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C. V. Holland - One of the best experts on this subject based on the ideXlab platform.
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51S The public health importance of Ascaris lumbricoides
2016Co-Authors: C. V. HollandAbstract:summary Numerous studies have shown that anthelminthic treatment can be effective in improving growth rates when given to malnourished children with Ascariasis. Recent investigations have also indicated that Ascaris infections can affect mental processing in some school children. Poor socio-economic conditions are among the key factors linked with higher prevalences of Ascariasis, as are defaecation practices, geophagia, cultural differences relating to personal and food hygiene, occupational necessity, agricultural factors, housing style, social class and gender. Chemotherapy is currently the major tool used for the strategic control of Ascariasis as a short-term goal. In the long term, improvements in hygiene and sanitation are thought to aid long-term control considerably. Targeted treatment, especially when aimed at schoolchildren, has been a major focus of recent control efforts in some areas. Universal treatment reaches more people and thus decreases further aggregate morbidity, especially in nutritionally vulnerable preschool-age children. Selective treatment requires technical effort to identify heavily infected individuals; acceptance by the community may vary in less educated popu-lations when some individuals receive treatment and others do not. Child-targeted treatment may be more cost-effective than population treatment in reducing the number of disease cases and, in high transmission areas, expanding coverage of a population can be a more cost-effective strategy than increasing the frequency of treatment. Key words: Ascaris lumbricoides, child growth, cognitive performance, chemotherapy control strategies, cost effectiveness. introduction public health relevance and recent global estimates Ascaris lumbricoides is a remarkably infectious and persistent parasite that infects a quarter of the world’s population (Pawlowski & Arfaa, 1984; Crompton, 1994). It has been widely recognized that Ascariasis plays a major role in the aetiology of childhood malnutrition (Crompton, 1992). Global numbers of infections have been estimated to b
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CV: Predisposition to Ascariasis: patterns, mechanisms and implications
2016Co-Authors: C. V. HollandAbstract:Ascaris lumbricoides, the human roundworm, is a remarkably infectious and persistent parasite. It is a member of the soil-transmitted helminths or geohelminths and infects in the order of 1472 million people worldwide. Despite, its high prevalence and wide distribution it remains along with its geohelminth counterparts, a neglected disease. Ascariasis is associated with both chronic and acute morbidity, particularly in growing children, and the level of morbidity assessed as disability-adjusted life years is about 10.5 million. Like other macroparasite infections, the frequency distribution of A. lumbricoides is aggregated or overdispersed with most hosts harbouring few or no worms and a small proportion harbouring very heavy infections. Furthermore, after chemotherapeutic treatment, individuals demonstrate consistency in the pattern of re-infection with Ascariasis, described as predisposition. These epidemiological phenomena have been identified, in a consistent manner, from a range of geographical locations in both children and adults. However, what has proved to be much more refractory to investigation has been the mechanisms that contribute to the observed epidemi-ological patterns. Parallel observations utilizing human subjects and appropriate animal model systems are essential to our understanding of the mechanisms underlying susceptibility/resistance to Ascariasis. Furthermore, these patterns ofAscaris intensity and re-infection have broader implications with respect to helminth control and interactions with other important bystander infections
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ascaris and Ascariasis
Microbes and Infection, 2011Co-Authors: Christina Dold, C. V. HollandAbstract:Ascaris lumbricoides and Ascaris suum are widespread parasitic nematodes of humans and pigs respectively. Recent prevalence data suggests that approximately 1.2 billion people are infected. Adult worms exhibit an overdispersed frequency distribution in their hosts and individuals harbouring heavy burdens display associated morbidity. In this review, we describe the parasite, its distribution and measures undertaken to control infection.
