Assessment of albendazole efficacy against Ascaris lumbricoides at three sites of Andhra Pradesh,Odisha,and Kerala in India

Objective:To assess efficacy of albendazole against Ascaris(A.)lumbricoides among school-children at three sites of Rajahmundry,Sundergarh and Wayanad.Methods:Sites were selected based on soil-transmitted helminths prevalence,different sociocultural-geographical characteristics and operational feasibility.9-12 Years old children from 14 schools were included.The study was conducted in two rounds:baseline&follow up survey.All eligible children found positive for A.lumbricoides at baseline were administered supervised single tablet albendazole 400 mg under the National Deworming Day Initiative.During post-treatment follow-up survey,eligible children who provided second stool sample were included in the final analysis.Stool samples were examined using WHO recommended Kato-Katz technique.Efficacy was estimated based on cure rate(CR)and Fecal Egg Count Reduction Rate(FECRR)among children found positive in baseline and follow-up surveys.Results:328 Out of 625(52.5%)were found positive for A.lumbricoides in the baseline survey and 85 out of 178 samples(47.8%)during post-treatment follow-up survey.Overall,the estimated CR was 52.2%.FECRR(95%CI)for albendazole was 72.6%(79.2%-66.0%).The FECRR was highest in East Godaveri[89.7%(96.8%-82.6%)],followed by Sundergarh[86.4%(95.3%-77.5%)]and Wayanad[69%(81.7%-56.4%)].Conclusions:Our study confirmed overall reduction in FEC although with varying albendazole efficacy for A.lumbricoides infection at three different locations in India.However,these finding may be assessed in context of ongoing MDA under Filaria control program and further studies by in vivo as well as in vitro methods are required to reach to a conclusion on possible resistance if any.

A Far-Out Case of Ascariasis Causing Small Bowel Obstruction in Mauritius

Ascaris lumbricoides (A. lumbricoides), the soil-transmitted helminth is the most prevalent parasitic infection of the gastrointestinal tract in developing countries. Heavy worm loads mainly due to untreated worm infestations are often associated with increased risk of severe sequelae. We report the first complicated case of A. lumbricoides causing small bowel obstruction in a 9-year-old boy that necessitated surgical intervention on a tropical island in the Indian Ocean, where cases of Ascariasis are rarely encountered.

Esophageal space-occupying lesion caused by Ascaris lumbricoides

Ascaris lumbricoides is the largest intestinal nematode parasite of man,which can lead to various complications because of its mobility.As the esophagus is not normal habitat of Ascaris,the report of esophageal ascariasis is rare.An old female presented with dysphagia after an intake of several red bean buns and haw jellies.The barium meal examination revealed a spherical defect in the lower esophagus.Esophageal bezoar or esophageal carcinoma was considered at the beginning.The patient fasted,and received fluid replacement treatment as well as some oral drugs such as proton pump inhibitor and sodium bicarbonate.Then upper gastrointestinal endoscopy was done to further confirm the diagnosis and found a live Ascaris lumbricoides in the gastric antrum and two in the duodenal bulb.The conclusive diagnosis was ascariasis.The esophageal space-occupying lesion might be the entangled worm bolus.Anthelmitnic treatment with mebendazole improved patient's clinical manifestations along with normalization of the radiological findings during a 2-wk follow-up.Authors report herein this rare case of Ascaris lumbricoides in the esophagus,emphasizing the importance of awareness of this parasitic infection as it often presents with different and unspecific symptoms.

Life-threatening complications of ascariasis in trauma patients:a review of the literature

BACKGROUND:Ascariasis is one of the most common human parasitic infections worldwide. In some rare cases,ascariasis may cause serious consequences even sudden death. This study was undertaken to review the life-threatening complications of ascariasis in trauma patients reported in the literature.DATA SOURCES:Relevant articles about ascariasis and trauma were searched from Pubmed,Google scholar,Scirus,and Wanfang databases.RESULTS:Twenty-four patients with ascariasis were collected from 21 articles searched. Most of these patients were from tropical and subtropical countries. Of the 24 patients,12 were children. Their major complications occurred in the airway passage and digestive tract. There were 3 fatal cases in these patients. Twelve of the 24 patients described in 10 articles were reported in the last 10 years.CONCLUSIONS:Early diagnosis and prompt intervention are essential to minimize the high morbidity and mortality of these serious complications in trauma patients. Physicians should be aware of the possibility of Ascaris infection in a trauma patient from endemic area of ascariasis. History of Ascaris infection and routine examination of feces for Ascaris eggs may be helpful to make a correct diagnosis.

