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Some unusual manisfestations of infection with Ascaris lumbricoides

Kanagarayer K

Malayan Medical Journal, 1927;2:23-4.

Matched MeSH terms: Ascariasis
Fulltext Acute lower gastrointestinal haemorrhage secondary to small bowel ascariasis

Stephen DD, Siow SL

Malays J Med Sci, 2012 Apr;19(2):92-5.
PMID: 22973144 MyJurnal

Acute lower gastrointestinal haemorrhage secondary to small bowel ascariasis is extremely rare. A high level of suspicion should be maintained when dealing with acute gastrointestinal haemorrhage in migrants and travellers. Small bowel examination is warranted when carefully repeated upper and lower endoscopies have failed to elicit the source of bleeding. Appropriate test selection is determined by the availability of local expertise. We present a case of acute lower gastrointestinal haemorrhage secondary to jejunal ascariasis and a literature search on lower gastrointestinal haemorrhage associated with jejunal infestation with Ascaris.

Matched MeSH terms: Ascariasis
An unusual presentation of acute cholecystitis: biliary ascariasis

Amjad N, Nor AM, Singh H

Hosp Med, 2001 Jun;62(6):370-1.
PMID: 11436449
Matched MeSH terms: Ascariasis/complications*; Ascariasis/diagnosis
Does ascariasis, trichuriasis and hookworm infection predispose to non-specific abdominal symptoms among adults in endemic areas?

Raj SM, Anteson R, Sivakumaran S, Abdullah MR, Low HC

Trop Doct, 1994 Apr;24(2):88-9.
PMID: 8009635
Matched MeSH terms: Ascariasis/complications*; Ascariasis/epidemiology
Albendazole, an effective single dose, broad spectrum anthelmintic drug

Ramalingam S, Sinniah B, Krishnan U

Am J Trop Med Hyg, 1983 Sep;32(5):984-9.
PMID: 6625078

Albendazole, a new anthelmintic drug was evaluated in Malaysia in 91 patients, with single or mixed infections of Ascaris, Trichuris, and hookworm. Albendazole was administered as a single dose of 400 mg, 600 mg, or 800 mg. The cure rate for Ascaris at all three doses was 100% at days 14 and 21 post-treatment; for hookworm it was 98.8%, 100% and 98%, respectively, at day 14 and 68.8%, 100% and 84%, respectively, at day 21; for Trichuris it was 31.2%, 57.1% and 42.3%, respectively, at day 14 and 27.3%, 60.9% and 48.0%, respectively, at day 21. The egg reduction rate at day 21 was 100% at all three doses for Ascaris, 94.5%, 100% and 96.1%, respectively, for hookworm; and 39.2%, 85.1% and 72.8%, respectively, for Trichuris. There were no side effects, and biochemical examination of blood and urine did not indicate any unfavourable changes. Based on this trial, the recommended dosage for Ascaris and hookworm is a 400 mg single dose, and for Trichuris is a 600 mg single dose. Albendazole appears to be more effective than other available anthelmintic drugs.

Matched MeSH terms: Ascariasis/complications; Ascariasis/drug therapy*
Should postpapillotomy screening for Ascaris lumbricoides infection be routine in communities endemic for ascariasis?

Raj SM, Radzi M

Am J Gastroenterol, 1999 Aug;94(8):2329.
PMID: 10445590
Matched MeSH terms: Ascariasis/diagnosis*; Ascariasis/therapy
Fulltext Intestinal geohelminthiasis and growth in pre-adolescent primary school children in Northeastern Peninsular Malaysia

Mahendra Raj S

Southeast Asian J Trop Med Public Health, 1998 Mar;29(1):112-7.
PMID: 9740282

A cohort of one hundred 8-9 year old school children in Northeastern Peninsular Malaysia underwent stool examination, weight and height measurements. Seventy-three children were infected with Ascaris lumbricoides and/or Trichuris trichiura. All infected children were treated with albendazole at baseline, 6 months and 9 months. Measurements were repeated on all but 2 children at 1 year. Repeat stool examination (n = 94) at 1 year revealed a marked reduction in the level of Ascaris infection and a modest reduction in Trichuris infection. There was no difference in net growth between treated children and uninfected controls. Post-hoc analysis by gender however revealed that infected girls (n = 33) experienced significantly higher increments in weight, height and weight for age. Furthermore, children found to be infected at baseline level but worm free at follow-up, were observed to have experienced greater increments in height and height for age. The evidence suggests that periodic antihelminthic treatment may have a positive effect on the growth of subsets of pre-adolescent children but it is emphasised that further work is required to validate these findings.