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the public health importance of ascaris lumbricoides
Parasitology, 2000Co-Authors: P Olorcain, C. V. HollandAbstract:Numerous studies have shown that anthelminthic treatment can be effective in improving growth rates when given to malnourished children with Ascariasis. Recent investigations have also indicated that Ascaris infections can affect mental processing in some school children. Poor socio-economic conditions are among the key factors linked with higher prevalences of Ascariasis, as are defaecation practices, geophagia, cultural differences relating to personal and food hygiene, occupational necessity, agricultural factors, housing style, social class and gender. Chemotherapy is currently the major tool used for the strategic control of Ascariasis as a short-term goal. In the long term, improvements in hygiene and sanitation are thought to aid long-term control considerably. Targeted treatment, especially when aimed at schoolchildren, has been a major focus of recent control efforts in some areas. Universal treatment reaches more people and thus decreases further aggregate morbidity, especially in nutritionally vulnerable preschool-age children. Selective treatment requires technical effort to identify heavily infected individuals; acceptance by the community may vary in less educated populations when some individuals receive treatment and others do not. Child-targeted treatment may be more cost-effective than population treatment in reducing the number of disease cases and, in high transmission areas, expanding coverage of a population can be a more cost-effective strategy than increasing the frequency of treatment.
M S Khuroo - One of the best experts on this subject based on the ideXlab platform.
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hepatobiliary and pancreatic Ascariasis
World Journal of Gastroenterology, 2016Co-Authors: Naira S Khuroo, Ajaz A Rather, M S KhurooAbstract: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.
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hepatobiliary and pancreatic Ascariasis
Indian Journal of Gastroenterology, 2001Co-Authors: M S KhurooAbstract:Ascariasis is a helminthic infection of global distribution with more than 1.4 billion persons infected throughout the world. The majority of infections occur in the developing countries of Asia and Latin America. Of 4 million people infected in the United States, a large percentage are immigrants from developing countries. Ascaris-related clinical disease is restricted to subjects with heavy worm load, and an estimated 1.2 to 2 million such cases, with 20,000 deaths, occur in endemic areas per year. More often, recurring moderate infections cause stunting of linear growth, cause reduced cognitive function, and contribute to existing malnutrition in children in endemic areas. HPA is a frequent cause of biliary and pancreatic disease in endemic areas. It occurs in adult women and can cause biliary colic, acute cholecystitis, acute cholangitis, acute pancreatitis, and hepatic abscess. RPC causing hepatic duct calculi is possibly an aftermath of recurrent biliary invasion in such areas. Ultrasonography can detect worms in the biliary tract and pancreas and is a useful noninvasive technique for diagnosis and follow-up of such patients. ERCP can help diagnose biliary and pancreatic Ascariasis, including ascaris in the duodenum. Also, ERCP can be used to extract worms from the biliary and pancreatic ducts when indicated. Pyrantel pamoate, mebendazole, albendazole and levamisole are effective drugs and can be used for mass therapy to control Ascariasis in endemic areas.
Altaf Shah - One of the best experts on this subject based on the ideXlab platform.
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etiology and outcome of acute pancreatitis in children in kashmir india an endemic area of hepatobiliary Ascariasis
World Journal of Surgery, 2013Co-Authors: Gul Javid, Showkat Ali Zargar, Altaf Shah, Abid Shoukat, Asif Iqball, Amit GuptaAbstract:The purpose of the present study was to determine the etiology, management, and outcome of acute pancreatitis (AP) in children in an endemic area of hepatobiliary Ascariasis (HBA). This was a prospective, hospital-based study over a 9-year period that included 156 children younger than 12 years of age who had a diagnosis of AP. Of the 156 patients, 71 were boys and 85 were girls with a mean age of 8.4 ± 1.5 years (range 3–12 years). The various factors contributing to AP were biliary Ascariasis in 93 cases (60 %), gallstones 16 (10 %), trauma 5 (3 %), choledochal cyst 4 (3 %), impacted bile duct stone 3 (2 %), and gallbladder sludge 2 (1 %). Idiopathic group 33 cases (21 %). Diagnosis was based on clinical picture, abdominal ultrasonography, and elevated serum amylase level. Pancreatitis was mild in 113 (72 %) patients and severe in 43 (28 %). With conservative therapy, 123 patients (79 %) improved, whereas the remaining 33, who had intractable abdominal pain, cholangitis, or worsening cholecystitis, underwent emergency endoscopic retrograde cholangiopancreatography for removal of worms (26 patients) and stones in the bile duct (7 patients). Bile duct stones were extracted in all 7 patients with that condition, and worms were extracted from 23 of the 26 patients with Ascariasis. Emergency surgery was performed in five patients. Three patients died. Pancreatitis recurred in 16 patients due to HBA. Pancreatitis is not uncommon in children. Ascariasis is a leading cause of AP in endemic areas. Patients usually respond to conservative management, but endoscopic treatment is effective. Surgery is rarely required.