Identification and Functional Analysis of Differentially Expressed Genes of Ascaris suum Goeze,1782 from Ascaris lumbricoides Linnaeus, 1758

In order to provide further evidence to prove that Ascaris suum Goeze,1782 and Ascaris lumbricoides Linnaeus,1758 are really different species in taxonomy,and to identity A.suum larval migrans-related genes for diagnosis and prevention use,A.suum genes that were differentialy expressed from the same gender of A.lumbricoides were enriched by subtracting the same expressed genes using suppression subtractive hybridization （SSH） assay.Specificity of the selectively enriched cDNA was verified by Southern blot analysis.The female A.suum specific cDNA library was then constructed and sequenced.Basic local alignment search tool （BLAST） analysis of female A.suum specific cDNA identified 6 specific ESTs with tentative functions related to larva migrans.This study provided further evidence for differentiating A.suum from A.lumbricoides.Mining for the detailed information and application of the 6 ESTs are worth being done in the future studies.

Serum malondialdehyde level in patients infected with Ascaris lumbricoides

AIM:The aim of the study was to investigate the changes of serum malondialdehyde level, I.e; the oxidative stress hypothesis in patients infected with Ascaris lumbricoides.METHODS: Serum malondialdehyde activity was measured in 43 patients who were positive for intestinal parasite of Ascaris lumbricoides. Scores were obtained for the positives and their age-and sex-matched 60 Ascaris lumbricoides negative healthy controls.RESULTS: The difference between malondialdehyde levels of patients infected with Ascaris lumbricoides and control group was statistically significant both for females (P＜0.05)and for males (P＜0.05). In the patient and control groups,no correlation was found between age and malondialdehyde levels (P＞0.05) both in females and in males. In addition,no significant correlation could be found between malondialdehyde levels of both females and males for patients and control groups (P＞0.05).CONCLUSION: Malondialdehyde levels clearly increase in patients infected with Ascaris lumbricoides.

Ascaris-mimicking common bile duct stone: A case report

BACKGROUND In most cases,it is not difficult to differentiate common bile duct(CBD)stone from Ascaris infection because they are different disease entities and have different imaging findings.The two diseases usually demonstrate unique characteristic findings on computed tomography or magnetic resonance cholangiopancreatography.However,we report a rare case from our experience in which a CBD stone mimicked and was misdiagnosed as Ascaris.CASE SUMMARY A 72-year-old male presented with elevated serum liver enzymes.Computed tomography showed a hyper-attenuated,elongated lesion in the CBD lumen and associated biliary inflammation.Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography revealed a linear filling defect in the bile duct.Moreover,elongated echogenic material with a central hypoechogenic area was seen on endoscopic ultrasound.Although the imaging findings caused us to suspect infection with the nematode Ascaris,the lesion was revealed to be a dark-brown-colored CBD stone through endoscopic extraction.CONCLUSION We report a rare case of a CBD stone that mimicked Ascaris.We also review the literature for side-by-side comparisons of the imaging features of CBD stones and ascariasis.

Hepatobiliary and pancreatic ascariasis

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.