Matched MeSH terms: Ascariasis/complications*; Ascariasis/drug therapy
Fulltext Comparative trials using albendazole and mebendazole in the treatment of soil-transmitted helminths in schoolchildren on Penang, Malaysia

Rahman WA

Southeast Asian J Trop Med Public Health, 1996 Dec;27(4):765-7.
PMID: 9253881

Trials using albendazole and mebendazole, as single 400 mg dose treatments, against soil-transmitted helminths, were carried out in 7-9 and 10-12 years-old schoolchildren living in urban and rural environments in Penang, Malaysia. Both drugs were equally effective in treating trichuriasis and ascariasis in both age groups and environments. However, mebendazole is not so effective in the treatment for hookworms when compared to albendazole. It is suggested that albendazole should be considered the drug of choice for mass chemotherapy for Penang.

Matched MeSH terms: Ascariasis/drug therapy; Ascariasis/epidemiology
Prevalence and distribution of soil-transmitted helminthiases among Orang Asli children living in peripheral Selangor, Malaysia

Al-Mekhlafi MS, Azlin M, Nor Aini U, Shaikh A, Sa'iah A, Fatmah MS, et al.

Southeast Asian J Trop Med Public Health, 2006 Jan;37(1):40-7.
PMID: 16771211

Soil-transmitted helminthiases are a public health problem in rural communities. A cross-sectional study of the prevalence and distribution of Ascaris lumbricoides, Trichuris trichiura and hookworm was conducted in 281 Orang Asli children (aborigines) aged between 2 and 15 years, from 8 Orang Asli villages in Selangor, Malaysia. All the children were infected with soil-transmitted helminthes, with 26.3% of the children infected either with A. lumbricoides, T. trichiura or hookworm and 72.6% having mixed infection. The overall prevalences of A. lumbricoides, T. trichiura and hookworm were 61.9, 98.2 and 37.0%, respectively. Approximately 19.0, 26.0 and 3.0% of the children had severe infection of ascariasis, trichuriasis and hookworm infection, respectively. The prevalences and mean egg per gram (epg) counts for A. lumbricoides and T. trichiura were not significantly dependent on age, therefore age-dependent convexity was not seen in this study. However, the results of this study reveal an age-dependent prevalence and mean epg count in children with hookworm infection. We conclude that ascariasis, trichuriasis and hookworm infection are still prevalent and therefore a public health concern in Orang Asli communities. Severe ascariasis and trichuriasis may lead to other health and medical problems.

Matched MeSH terms: Ascariasis/epidemiology*; Ascariasis/transmission
Prevalence and predictors of low serum retinol and hypoalbuminaemia among children in rural Peninsular Malaysia

Al-Mekhlafi MH, Azlin M, Aini UN, Shaik A, Sa'iah A, Norhayati M

Trans R Soc Trop Med Hyg, 2007 Dec;101(12):1233-40.
PMID: 17936317

Vitamin A deficiency and malnutrition are still considered public health problems in rural areas of developing countries, including Malaysia. A cross-sectional exploration study was carried out on 281 Orang Asli (Aborigine) children aged between 2 and 15 years in Selangor, Malaysia. The overall prevalence of low serum retinol (<70 micromol/l) and hypoalbuminaemia (<35 g/l) were 25.2 and 7.8%, respectively. Univariate analysis showed that severe ascariasis, significant stunting and giardiasis were significantly associated with low concentration of serum retinol. As well as intestinal parasitic infections, low socio-economic status was a significant predictor of hypoalbuminaemia. Logistic regression analysis identified severe ascariasis and significant stunting as predictors of low serum retinol, while mixed intestinal parasitic infection and low household income were predictors of hypoalbuminaemia. In conclusion, control measures for intestinal parasitic infections should be included as one of the strategies for the prevention and control of malnutrition and vitamin A deficiency in this population.

