Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:



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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.



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.



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.


April 2003


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.



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  


7805.      Araki T, Tada S, Ueno N, Suko H, Yoneda Y, Matsumoto T. Gastrointest Endosc. 2003 Apr;57(4):565.  No abstract


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



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