Eosinophilic cholecystitis along with pericarditis caused by Ascaris lumbricoides: A case report

Although the etiology of eosinophilic cholecystitis is still obscure, the postulated causes include allergies, parasites, hypereosinophilic syndrome, and eosinophilic gastroenteritis. It is sometimes accompanied by several complications, but a simultaneous onset with pericarditis is very rares. A 28-year-old woman complained of acute right hypocondrial pain and dyspnea associated with systemic eruption. Several imaging modalities revealed acute cholecystitis and pericarditis with massive pericardial effusion. A marked peripheral blood eosinophilia was observed, and the eruption was diagnosed as urticaria. Her serum had a high titer of antibody against Ascaris lumbricoides . Treatment with albendazole drastically improved all clinical manifestations along with normalization of the imaging features and eosinophilia. We report herein a rare case of simultaneous onset of acute cholecystitis and pericarditis associated with a marked eosinophilia caused by parasitic infection.

Diagnosis of Ascaris lumbricoides infection using capsule endoscopy

Ascaris lumbricoides (A. lumbricoides ) is the most common intestinal roundworm parasite, infecting approximately one quarter of the world's population. Infection can lead to various complications because it can spread along the gastrointestinal tract. Although A. lumbricoides infection is a serious healthcare issue in developing countries, it now also has a worldwide distribution as a result of increased immigration and travel. Intestinal obstruction is the most common complication of A. lumbricoides infection, potentially leading to even more serious consequences such as small bowel perforation and peritonitis. Diagnosis is based primarily on stool samples and the patient's history. Early diagnosis, aided in part by knowledge of the local prevalence, can result in early treatment, thereby preventing surgical complications associated with intestinal obstruction. Further, delay in diagnosis may have fatal consequences. Capsule endoscopy can serve as a crucial, non-invasive diagnostic toolfor A. lumbricoides infection, especially when other diagnostic methods have failed to detect the parasite. We report a case of A. lumbricoides infection that resulted in intestinal obstruction at the level of the ileum. Both stool sample examination and open surgery failed to indicate the presence of A. lumbricoides, and the cause of the obstruction was only revealed by capsule endoscopy. The patient was treated with anthelmintics.

Current status of the efficacy and effectiveness of albendazole and mebendazole for the treatment of Ascaris lumbricoides in North-Western Indonesia

Objective:To investigate the efficacy and effectiveness of albendazole and mebendazole in the treatment of Ascaris lumbricoides(A.lumbricoides) in the North-Western Indonesia.Methods: 229 primary school children who were positive for A.lumbricoides in their stool were recruited in the study.123 children received single-dose of 400 mg albendazole and 106 children received single-dose 500 mg of mebendazole.After 1 week,their stools were examined for the cure rate (CR) and egg reduction rate(ERR).Egg culture was also performed and observation was made on week-1,-3,-4.Results:have shown a non-significant difference in CR 96.7%vs.100%:and ERR of 99.3%vs.100.0%for albendazole and mebendazole groups respectively(P】0.05).In-vitro egg culture has shown trends of decrease in the percentage of the unfertilized eggs and in≥2 cell eggs in both treatment groups(P【0.05).The embryonated eggs from the albendazole groups has shown an increase from 7.3%on week-1 to 13.8%on week-4,whilst the mebendazole group has shown a constant increase during the whole 4 weeks of culture from 7.5%to 28.3%(P【0.01). Conclusions:No evidence of drug resistance is noted so far from the area of North-Western part of Indonesia.In addition,although both drugs showed incomplete ovicidal effects,single-dose albendazole is better than mebendazole in sterilizing A.lumbricoides eggs.

Intestinal ascariasis at pediatric emergency room in a developed country

Ascaris lumbricoides infection is rare among children in developed countries.Although large numbers of adult Ascaris in the small intestine can cause various abdominal symptoms,this infection remains asymptomatic until the number of worms in the intestine considerably increases in most cases.Ascaris causing bilious vomiting suggesting ileus is rare,especially in developed countries.A 6-year-old boy who lived in Japan,presented with abdominal colic,bilious vomiting at the pediatric emergency room.He appeared pale,and had no abdominal distention,tenderness,palpable abdominal mass,or findings of dehydration.He experienced bilious vomiting again during a physical examination.Laboratory tests showed mild elevation of white blood cells and C-reactive protein levels.Antigens of adenovirus,rotavirus,and norovirus were not detected from his stool,and stool culture showed normal flora.Ultrasonography showed multiple,round-shaped structures within the small intestine,and a tubular structure in a longitudinal scan of the small intestine.Capsule endoscopy showed a moving worm of Ascaris in the jejunum.Intestinal ascariasis should be considered as a cause of bilious vomiting in children,even at the emergency room in industrial countries.Ultrasound examination and capsule endoscopy are useful for diagnosis of pediatric intestinal ascariasis.