Matched MeSH terms: Ascariasis/blood; Ascariasis/epidemiology
Effect of intestinal helminthiasis on intestinal permeability of early primary schoolchildren

Raj SM, Sein KT, Anuar AK, Mustaffa BE

Trans R Soc Trop Med Hyg, 1996 11 1;90(6):666-9.
PMID: 9015510

Intestinal permeability of 246 early primary schoolchildren at 2 schools (106 of whom were infected with intestinal helminths) was assessed by using the lactulose/mannitol differential absorption test. The ratio of the urinary recoveries of lactulose and mannitol was determined after oral administration of a standard solution of the 2 sugars. Assessment of intestinal permeability was repeated on 100 infected children after treatment and on a cohort of 68 uninfected children. Infected and uninfected groups were compared with respect to baseline lactulose/mannitol ratio (L/M1) and change in lactulose/mannitol ratio between assessments (delta L/M). The correlations between baseline intensity of infection and L/M1, and between fall in intensity and delta L/M, were evaluated. Based on a crude index of socioeconomic status, each child was assigned to one of 3 socioeconomic groups; all but 3 children belonged to either groups 2 or 3. Trichuris trichiura and Ascaris lumbricoides were the 2 predominant infections; the hookworm infection rate was relatively low. The results suggested that helminthiasis exerted only a marginal effect on intestinal permeability, the impact of which in children from lower socioeconomic backgrounds was negligible in comparison with the cumulative effects of other factors.

Matched MeSH terms: Ascariasis/drug therapy; Ascariasis/metabolism
Effect of intestinal helminthiasis on school attendance by early primary schoolchildren

Raj SM, Sein KT, Anuar AK, Mustaffa BE

Trans R Soc Trop Med Hyg, 1997 3 1;91(2):131-2.
PMID: 9196748

Stool examination of 249 early primary schoolchildren at 2 schools in north-eastern peninsular Malaysia revealed that 73 were infected with Ascaris lumbricoides, 103 with Trichuris trichiura, and 18 with hookworms. Infected children were treated with a single dose of 400 mg of albendazole. The school attendance records during a 60 d period before treatment and 2 consecutive 60 d periods after treatment were examined. The absenteeism rate did not improve more among infected children after treatment than it did among the uninfected control children. The correlation between worm intensity and the number of lost school-days was poor. There was no evidence that intestinal helminthiasis caused school absenteeism among this group of children.

Matched MeSH terms: Ascariasis/drug therapy; Ascariasis/parasitology
The effect of repeated chemotherapy on age-related predisposition to Ascaris lumbricoides and Trichuris trichiura

Chan L, Kan SP, Bundy DA

Parasitology, 1992 Apr;104 ( Pt 2):371-7.
PMID: 1594301

This study examines the persistence of predisposition to Ascaris lumbricoides and Trichuris trichiura during repeated chemotherapy in an urban community in Kuala Lumpur, Malaysia. Significant predisposition was observed over 2 periods of reinfection with and without age-standardization of data. Analysis of different age groups indicated that predisposition was most strongly detectable in the younger age classes. The intensities of infection with both parasites were strongly correlated at each cycle of intervention, suggesting that individuals were similarly predisposed to both species.

Matched MeSH terms: Ascariasis/drug therapy*; Ascariasis/epidemiology
Fulltext Expression of Ascaris lumbricoides putative virulence-associated genes when infecting a human host

Mohd-Shaharuddin N, Lim YAL, Ngui R, Nathan S

Parasit Vectors, 2021 Mar 23;14(1):176.
PMID: 33757548 DOI: 10.1186/s13071-021-04680-y

