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Helminths

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Soil transmitted group of parasitic nematode worms that cause infection via contact with parasite eggs or larvae that thrive in warm and moist soils of tropical and subtropical countries.

25% of the world’s population re infected with intestinal helminths.

Intestinal helminths can persist for years and are associated with increased risks of illness and deaths.

Helminthic infestation of the hepatobiliary system occurs primarily with A lumbricoides, Echinococcus granulosus, Clonorchis sinensis, Opisthorchis felineus, O viv2242inii and Fasciola hepatica.

Complex multicellular worms.

Globally ascariasis this is the most common human parasitic disease.

Ascariasis is endemic in regions with poor sanitation, pre-disposing to contamination of soil where human or pig feces are used as fertilizers.

Parasites Ascaris lumbricoides (roundworms), Trichuris trichiura (whipworms)and hookworm (Necator americanus or Ancylostoma duodenale) infect an estimated 2 billion people worldwide.

Adult ascaris worms live one-two years.

Ascariasis Transmit via fecaloral route with no person to person transmission.

Trichuris trichiura a roundworm known as whipworm.

As adult worms can live in the human intestinal tract for years.

A high worm burden causes G.I. obstructive symptoms including abdominal distention, bloating, nausea, vomiting, diarrhea, and weight loss.

When the hepatobiliary system is inhabited by a mass of worms, obstructive cholangitis and pancreatitis can occur.

Common for children to have chronic infection with all three worms and they may suffer from malnutrition, stunting of growth, impaired cognition, retardation and educational deficits.

Soil transmitted helminths one the most important reasons for physical and retardation in the world.

People affected most reside in the most impoverished countries.

Such infections may increase susceptibility to malaria, HIV and tuberculosis infections.

Typically associated with eosinophilia.

Marked eosinophilia seen when helminths invade and migrate through tissues.

Prevalence of intestinal parasites detected by stool examination among resettled African and Asian refugees to the US ranges from 14-64%.

Diagnosis is suspected it in individuals with exposure to endemic area.

Stool microscopy confirms infection generally, but can be negative in the early stages infection.

PCR assay and serologic testing are usually not performed.

Imaging studies are often diagnostic in symptomatic patients.

Periodic administration of antihelmintic drugs albendazole or mebendazole to at risk populations attempts to control morbidity due to soil transmitted helminthology infections.

Treatment with oxantel pamoate-albendazole for T. trichiura is more successful than standard therapy (Speich B et al ).

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