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Nature Reviews. Disease Primers May 2020Trichuriasis and ascariasis are neglected tropical diseases caused by the gastrointestinal dwelling nematodes Trichuris trichiura (a whipworm) and Ascaris lumbricoides... (Review)
Review
Trichuriasis and ascariasis are neglected tropical diseases caused by the gastrointestinal dwelling nematodes Trichuris trichiura (a whipworm) and Ascaris lumbricoides (a roundworm), respectively. Both parasites are staggeringly prevalent, particularly in tropical and subtropical areas, and are associated with substantial morbidity. Infection is initiated by ingestion of infective eggs, which hatch in the intestine. Thereafter, T. trichiura larvae moult within intestinal epithelial cells, with adult worms embedded in a partially intracellular niche in the large intestine, whereas A. lumbricoides larvae penetrate the gut mucosa and migrate through the liver and lungs before returning to the lumen of the small intestine, where adult worms dwell. Both species elicit type 2 anti-parasite immunity. Diagnosis is typically based on clinical presentation (gastrointestinal symptoms and inflammation) and the detection of eggs or parasite DNA in the faeces. Prevention and treatment strategies rely on periodic mass drug administration (generally with albendazole or mebendazole) to at-risk populations and improvements in water, sanitation and hygiene. The effectiveness of drug treatment is very high for A. lumbricoides infections, whereas cure rates for T. trichiura infections are low. Novel anthelminthic drugs are needed, together with vaccine development and tools for diagnosis and assessment of parasite control in the field.
Topics: Animals; Ascariasis; Ascaris lumbricoides; Humans; Prevalence; Trichuriasis; Trichuris
PubMed: 32467581
DOI: 10.1038/s41572-020-0171-3 -
Recent Patents on Inflammation &... 2020Ascaris lumbricoides is the most common helminthic infection. More than 1.2 billion people have ascariasis worldwide. (Review)
Review
BACKGROUND
Ascaris lumbricoides is the most common helminthic infection. More than 1.2 billion people have ascariasis worldwide.
OBJECTIVE
This article aimed to provide an update on the evaluation, diagnosis, and treatment of ascariasis.
METHODS
A PubMed search was conducted in February 2020 in Clinical Queries using the key terms "ascariasis" OR "Ascaris lumbricoides". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews published within the past 10 years. The search was restricted to English literature. The information retrieved from the above search was used in the compilation of the present article. Patents were searched using the key term "ascariasis" OR "Ascaris lumbricoides" in www.freepatentsonline.com.
RESULTS
Ascaris lumbricoides is transmitted through the ingestion of embryonated eggs from fecal- contaminated material. Ascariasis has high endemicity in tropical and subtropical areas. Predisposing factors include poverty, poor sanitation, inadequate sewage disposal, and poor personal hygiene. The prevalence is greatest in children younger than 5 years of age. The majority of patients with intestinal ascariasis are asymptomatic. For those with symptoms, anorexia, nausea, bloating, abdominal discomfort, recurrent abdominal pain, abdominal distension, and intermittent diarrhea are not uncommon. Other clinical manifestations vary widely, depending on the underlying complications. Complications include Löeffler syndrome, intestinal obstruction, biliary colic, recurrent pyogenic cholangitis, cholecystitis, acalculous cholecystitis, obstructive jaundice, cholelithiasis, pancreatitis, and malnutrition. The diagnosis is best established by microscopic examination of fecal smears or following concentration techniques for the characteristic ova. Patients with A. lumbricoides infection warrant anthelminthic treatment, even if they are asymptomatic, to prevent complications from migration of the parasite. Albendazole and mebendazole are the drugs of choice for children and nonpregnant individuals with ascariasis. Pregnant women with ascariasis should be treated with pyrantel pamoate. Recent patents related to the management of ascariasis are also discussed.