Eosinophilic cholecystitis caused by Ascaris lumbricoides

Eosinophilic cholecystitis is caused by the accumulation of eosinophils in the gallbladder wall and diagnosis is usually made based on histopahologic studies. The purpose of this paper is to comment on a case report published in World 3 GaslToenterol 2007 .July; 13 （27）： 3760-3762, about eosinophilic cholecystitis along with pericarditis without histopathological studies, which are considered necessary for its diagnosis.

Serum cytokines profiles in Nigerian children with Ascaris lumbricoides infection

Objective:To investigate the cytokines pr of ile in the serum of some Nigerian children with Ascaris lumbricoides(A.lumbricoides) infection and relations between the intensity of infection, age and the concentration of these cytokines.Methods:Feacal samples from consenting children were examined using formol ether concentration techniques and Kato-Katz thick smear technique.Sera of 96 children comprising 76 A.lumbricoides infection and 20 controls were subjected to enzymes-linked immunosorbent assay.Results:The mean sera concentration of tumor necrosis factor alpha(TNF-α),interleukin-4(IL-4),interleukin-5(IL-5),interleukin- 10(IL-10) were(16.7±7.6) pg/mL,(4.6±0.8)pg/mL,(391.6±52.0) pg/mL and(181.2±30.4) pg/mL,respectively.The control subjects had the following mean serum cytokines:TNF-α(2.9±1.8) pg/m,IL-4(4.0±0.1) pg/mL,IL-5(125.1±50.1) pg/mL,IL-10(74.5±54.2) pg/ mL,respectively.The difference between the sera cytokines concentration of the A.lumbricoides infected children and their controls were statistically significant for TNF-α,IL- 5 and IL-10(χ~2= 9.99,P【 0.05;χ~2 = 137.24,P 【 0.05;χ~2 = 44.30,P 【 0.05,respectively). The intensity of infection correlated positively with TNF-α,and IL-5(r = 0.93 and 0.98, respectively) while IL-4 and IL- 10 correlated negatively with the intensity of infection(r = -0.62 and 0.99,respectively).TNF-α,IL-4 and IL-5 correlated positively with age(r = 0.19,0.33 and 0.66,respectively).The mean cytokines between those with mild and moderate infections were statistically significant for TNF-α,IL-5 and IL-10(χ~2 = 3.60,4.52 and 5.30, respectively).The ratio of TNF-α:IL-10 was 0.092.Conclusions:Elevated IL-5,IL-10 and TNF-αfound in the sera of the volunteers with Ascariasis implicates these cytokines as key mediators in the host responses to A.lumbriocoides infection in our studied area.

THE EVALUATION OF THE EFFECT OF MEBENDAZOLE ON TREATING ASCARIS LUMBRICOIDES AND TRICHURIS TRICHURA INFECTION WITH TWO KINDS OF THERAPY

A total of 309 cases infected with ascariasis and trichuriasis were selected as subjects, of whom 177 cases received mebendazole tablet 500mg/d for the treatment of ascariasis and trichuriais,132 cases received mebendazole tablet 200mg/d for three days, Before and after the treatment, all the patients' feces were examined with Kato's technique, the results indicated that the cure rate of ascariasis was 71. 4% (70/98) in the experiment group and 78. 6% (66/84) in the control group respectively; There was no difference between the two groups (P > 0. 05 ). The cure rate of trichuriasis infection was 87. 5% (14/16 ) in the experimental group and 93. 3% (14/15 ) in the control group;There was also no difference between the two groups (P= 0. 401 ). But the cure rate of mixed infection of ascariasis and trichuriasis was 54. 0% (34/63) and 75. 8% (25/33) respectively; The cure rate of the experimental group was apparently lower than the that of the control group (P < 0. 05 ). The average reduced rate of egg count in per gram feces (E,P, G ) for ascariasis infection was 63. 6% (14/22) in the experimental group and 93. 8% (15/16) in the control group. In conclusion, to treat ascariasis and trichuriasis infection with mebendazole tablet should be used the three-day therapy with a total dose of 600mg or 1200mg.