BACKGROUND: Ascaris lumbricoides is the most common causative agent of soil-transmitted helminth infections worldwide, with an estimated 450 million people infected with this nematode globally. It is suggested that helminths are capable of evading and manipulating the host immune system through the release of a spectrum of worm proteins which underpins their long-term survival in the host. We hypothesise that the worm overexpresses these proteins when infecting adults compared to children to cirvumvent the more robust defence mechanisms of adults. However, little is known about the parasite's genes and encoded proteins involved during A. lumbricoides infection. Hence, this study was conducted to assess the expression profile of putative virulence-associated genes during an active infection of adults and children.
METHODS: In this study, quantitative PCR was performed to evaluate the expression profile of putative virulence-associated genes in A. lumbricoides isolated from infected children and adults. The study was initiated by collecting adult worms expelled from adults and children following anthelminthic treatment. High-quality RNA was successfully extracted from each of six adult worms expelled by three adults and three children, respectively. Eleven putative homologues of helminth virulence-associated genes reported in previous studies were selected, primers were designed and specific amplicons of A. lumbricoides genes were noted. The expression profiles of these putative virulence-associated genes in A. lumbricoides from infected adults were compared to those in A. lumbricoides from infected children.
RESULTS: The putative virulence-associated genes VENOM, CADHERIN and PEBP were significantly upregulated at 166-fold, 13-fold and fivefold, respectively, in adults compared to children. Conversely, the transcription of ABA-1 (fourfold), CATH-L (threefold) and INTEGRIN (twofold) was significantly suppressed in A. lumbricoides from infected adults.
CONCLUSIONS: On the basis of the expression profile of the putative virulence-associated genes, we propose that the encoded proteins have potential roles in evasion mechanisms, which could guide the development of therapeutic interventions.

Matched MeSH terms: Ascariasis/immunology; Ascariasis/parasitology*
Fulltext Intestinal helminthiasis in relation to height and weight of early primary school children in northeastern peninsular Malaysia

Mahendra Raj S, Sein KT, Khairul Anuar A, Mustaffa BE

Southeast Asian J Trop Med Public Health, 1997 Jun;28(2):314-20.
PMID: 9444012

Stool examination, height and weight measurements were undertaken on 249 early primary school children at two schools in North-eastern Peninsular Malaysia. Helminth infected children were treated and follow-up anthropometric measurements and stool examination undertaken on all (n = 100) children at one of the schools 16 months later; to observe the relationship between acquisition of infection and growth. Baseline Ascaris prevalence rates at the two schools were 16.0% (23/144) and 47.6% (50/105) respectively whilst Trichuris rates were 33.3% (48/144) and 52.4% (55/105). Hookworm infection was uncommon. There was no difference in weight or height for age between infected and uninfected children at any time. Acquisition of worm infection over the initial 16 month follow-up period was not associated with significant decreases in growth rates. However the small subsets of children with heavy Ascaris infection were consistently lighter and shorter at all evaluation times. They also gained significantly less weight and tended to have reduced linear growth rates between measurements. Further interventional studies are required to determine if this association is one of cause and effect or largely incidental.

Matched MeSH terms: Ascariasis/epidemiology*; Ascariasis/physiopathology
Fulltext The prevalence of Trichuris, Ascaris and hookworm infection in Orang Asli children

Norhayati M, Zainudin B, Mohammod CG, Oothuman P, Azizi O, Fatmah MS

Southeast Asian J Trop Med Public Health, 1997 Mar;28(1):161-8.
PMID: 9322301

A community study on the age and sex related prevalence, intensity infection and frequency distribution of Ascaris, Trichuris and hookworm was carried out in 205 Orang Asli (Aborigines) children (95 boys, 110 girls) aged 1-13 years. The overall prevalence of Ascaris, Trichuris and hookworm was 62.9%, 91.7% and 28.8%, respectively. Almost two-thirds of the children were infected with moderate and severe intensity infection of Trichuris, 46.3% had moderate to severe intensity infection of Ascaris. However only 1.5% had moderate intensity of hookworm infection. The prevalence and mean intensity infection (measured by eggs per g) of Ascaris was age-dependent; lower in age group 1-4 years reached peak and stable at age group 5 years and above. The prevalence of Trichuris was high in all age groups and it fluctuated with age; the mean intensity of infection of Trichuris (measured by eggs per g) was age-dependent. Hookworm infection also rose with age and reached peak at 5-6 years, following that the prevalence declined. The frequency distributions of Ascaris, and hookworm were overdispersed. A strong positive correlation (p < 0.001) were observed between Ascaris and Trichuris and between hookworm and Trichuris. A positive correlation (p < 0.01) were also observed between Ascaris and hookworm.