CONCLUSION
The average cure rate with anthelminthic treatment is over 95%. Unfortunately, most treated patients in endemic areas become re-infected within months. Health education, personal hygiene, improved sanitary conditions, proper disposal of human excreta, and discontinuing the use of human fecal matter as a fertilizer are effective long-term preventive measures. Targeting deworming treatment and mass anthelminthic treatment should be considered in regions where A. lumbricoides is prevalent.
Topics: Animals; Anthelmintics; Ascariasis; Ascaris lumbricoides; Humans; Patents as Topic
PubMed: 32628606
DOI: 10.2174/1872213X14666200705235757 -
The Korean Journal of Parasitology Jun 2021The use of albendazole and mebendazole, i.e., benzimidazole broad-spectrum anthelmintics, in treatment of parasitic infections, as well as cancers, is briefly reviewed.... (Review)
Review
The use of albendazole and mebendazole, i.e., benzimidazole broad-spectrum anthelmintics, in treatment of parasitic infections, as well as cancers, is briefly reviewed. These drugs are known to block the microtubule systems of parasites and mammalian cells leading to inhibition of glucose uptake and transport and finally cell death. Eventually they exhibit ovicidal, larvicidal, and vermicidal effects on parasites, and tumoricidal effects on hosts. Albendazole and mebendazole are most frequently prescribed for treatment of intestinal nematode infections (ascariasis, hookworm infections, trichuriasis, strongyloidiasis, and enterobiasis) and can also be used for intestinal tapeworm infections (taeniases and hymenolepiasis). However, these drugs also exhibit considerable therapeutic effects against tissue nematode/cestode infections (visceral, ocular, neural, and cutaneous larva migrans, anisakiasis, trichinosis, hepatic and intestinal capillariasis, angiostrongyliasis, gnathostomiasis, gongylonemiasis, thelaziasis, dracunculiasis, cerebral and subcutaneous cysticercosis, and echinococcosis). Albendazole is also used for treatment of filarial infections (lymphatic filariasis, onchocerciasis, loiasis, mansonellosis, and dirofilariasis) alone or in combination with other drugs, such as ivermectin or diethylcarbamazine. Albendazole was tried even for treatment of trematode (fascioliasis, clonorchiasis, opisthorchiasis, and intestinal fluke infections) and protozoan infections (giardiasis, vaginal trichomoniasis, cryptosporidiosis, and microsporidiosis). These drugs are generally safe with few side effects; however, when they are used for prolonged time (>14-28 days) or even only 1 time, liver toxicity and other side reactions may occur. In hookworms, Trichuris trichiura, possibly Ascaris lumbricoides, Wuchereria bancrofti, and Giardia sp., there are emerging issues of drug resistance. It is of particular note that albendazole and mebendazole have been repositioned as promising anti-cancer drugs. These drugs have been shown to be active in vitro and in vivo (animals) against liver, lung, ovary, prostate, colorectal, breast, head and neck cancers, and melanoma. Two clinical reports for albendazole and 2 case reports for mebendazole have revealed promising effects of these drugs in human patients having variable types of cancers. However, because of the toxicity of albendazole, for example, neutropenia due to myelosuppression, if high doses are used for a prolonged time, mebendazole is currently more popularly used than albendazole in anti-cancer clinical trials.
Topics: Albendazole; Animals; Anthelmintics; Antineoplastic Agents; Ascariasis; Female; Humans; Male; Mebendazole; Parasites; Trichuriasis
PubMed: 34218593
DOI: 10.3347/kjp.2021.59.3.189 -
Medical Ultrasonography Aug 2022Ascariasis no longer widespread within Europe and so experience in diagnosis and treatment is limited for many specialists. On the other hand, clinicians face increasing... (Review)
Review
Ascariasis no longer widespread within Europe and so experience in diagnosis and treatment is limited for many specialists. On the other hand, clinicians face increasing numbers of migrants from high prevalence countries and are therefore, challenged to update in this field of infectious diseases. Here we present imaging features and current knowledge of this infection.