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gallbladder Ascariasis presentation and management
British Journal of Surgery, 2002Co-Authors: Gul Javid, Nazir A Wani, G M Gulzar, O Javid, Bashir Ahmed Khan, Altaf ShahAbstract:Background: As many as 1·5 billion people around the world harbour Ascaris lumbricoides in the digestive tract. Gallbladder Ascariasis, although less common than bile duct Ascariasis, is quite often seen in endemic areas. Methods: Some 1300 patients with hepatobiliary Ascariasis, admitted between October 1992 and June 1998, were analysed prospectively. The clinical features and outcome of 56 cases of gallbladder Ascariasis are presented. Results: Forty-seven patients were diagnosed by ultrasonography and nine were diagnosed at laparotomy. Only ten patients diagnosed by ultrasonography expelled the worms spontaneously, with resolution of symptoms and signs. The remaining 37 patients underwent cholecystectomy. Conclusion: Gallbladder Ascariasis is a significant entity in endemic areas which usually requires cholecystectomy. © 1999 British Journal of Surgery Society Ltd
Gul Javid - One of the best experts on this subject based on the ideXlab platform.
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etiology and outcome of acute pancreatitis in children in kashmir india an endemic area of hepatobiliary Ascariasis
World Journal of Surgery, 2013Co-Authors: Gul Javid, Showkat Ali Zargar, Altaf Shah, Abid Shoukat, Asif Iqball, Amit GuptaAbstract:The purpose of the present study was to determine the etiology, management, and outcome of acute pancreatitis (AP) in children in an endemic area of hepatobiliary Ascariasis (HBA). This was a prospective, hospital-based study over a 9-year period that included 156 children younger than 12 years of age who had a diagnosis of AP. Of the 156 patients, 71 were boys and 85 were girls with a mean age of 8.4 ± 1.5 years (range 3–12 years). The various factors contributing to AP were biliary Ascariasis in 93 cases (60 %), gallstones 16 (10 %), trauma 5 (3 %), choledochal cyst 4 (3 %), impacted bile duct stone 3 (2 %), and gallbladder sludge 2 (1 %). Idiopathic group 33 cases (21 %). Diagnosis was based on clinical picture, abdominal ultrasonography, and elevated serum amylase level. Pancreatitis was mild in 113 (72 %) patients and severe in 43 (28 %). With conservative therapy, 123 patients (79 %) improved, whereas the remaining 33, who had intractable abdominal pain, cholangitis, or worsening cholecystitis, underwent emergency endoscopic retrograde cholangiopancreatography for removal of worms (26 patients) and stones in the bile duct (7 patients). Bile duct stones were extracted in all 7 patients with that condition, and worms were extracted from 23 of the 26 patients with Ascariasis. Emergency surgery was performed in five patients. Three patients died. Pancreatitis recurred in 16 patients due to HBA. Pancreatitis is not uncommon in children. Ascariasis is a leading cause of AP in endemic areas. Patients usually respond to conservative management, but endoscopic treatment is effective. Surgery is rarely required.
