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When the embryonated eggs are ingested they hatch and

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When the embryonated eggs are ingested, they hatch and eventually the mature worms attachthemselves to the mucosa of caecum and colon. They are mainly transmitted through food that iscontaminated by soil or dirty fingers.Clinical FeaturesOften, mild infections are asymptomatic, but heavy infections may result in abdominal discomfort,bloody diarrhoea, loss of weight and prolapse of rectum.DiagnosisDiagnosis is made by examining a stool sample microscopically for ova and cyst.146
ManagementYou can eliminate this infection by giving oral Mebendazole 100 mg 12 hourly for 3 days.Prevention and ControlJust like the threadworm, the prevention of trichuriasis can be achieved through good personal hygieneand proper disposal of faeces.7.3.3 Roundworms (Ascariasis)This disease is caused by theAscaris lumbricoides, which infects the small intestine.Ascaris is a largeintestinal parasite which often infects children because of their habit of putting all kinds of things intheir mouth.It is one of the commonest and most widespread infection of the small intestine.Theworms may multiply in large numbers in the intestinal lumen and cause intestinal obstruction at the ileo-caecal valve.The worms also contribute to severe malnutrition and Vitamin A deficiency and maywander out of the intestinal lumen into the peritoneal cavity.Mode of TransmissionAscariasis is a soil – transmitted parasite.Once the eggs are passed out in faeces, they requireembryonation in the soil before they can become infective.This takes 8-50 days.Embryonated eggscan be carried away from the contaminated place into houses by feet, footwear or in dust by wind.Human beings may injest the eggs as they eat or drink using contaminated hands and utensils, or througheating raw contaminated foods like fruitsOnce the eggs are ingested by a human being they hatch intoworms.In order to reach maturity, thelarvae need to pass through the lungs and trachea to the pharynx.Once they are swallowed they returnto the gastro-intestinal tract where they can live for about a year.
Figure 20: Life cycle of Ascaris Lumbricoides.Clinical FeaturesInfection with a few ascariasis is usually asymptomatic and if symptoms are present, they are notcharacteristic.There may be vague abdominal discomfort or occasionally the worm may leave the bodyin vomitus or stool.Also during the stage of larval migration through the lungs there may be temporarysymptoms of pneumonitis (cough).DiagnosisDiagnosis is by stool microscopy which should show ascaris ova and cyst.ManagementAny one of the following drug treatments is useful in the management of ascariasis.i.Oral Mebendazole 100 mg 12 hourly for 3 daysii.Oral Levamisole 5mg/kg body wt) single dose148
iii.Oral Piperazine 150 mg/kg body wt single dose to a maximum of 4 g.

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Term
Fall
Professor
dr. joseph njoroge

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