Topics: Ascariasis; Europe; Humans; Prevalence; Transients and Migrants
PubMed: 34379712
DOI: 10.11152/mu-3343 -
Current Biology : CB May 2020Wang and Davis provide an overview of the parasite nematode Ascaris, including the history of its role in biological research.
Wang and Davis provide an overview of the parasite nematode Ascaris, including the history of its role in biological research.
Topics: Animals; Ascariasis; Ascaris; Female; Humans; Male; Reproduction
PubMed: 32428467
DOI: 10.1016/j.cub.2020.02.064 -
Journal of Special Operations Medicine... 2018
Topics: Albendazole; Animals; Anthelmintics; Ascariasis; Ascaris; Child; Humans; Swine
PubMed: 29889967
DOI: 10.55460/FFEM-COO8 -
Radiologic Clinics of North America May 2022Although many of the thoracic infections endemic to Africa are also present around the world, this article focuses on entities that are emerging or disproportionately... (Review)
Review
Although many of the thoracic infections endemic to Africa are also present around the world, this article focuses on entities that are emerging or disproportionately affect populations living in sub-Saharan Africa. Important emerging or reemerging viral and bacterial diseases that commonly affect the lung include dengue fever, plague, leptospirosis, and rickettsioses. Most parasitic infections endemic to Africa can also manifest within the thorax, including malaria, amebiasis, hydatid disease, schistosomiasis, paragonimiasis, ascariasis, strongyloidiasis and cysticercosis. Level of sanitation, interaction between humans and host animals, climate change, political instability, and global travel all affect the distribution and burden of these diseases.
Topics: Amebiasis; Animals; Ascariasis; Humans; Parasitic Diseases; Schistosomiasis; Strongyloidiasis
PubMed: 35534131
DOI: 10.1016/j.rcl.2022.01.003 -
World Journal of Gastroenterology Sep 2016Hepatobiliary and pancreatic ascariasis (HPA) was described as a clinical entity from Kashmir, India in 1985. HPA is caused by invasion and migration of nematode,... (Review)
Review
Hepatobiliary and pancreatic ascariasis (HPA) was described as a clinical entity from Kashmir, India in 1985. HPA is caused by invasion and migration of nematode, Ascaris lumbricoides, in to the biliary tract and pancreatic duct. Patients present with biliary colic, cholangitis, cholecystitis, hepatic abscesses and acute pancreatitis. Ascarides traverse the ducts repeatedly, get trapped and die, leading to formation of hepatolithiasis. HPA is ubiquitous in endemic regions and in Kashmir, one such region, HPA is the etiological factor for 36.7%, 23%, 14.5% and 12.5% of all biliary diseases, acute pancreatitis, liver abscesses and biliary lithiasis respectively. Ultrasonography is an excellent diagnostic tool in visualizing worms in gut lumen and ductal system. The rational treatment for HPA is to give appropriate treatment for clinical syndromes along with effective anthelmintic therapy. Endotherapy in HPA is indicated if patients continue to have symptoms on medical therapy or when worms do not move out of ductal lumen by 3 wk or die within the ducts. The worms can be removed from the ductal system in most of the patients and such patients get regression of symptoms of hepatobiliary and pancreatic disease.
Topics: Algorithms; Animals; Ascariasis; Ascaris lumbricoides; Biliary Tract; Biliary Tract Diseases; Cholangitis; Cholecystitis; Humans; India; Liver Diseases, Parasitic; Pancreatitis; Prevalence
PubMed: 27672273
DOI: 10.3748/wjg.v22.i33.7507 -
The New England Journal of Medicine Aug 2023
Topics: Humans; Ascariasis; Biliary Tract Diseases
PubMed: 37632462
DOI: 10.1056/NEJMicm2301930 -
Radiographics : a Review Publication of... Aug 2023
Topics: Humans; Ascariasis; Pancreas; Pancreatitis; Biliary Tract Diseases
PubMed: 37471244
DOI: 10.1148/rg.230049