Identification of Patients with Ascariasis

Ascariasis: is one of the commonest infections of the small intestine. Caused by a nematode called Ascaris lumbricoides ( round worm) 

Mode of Transmission of Ascariasis

• Common ways of acquiring ascariasis include failure to adhere to hygienic practices such as washing hands before food preparation and proper storage of food.
• Therefore the disease is related to poor sanitation and hygiene.
• Infection is acquired from ingestion of food contaminated with mature eggs
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• The usual vehicles are fruits and other raw food
• Children are more frequently infected and have higher worm burden than adults because they like putting contaminated objects into their mouths
• Heavy infection in children can contribute to under-nutrition.
• Adults have much lighter infections, although re-infection can occur throughout life.

Signs and Symptoms of Ascariasis

• Fever
• Cough
• Abdominal discomfort, restlessness and insomnia (sleeplessness)
• Eosinophilia due to allergic reaction
• Intestinal obstruction
• Passing adult worm in the stool or vomitus
• Obstructive jaundice

Treatment of Ascariasis

Treatment is effective only against the adult worms.
The drugs of choice are as follows:

• Albendazole: for children 2-5 years a single dose of 200mg and for older children and adults, one dose of 400mg is given.
• Mebendazole: a single dose 500mg.
• Levamisole: a single of 2.5mg/kg body weight.
• Piperazine (antepar): syrup at a dose of 150mg/kg body weight (to a maximum of 4g) as a single dose.

Note that these drugs are given between meals . They should be avoided during the first three months of pregnancy.

Prevention and Control of Ascariasis 

• Environmental measures such as provision of adequate and safe water supplies. Proper disposal of faeces 
• Prevention of faecal contamination of food and water
• Discourage use of fresh  human faeces as manure 

Health education on: 

• Proper use of latrines o Personal hygiene e.g. washing hands after using toilet or before handling food 
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• Washing fruits and vegetables before eating 
• Use of dry racks for utensils so that they are above the soil and dust 

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• Small intestine
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