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Human Ascariasis: An Updated Review.
Recent Pat Inflamm Allergy Drug Discov. 2020 Jul 05 [Online ahead of print]RP

Abstract

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 the 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 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.

Authors+Show Affiliations

Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta. Canada.Department of Family Medicine, The University of Alberta, Edmonton, Alberta. Canada.Department of Family Medicine, The University of Calgary, Calgary, Alberta. Canada.Department of Paediatrics, The Chinese University of Hong Kong, and Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital. Hong Kong.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32628606

Citation

Leung, Alexander K C., et al. "Human Ascariasis: an Updated Review." Recent Patents On Inflammation & Allergy Drug Discovery, 2020.
Leung AKC, Leung AAM, Wong AHC, et al. Human Ascariasis: An Updated Review. Recent Pat Inflamm Allergy Drug Discov. 2020.
Leung, A. K. C., Leung, A. A. M., Wong, A. H. C., & Hon, K. L. (2020). Human Ascariasis: An Updated Review. Recent Patents On Inflammation & Allergy Drug Discovery. https://doi.org/10.2174/1872213X14666200705235757
Leung AKC, et al. Human Ascariasis: an Updated Review. Recent Pat Inflamm Allergy Drug Discov. 2020 Jul 5; PubMed PMID: 32628606.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Human Ascariasis: An Updated Review. AU - Leung,Alexander K C, AU - Leung,Amy A M, AU - Wong,Alex H C, AU - Hon,Kam L, Y1 - 2020/07/05/ PY - 2020/03/22/received PY - 2020/05/25/revised PY - 2020/06/11/accepted PY - 2020/7/7/entrez PY - 2020/7/7/pubmed PY - 2020/7/7/medline KW - Albendazole KW - Ascaris lumbricoides KW - Löeffler syndrome KW - biliary obstruction KW - intestinal obstruction KW - mebendazole KW - pancreatitis KW - pyrantel pamoate. JF - Recent patents on inflammation & allergy drug discovery JO - Recent Pat Inflamm Allergy Drug Discov N2 - 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 the 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 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. SN - 1872-213X UR - https://www.unboundmedicine.com/medline/citation/32628606/Human_Ascariasis:_An_Updated_Review L2 - https://www.eurekaselect.com/183494/article DB - PRIME DP - Unbound Medicine ER -
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