Matched MeSH terms: Ascariasis/diagnosis; Ascariasis/epidemiology*
Fulltext Ascaris and Trichuris do not contribute to growth retardation in primary school children

Lai KP, Kaur H, Mathias RG, Ow-Yang CK

Southeast Asian J Trop Med Public Health, 1995 Jun;26(2):322-8.
PMID: 8629068

To access the effectiveness of the treatment of soil-transmitted helminthiasis (STH) on the growth of primary school children, 353 children were block stratified to receive either mebendazole plus pyrantel oxantel pamoate every three months or a placebo. The children were followed for two years with 89% completing the trial. Follow-up stools indicated that the treatment was efficacious for ascariasis and trichuriasis. There was virtually no hookworm infection. The children were malnourished as measured by the number below -2 SD of height and weight standards. There was no difference in height or weight between the treatment and control groups by sex initially or at the end of two years of follow-up. The treatment of Ascaris and Trichuris had no effect on growth parameters. The effect of STH on growth may be mediated through hookworm infections.

Matched MeSH terms: Ascariasis/complications*; Ascariasis/drug therapy
Fulltext Efficacy of single dose albendazole on the prevalence and intensity of infection of soil-transmitted helminths in Orang Asli children in Malaysia

Norhayati M, Oothuman P, Azizi O, Fatmah MS

Southeast Asian J Trop Med Public Health, 1997 Sep;28(3):563-9.
PMID: 9561609

The efficacy of a single-dose 400 mg albendazole to treat Ascaris, Trichuris and hookworm infection was studied in Orang Asli community. Kato-Katz examination was performed on fecal samples which were collected before treatment, 1 and 4 months after treatment. A total of 123 children were involved in all three surveys. The cure rate of Ascaris infection was 97.4% and the egg reduction after treatment was 99.9%. The cure rate for hookworm infection was 93.1% with 96.6% egg reduction. Although the cure rate was low in Trichuris infection (5.5%), egg reduction was more evident (49.1%). The reinfection rate at 4 months after treatment was 54.5%, 3.6% and 10.3% for Ascaris, Trichuris and hookworm infection, respectively. Within 4 months after treatment almost one-fifth children with Ascaris and hookworm infection reached pre-treatment intensity infection. In Trichuris infection, however more than half of the children reached their pre-treatment intensity infection at 4 months after treatment. Findings suggest that 4-monthly targeted periodic treatment with 400 mg single-dose albendazole in highly endemic areas can have a significant impact on intensity infection of Ascaris and hookworm, but not on Trichuris infection.

Matched MeSH terms: Ascariasis/drug therapy*; Ascariasis/transmission
Fulltext Helminthic infections of urban and rural schoolchildren in Penang Island, Malaysia: implications for control

Rahman WA

Southeast Asian J Trop Med Public Health, 1998 Sep;29(3):596-8.
PMID: 10437964

The intestinal parasites of schoolchildren from an urban and a rural area on Penang island, Malaysia were compared. Examination of stool samples for helminth eggs showed that helminths found were Trichuris, Ascaris and hookworms. The results indicate that there is no significant difference (p<0.05) between rural and urban schoolchildren as regards to the prevalence of the three species of helminths. An extensive control program targetted at schoolchildren to monitor the helminth problem on the island is suggested.

Matched MeSH terms: Ascariasis/epidemiology*; Ascariasis/prevention & control
The prevalence of malnutrition and geo-helminth infections among primary schoolchildren in rural Kelantan

Zulkifli A, Anuar AK, Atiya AS, Yano A

Southeast Asian J Trop Med Public Health, 2000 Jun;31(2):339-45.
PMID: 11127336

A cross-sectional study of the nutritional status of schoolchildren aged 7-10 years from the Kuala Betis Resettlement Scheme in Gua Musang, Kelantan was done. A total of 291 schoolchildren were examined but only 183 (62.9%) fecal samples were returned for geo-helminth infection analysis. The prevalence of stunting was 40.4% and underweight was 28.4%. A total of 127 schoolchildren (69.4%) were positive for at least one of the 3 geo-helminth infections. The most common geo-helminth was Ascaris lumbricoides (62.8%), followed by Trichuris trichiura (38.9%), and hookworm infection was relatively low (12.6%). All the anthropometric indices measured were lower in the geo-helminth infected children compared to the uninfected childen, except for the weight-for-height z-score. However the differences were insignificant Geo-helminth infections may not be a significant factor in malnutrition of these schoolchildren. However, with the availability of safe, efficacious and cheap broad spectrum anthelmintics, regular mass treatment should be given in selected areas where the prevalence of geo-helminth infections is still high, so that these schoolchildren will be able to achieve their growth potential during their school years.

Matched MeSH terms: Ascariasis/complications; Ascariasis/epidemiology

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