
children should be treated as early as possible, and in areas of very high
prevalence, thrice-yearly mass chemotherapy probably improves health better than
twice-yearly treatment.
7803.
Montresor A, Awasthi S, Crompton DW. Use of benzimidazoles in children
younger than 24 months for the treatment of soil-transmitted helminthiasis. :
Acta Trop. 2003 May;86(2-3):223-32.
Strategy
Development and Monitoring for Parasitic Diseases and Vector Control,
Communicable Diseases Control, Prevention and Eradication, World Health
Organization, 20 Avenue Appia, 1211 27, Geneva, Switzerland Considerable
experience and limited quantitative evidence indicate that infections with the
soil-transmitted helminths Ascaris lumbricoides and Trichuris trichiura usually
start to become established in children aged 12
months
and older. Since children living in countries where the infections are endemic
are at risk of morbidity, even those as young as 12 months may need to be
considered for inclusion in public health programmes designed to reduce
morbidity by means of regular anthelminthic chemotherapy. This situation raises
the question as to whether such young children should be given anthelminthic
drugs. Systems for the absorption, distribution, metabolism and elimination of
drugs do not fully develop until children are in their second year of life.
Current knowledge, however, reveals that the incidence of side effects linked to
benzimidazole drugs in young children is likely to be the same as in older
children. Accordingly, we conclude that albendazole and mebendazole may be used
to treat children as young as 12 months if local circumstances show that relief
from ascariasis and trichuriasis is justified.
7804.
Pirlich
M, Schachschal G, Wermke W. Image of the month. Gastroenterology. 2003
Apr;124(4):879, 1171. No abstract
Pathogenesis:
7805.
Araki
T, Tada S, Ueno N, Suko H, Yoneda Y, Matsumoto T. Gastrointest Endosc. 2003
Apr;57(4):565. No
abstract
Therapy:
7806.
Cooper PJ, Chico ME, Rodrigues LC, Ordonez M, Strachan D, Griffin GE,
Nutman TB. Reduced risk of atopy among school-age children infected with
geohelminth parasites in a rural area of the tropics. J Allergy Clin Immunol.
2003 May;111(5):995-1000.
BACKGROUND:
Childhood infections might protect against the expression of atopy. Geohelminths
are among the most prevalent infections of childhood and might contribute to the
low prevalence of allergic disease reported from rural areas of the tropics.
OBJECTIVE: We sought to establish whether geohelminth infections protect against
atopy and to explore whether this protection is dependent on infection
chronicity. METHODS: The risk of atopy (measured by means of allergen skin test
reactivity) associated with active geohelminth infections (measured by means of
the presence of eggs in stool samples) or with chronic geohelminth infections
(measured by means of high levels [>/=3564 IU/mL] of total serum IgE or the
presence of detectable anti-Ascaris lumbricoides IgG4 antibodies) was
investigated in an analytic cross-sectional study conducted among school-age
children attending rural schools in Pichincha Province in Ecuador. RESULTS: A
total of 2865 children aged 5 to 19 years from 55 schools was examined. Active
infection with any geohelminth and infections with A lumbricoides or Ancylostoma
duodenale were associated with significant protective effects against allergen
skin test reactivity. Children with the highest levels of total IgE or with
anti-A lumbricoides IgG4 antibodies were protected against skin test reactivity
also, and the protective effects of high IgE or anti-A lumbricoides IgG4 and or
active geohelminth infections were statistically independent. CONCLUSION: Active
infections with geohelminth parasites and the presence of serologic markers of
chronic infections (high levels of total serum IgE or anti-A lumbricoides IgG4)
are independent protective factors against allergen skin test reactivity among
school-age children living in an endemic region of the rural tropics.
7807.
Miller G, Schecter
WP, Harris HW. Gallbladder ascariasis in a patient with severe pancreatitis.
Surgery. 2003 Apr;133(4):445-6. No
abstract