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gallbladder Ascariasis presentation and management
British Journal of Surgery, 2002Co-Authors: Gul Javid, Nazir A Wani, G M Gulzar, O Javid, Bashir Ahmed Khan, Altaf ShahAbstract:Background: As many as 1·5 billion people around the world harbour Ascaris lumbricoides in the digestive tract. Gallbladder Ascariasis, although less common than bile duct Ascariasis, is quite often seen in endemic areas. Methods: Some 1300 patients with hepatobiliary Ascariasis, admitted between October 1992 and June 1998, were analysed prospectively. The clinical features and outcome of 56 cases of gallbladder Ascariasis are presented. Results: Forty-seven patients were diagnosed by ultrasonography and nine were diagnosed at laparotomy. Only ten patients diagnosed by ultrasonography expelled the worms spontaneously, with resolution of symptoms and signs. The remaining 37 patients underwent cholecystectomy. Conclusion: Gallbladder Ascariasis is a significant entity in endemic areas which usually requires cholecystectomy. © 1999 British Journal of Surgery Society Ltd
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sonographic findings in gallbladder Ascariasis
Journal of Clinical Ultrasound, 1992Co-Authors: M S Khuroo, Showkat Ali Zargar, Gul Javid, Ghulam Nabi Yattoo, Mohammad Yousuf Dar, Bashir Ahmad Khan, Mohamad Iqbal Boda, R MahajanAbstract:Invasion of the adult roundworm, Ascaris lumbricoides, into the gallbladder is rare and was seen in 14(2.1%) of the 665 cases with hepatobiliary Ascariasis. The diagnosis was suggested in all 13 cases in which sonography was performed and in 5 of the 11 cases at endoscopic retrograde cholangiography. Sonographic findings included a nonshadowing, long, echogenic structure in the form of a coil, an echogenic strip with central anechoic tube, an echogenic structure extending across the gallbladder giving it a septate appearance, and characteristic erratic, nondirectional, zig-zag movements of these echogenic structures in the gallbladder. Serial sonograms accurately predicted spontaneous exit of the worm. Pregnancy and anomalous origin of the cystic duct directly from the papilla of Vater facilitated worm invasion into the gallbladder. We conclude that real-time sonography offers a simple, rapid approach for the diagnosis and follow-up of patients, whereas endoscopic retrograde cholangiography has limited diagnostic value in this disorder. ©1992 by John Wiley & Sons, Inc.
D W T Crompton - One of the best experts on this subject based on the ideXlab platform.
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ascaris and Ascariasis
Advances in Parasitology, 2001Co-Authors: D W T CromptonAbstract:Abstract In recent years much new information has been obtained baout the epidemiology, population biologyand public health significance of infections of Asacaris lumbricoides in humans. Results from experimental infections of A. suum in pigs have helped to elucidate the observations made in the community on human Ascariasis. The main purpose of the review is to see how new infomation may contribute to further acceptance of Ascariasis as a serious contributor to ill-health and so to the design and implementation of suatainable control programmes intended to reduce the morbidity due te infection with A. lumbricoides . Eradication is neither a realistic nor prudent aim given the current shortage of appropriate sanitation in many countries where Ascariasis is endemic. A substabtial body of evidence shows that for the four common species of soil-transmitted nematode, including A. lumbricoides , regular adminitration of broad-spectrum antelminthic drugs to children attending primary schools is a cost-effective means of controlling the infections. Anthelminthic drugs must be of proven quality anf efficacy and health professionsla shoud be prepared to detect and manage drug resistance should that emerge. Despite a deeper understanding of the immune response of a variety of hosts to infections with either A. lumbricoides or A. suum there is at present little prospect of an effective vaccine against Ascariasis. The relationship between A. lumbricoides and A. suum is addressed, particularly since both species, if they are indeed separate species, occur in people and their pigs in many communities.
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ascaris and Ascariasis
Advances in Parasitology, 2001Co-Authors: D W T CromptonAbstract:In recent years much new information has been obtained about the epidemiology, population biology and public health significance of infections of Ascaris lumbricoides in humans. Results from experimental infections of A. suum in pigs have helped to elucidate the observations made in the community on human Ascariasis. The main purpose of the review is to see how new information may contribute to further acceptance of Ascariasis as a serious contributor to ill-health and so to the design and implementation of sustainable control programmes intended to reduce the morbidity due to infection with A. lumbricoides. Eradication is neither a realistic nor prudent aim given the current shortage of appropriate sanitation in many countries where Ascariasis is endemic. A substantial body of evidence shows that for the four common species of soil-transmitted nematode, including A. lumbricoides, regular administration of broad-spectrum anthelminthic drugs to children attending primary schools is a cost-effective means of controlling the infections. Anthelminthic drugs must be of proven quality and efficacy and health professionals should be prepared to detect and manage drug resistance should that emerge. Despite a deeper understanding of the immune response of a variety of hosts to infections with either A. lumbricoides or A. suum there is at present little prospect of an effective vaccine against Ascariasis. The relationship between A. lumbricoides and A. suum is addressed, particularly since both species, if they are indeed separate species, occur in people and their pigs in many communities.