Investigation on Low Hemoglobin and Ascaris Infection among Primary and Secondary School Students in Hohhot

Introduction: Anemia and Ascaris infection are important indicators to reflect the health status of students. In this study, by investigating the current situation of low hemoglobin and positive rate of Ascaris eggs of primary and secondary school students in Hohhot, the health status of local primary and secondary school students is actually reflected. Objectives: To understand the prevalence of Low Hemoglobin and Ascaris infection among primary and secondary school students in Hohhot in 2015 and to give some suggestions on the health status of primary and secondary school students in Hohhot. Study Design: This project uses a cross-sectional study to investigate the distribution of disease and health status of primary and middle school students in Hohhot at a specific time, and to provide a clue to the cause of the hypothesis test. Methods: A stratified cluster random sampling method was used to select 4 districts, 4 counties and 1 flag in Hohhot, a total of 36 primary and secondary schools for sample survey. Cyanine HiCN and smear method is to detect hemoglobin and ascaris eggs positive. Results: In 2015, the positive rate of low hemoglobin in primary and secondary school students was 21.45% in urban and rural areas, 33.17% in urban and rural areas, 43.69% in rural areas, 13.59% in ascaris eggs, 10.69% in urban and rural areas, 7.81% in rural areas. There are geographical differences and gender differences between cities, urban-rural junctions and rural areas (p Conclusion: The prevalence of low hemoglobin in primary and secondary school students in Hohhot is high in rural areas. The detection rate of ascaris egg positive rate in the city is high. Monitoring, publicity and education should continue to be strengthened.

ASCARI KZ-1：不是很完美

看过Ascari KZ-1的性能参数，你或许会觉得它肯定是某种需要出卖身体器官——不是小手指．而是真正有用的东西．如肾或眼睛（千万不能近视）——才能换得回来的东西。不过在你动身前往买卖人体器官的黑市之前．最好认真阅读一下我们对它的剖析。

牡丹江市三道关林区野生鼠总科动物感染绦虫和蛔虫的情况调查

为调查牡丹江市三道关林区野生鼠总科(Muroidea)动物组成情况以及鼠总科动物感染绦虫和蛔虫的情况,采用铗日法,于2023年3—10月在牡丹江市三道关林区利用捕鼠笼捕捉野生鼠总科动物。将捕捉到的野生鼠总科动物根据形态学特征进行分类并解刨,将小肠用生理盐水冲洗,取出虫体后,在显微镜下进行形态学分析并判断其种属,分析并记录各种野生鼠总科动物感染绦虫和蛔虫的情况。结果表明:在牡丹江市三道关林区不同生境共捕获野生鼠总科动物247只,隶属于1目2科3属5种,其中包括大林姬鼠(Apodemus peninsulae)、黑线姬鼠(Apodemus agrarius)、棕背鼠平(Myodes rufocanus)、东方田鼠(Microtus fortis)、大仓鼠(Tscherskia triton),种类组成以大林姬鼠和黑线姬鼠为主,分别占40.89%和34.01%;经形态学鉴定,感染的绦虫均为缩小膜壳绦虫(Hymenolepis dimimula),三道关林区野生鼠类感染缩小膜壳绦虫和蛔虫的概率分别为2.43%、1.62%。其中,大林姬鼠感染缩小膜壳绦虫的概率为2.97%,黑线姬鼠感染缩小膜壳绦虫的概率为4.76%,黑线姬鼠感染蛔虫的概率为4.76%,其余鼠未见有感染。综上所述,三道关野生鼠总科动物感染缩小膜壳绦虫的概率较全国其他省份低,但出现蛔虫感染现象,对人类健康构成一定威胁,相关部门应加强鼠患和寄生虫的防治工作。

