| disease | Ascariasis |
| alias | Ascariasis |
The roundworm (Ascaris lumbricoides Linnaeus, 1758), commonly known as ascaris, is one of the most common Chinese Taxillus Herb worms in the human body. Adult Chinese Taxillus Herb reside in the small intestine and can cause ascariasis (Ascariasis). Additionally, Toxocara canis, commonly known as dog roundworm, is a common intestinal Chinese Taxillus Herb worm in dogs. Its larvae can migrate within the human body, causing visceral larva migrans (VLM).
bubble_chart Epidemiology
Ascaris lumbricoides is distributed worldwide, particularly in warm, humid, and unsanitary areas where human infection is common. The infection rate is higher in rural areas than in urban areas, and higher in children than in adults. Currently, the infection rate in rural populations in most regions of China remains as high as 60-90%.
The roundworm (Ascaris lumbricoides Linnaeus, 1758), commonly known as ascaris, infects humans when they accidentally ingest its eggs in the infective stage.
bubble_chart Pathological Changes
During the larval pathogenic stage, some patients may show infiltrative changes on chest X-rays, often with migratory lesions. In the adult pathogenic stage, injuries to the intestinal mucosa, urticaria, cutaneous pruritus, angioneurotic edema, conjunctivitis, suppurative cholangitis, cholecystitis, and even biliary duct necrosis, perforation, as well as intestinal volvulus and necrosis may occur.
bubble_chart Clinical Manifestations
1. Pathogenesis during the larval stage: Clinical manifestations may include fever, cough, asthma, bloody sputum, and an increased proportion of eosinophils in the blood.
2. Pathogenesis during the adult stage: a. Patients often exhibit symptoms such as loss of appetite, nausea, vomiting, and intermittent periumbilical pain. b. Symptoms such as urticaria, cutaneous pruritus, angioneurotic edema, and conjunctivitis may occur. c. Sudden onset of colicky pain in the right upper abdomen, radiating to the right shoulder, back, and lower abdomen. The pain is intermittently aggravated and accompanied by nausea, vomiting, etc.
Due to the large number of eggs produced by roundworms, the detection rate using the direct smear method is about 80% for one smear, and can reach 95% for three smears. For those with negative direct smears, the sedimentation concentration method or saturated saline flotation method can also be used, which yield better detection results.
The detection of eggs in the patient's stool confirms the diagnosis. For those with clinical manifestations suggestive of ascariasis but no eggs found in the stool, a therapeutic diagnosis with anthelmintic treatment can be used, and the morphology of the expelled worms can be identified. For patients suspected of having pulmonary ascariasis or allergic pneumonia caused by Ascaris larvae, examination of the sputum for Ascaris larvae can confirm the diagnosis.
bubble_chart Treatment Measures
The prevention and control of ascariasis should adopt comprehensive measures, including screening and treating patients and carriers, managing feces, controlling water sources, and preventing infection. Strengthening health education, promoting hygiene knowledge, paying attention to dietary hygiene and personal hygiene, washing hands before meals and after using the toilet, avoiding raw unwashed vegetables and fruits, not drinking untreated water, and preventing the ingestion of Ascaris eggs can reduce infection opportunities. Using sanitized human feces as fertilizer and preventing fecal contamination of the environment are important measures to cut off the transmission route of Ascaris. In areas where liquid manure is used as fertilizer, the five-compartment three-pool fecal storage method can be employed to allow most eggs to settle at the bottom of the pools. Due to the action of free ammonia and anaerobic fermentation in the fecal water, the eggs can be killed while also increasing fertilizer efficiency. Utilizing biogas fermentation not only solves household lighting and cooking needs but also facilitates the sanitization of feces. The fecal residue can be cleared every six months or so, by which time the vast majority of eggs have lost their infectivity. In areas where dry feces are used as fertilizer, the mud-sealed composting method can be adopted. After three days, the temperature inside the compost pile can rise to 52°C or higher, killing Ascaris eggs.
Commonly used anthelmintic drugs include albendazole, mebendazole, levamisole, and piperazine citrate (commercially known as "Antepar"), all of which have good deworming effects and few side effects.
After treatment, if no parasite eggs are found in the stool after 3 to 4 months, it is considered cured.
Due to the possibility of reinfection, it is best to deworm every 3 to 4 months.
Strengthen publicity and education, popularize health knowledge, pay attention to dietary hygiene and personal hygiene, wash hands before meals and after using the toilet, avoid eating unwashed vegetables and fruits, do not drink untreated water, prevent the ingestion of roundworm eggs, and reduce the chance of infection.
Using harmless human feces as fertilizer and preventing fecal contamination of the environment are important measures to cut off the transmission route of roundworms. In areas where liquid manure is used as fertilizer, the five-compartment three-pool fecal storage method can be adopted, allowing most of the eggs in the feces to settle at the bottom of the pool. Due to the action of free ammonia in the fecal water and anaerobic fermentation, the eggs can be killed, while also increasing fertilizer efficiency. Utilizing biogas fermentation not only solves the lighting and cooking needs of rural households but also facilitates the harmless treatment of feces. The fecal residue can be cleared approximately every six months. By this time, the vast majority of eggs have lost their ability to infect. In areas where dry manure is used as fertilizer, the mud-sealed composting method can be employed. After three days, the temperature inside the manure pile can rise to 52°C or higher, effectively killing roundworm eggs.
Biliary ascariasis, ascaris pancreatitis, appendicitis, or ascaris granuloma.