Global prevalence of Ascaris infection in humans(2010–2021):a systematic review and meta-analysis

Background:Ascariasis is one of the most important neglected tropical diseases of humans worldwide.The epidemiology of Ascaris infection appears to have changed with improvements in sanitation and mass drug administration,but there is no recent information on prevalence worldwide.Here,we performed a systematic review and meta-analysis to assess the global prevalence of human Ascaris infection from 2010 to 2021.Methods:We searched MEDLINE/PubMed,and Scopus databases for studies measuring prevalence of Ascaris infection,published between 1 January 2010 and 1 January 2022.We included studies of the general human population in endemic regions,which used accepted coprodiagnostic methods,and excluded studies of people with occupations with an increased risk or probability of ascariasis and/or specifc diseases other than ascariasis.We applied randomefects models to obtain pooled prevalence estimates for six sustainable development goal regions of the world.We extrapolated the prevalence estimates to the global population in 2020,to estimate the number of individuals with Ascaris infection.We conducted multiple subgroup and meta-regression analyses to explore possible sources of heterogeneity,and to assess relationships between prevalence estimates and demographic,socio-economic,geoclimatic factors.Results:Of 11,245 studies screened,we analysed 758 prevalence estimates for a total number of 4,923,876 participants in 616 studies from 81 countries.The global prevalence estimated was 11.01%(95%confdence interval:10.27–11.78%),with regional prevalences ranging from 28.77%(7.07–57.66%)in Melanesia(Oceania)to 1.39%(1.07–1.74%)in Eastern Asia.We estimated that~732(682–782)million people harboured Ascaris worldwide in 2021.The infected people in Latin America and the Caribbean region had a higher prevalence of high intensity infection(8.4%,3.9–14.1%).Prevalence estimates were higher in children,and people in rural communities or in countries or regions with lower income and human development indices.There was a trend for a higher prevalence in regions with increasing mean annual relative humidity,precipitation and environmental temperature.Conclusions:Our fndings indicate that,despite a renewed commitment by some communities or authorities to control ascariasis,a substantial portion of the world’s human population(>0.7 billion)is infected with Ascaris.Despite the clinical and socioeconomic importance of ascariasis,many past routine surveys did not assess the intensity of Ascaris infection in people.We propose that the present fndings might stimulate the development of customised strategies for the improved control and prevention of Ascaris infection worldwide.

Cytosolic Ca^(2+)as a multifunctional modulator is required for spermiogenesis in Ascaris suum

The dynamic polar polymers actin fi laments and microtu-bules are usually employed to provide the structural ba-sis for establishing cell polarity in most eukaryotic cells.Radially round and immotile spermatids from nematodes contain almost no actin or tubulin,but still have the abil-ity to break symmetry to extend a pseudopod and initiate the acquisition of motility powered by the dynamics of cytoskeleton composed of major sperm protein(MSP)during spermiogenesis(sperm activation).However,the signal transduction mechanism of nematode sperm activation and motility acquisition remains poorly under-stood.Here we show that Ca^(2+) oscillations induced by the Ca^(2+) release from intracellular Ca^(2+) store through inositol(1,4,5)-trisphosphate receptor are required for Ascaris suum sperm activation.The chelation of cytosolic Ca^(2+) suppresses the generation of a functional pseudopod,and this suppression can be relieved by introducing ex-ogenous Ca^(2+) into sperm cells.Ca^(2+) promotes MSP-based sperm motility by increasing mitochondrial membrane potential and thus the energy supply required for MSP cytoskeleton assembly.On the other hand,Ca^(2+) promotes MSP disassembly by activating Ca^(2+)/calmodulin-depend-ent serine/threonine protein phosphatase calcineurin.In addition,Ca^(2+)/camodulin activity is required for the fusion of sperm-specifi c membranous organelle with the plasma membrane,a regulated exocytosis required for sperm mo-tility.Thus,Ca^(2+)plays multifunctional roles during sperm activation in Ascaris suum.