Your SlideShare is downloading. ×
0
Ascariasis October 6, 2009 Presented by Melissa Torres Photo extracted from:  http://emedicine.medscape.com/article/212510
Soil transmitted helminths <ul><li>Parasite nematodes </li></ul><ul><ul><li>Infection from contact with eggs/ larvae in so...
What is Ascariasis? <ul><li>Most common helminthic disease </li></ul><ul><ul><li>Estimated worldwide prevalence of 25% </l...
Symptomatic Ascariasis <ul><li>May manifest into </li></ul><ul><ul><li>Growth retardation </li></ul></ul><ul><ul><li>Pneum...
Climate is an important factor <ul><li>Warm and moist climates </li></ul><ul><ul><li>Latin America and Caribbean </li></ul...
A. lumbricoides Extracted from Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm Figure 1: Adul...
Ascaris lumbricoides <ul><li>Largest of nematodes infecting humans </li></ul><ul><li>Highest daily egg output </li></ul><u...
Ascaris lumbricoides Extracted from  Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm Figure 2...
Egg shed facts: <ul><li>Humans with ascariasis can shed in their faeces </li></ul><ul><ul><li>Fertilized eggs only </li></...
Ascaris suum <ul><li>Swine nematode </li></ul><ul><ul><li>Difficult to distinguish from  A. lumbricoides </li></ul></ul><u...
Life Cycle
Diagnosis <ul><li>Stool examination </li></ul><ul><ul><li>Kato-Katz fecal smear </li></ul></ul><ul><ul><li>McMaster method...
Treatment <ul><li>Drug therapy </li></ul><ul><ul><li>Adult worms only! </li></ul></ul><ul><li>Benzimidazole anthelminthic ...
Treatment <ul><li>Paralyzing vermifuges </li></ul><ul><ul><li>pyrantel pamoate </li></ul></ul><ul><ul><li>Piperazine </li>...
Surgery <ul><li>Deworming  </li></ul><ul><ul><li>Should be done first </li></ul></ul><ul><li>Intestinal or Bilial surgery ...
Prevention <ul><li>Community control </li></ul><ul><ul><li>Difficult to achieve </li></ul></ul><ul><li>Health education </...
References <ul><li>Bethony, S.B., et al. (2006). Soil transmitted helminth infections: ascariaisis, trichuriasis, and hook...
The hygiene hypothesis <ul><li>Enhanced TH2 response </li></ul><ul><ul><li>Susceptibility versus protection </li></ul></ul...
Upcoming SlideShare
Loading in...5
×

Ascariasis final

859

Published on

Test file

Published in: Devices & Hardware
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
859
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
39
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Transcript of "Ascariasis final"

  1. 1. Ascariasis October 6, 2009 Presented by Melissa Torres Photo extracted from: http://emedicine.medscape.com/article/212510
  2. 2. Soil transmitted helminths <ul><li>Parasite nematodes </li></ul><ul><ul><li>Infection from contact with eggs/ larvae in soil </li></ul></ul><ul><ul><li>Human to human direct transmission is impossible* </li></ul></ul><ul><li>Nematodes include </li></ul><ul><ul><li>Roundworms, whipworms, and hookworms </li></ul></ul><ul><ul><li>Common to be infected with all three worms </li></ul></ul><ul><li>One of the world’s most important causes of physical and intellectual growth retardation. </li></ul>
  3. 3. What is Ascariasis? <ul><li>Most common helminthic disease </li></ul><ul><ul><li>Estimated worldwide prevalence of 25% </li></ul></ul><ul><ul><li>0.8-1.22 billion people </li></ul></ul><ul><li>Usually asymptomatic </li></ul><ul><li>Most prevalent in children </li></ul><ul><ul><li>Highest prevalence = 2 to 10 year olds </li></ul></ul><ul><ul><li>Highest intensity = 5 to 15 year olds </li></ul></ul>
  4. 4. Symptomatic Ascariasis <ul><li>May manifest into </li></ul><ul><ul><li>Growth retardation </li></ul></ul><ul><ul><li>Pneumonitis/ verminous pneumonia </li></ul></ul><ul><ul><li>Intestinal obstruction </li></ul></ul><ul><ul><li>Hepatobiliary and pancreatic injury </li></ul></ul><ul><ul><li>Eosinophilia* </li></ul></ul>
  5. 5. Climate is an important factor <ul><li>Warm and moist climates </li></ul><ul><ul><li>Latin America and Caribbean </li></ul></ul><ul><ul><li>Sub-Saharan Africa </li></ul></ul><ul><ul><li>Middle East and north Africa </li></ul></ul><ul><ul><li>India </li></ul></ul><ul><ul><li>South Asia </li></ul></ul><ul><ul><li>East Asia and Pacific Islands </li></ul></ul><ul><ul><li>China </li></ul></ul>
  6. 6. A. lumbricoides Extracted from Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm Figure 1: Adult male and female soil-transmitted helminths Extracted from http://en.wikipedia.org/wiki/Ascaris_lumbricoides
  7. 7. Ascaris lumbricoides <ul><li>Largest of nematodes infecting humans </li></ul><ul><li>Highest daily egg output </li></ul><ul><li>Shortest lifespan </li></ul>Extracted from Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm Table 2: Characteristics of the soil-transmitted helminths: adult worms of greatest public-health significance
  8. 8. Ascaris lumbricoides Extracted from Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm Figure 2: Soil transmitted helminth eggs <ul><li>Fertilized eggs </li></ul><ul><ul><li>Contain a zygote </li></ul></ul><ul><ul><li>And a thick eggshell consisting of four layers </li></ul></ul>
  9. 9. Egg shed facts: <ul><li>Humans with ascariasis can shed in their faeces </li></ul><ul><ul><li>Fertilized eggs only </li></ul></ul><ul><ul><ul><li>45% of infected persons </li></ul></ul></ul><ul><ul><li>Unfertilized eggs only </li></ul></ul><ul><ul><ul><li>20% of infected persons </li></ul></ul></ul><ul><ul><li>Or fertilized and unfertilized eggs </li></ul></ul><ul><ul><ul><li>40% of infected persons </li></ul></ul></ul>
  10. 10. Ascaris suum <ul><li>Swine nematode </li></ul><ul><ul><li>Difficult to distinguish from A. lumbricoides </li></ul></ul><ul><li>Possibility of zoonotic infection </li></ul><ul><ul><li>In well developed countries </li></ul></ul><ul><ul><li>Little evidence shown on transmission of porcine ascariasis to humans </li></ul></ul>
  11. 11. Life Cycle
  12. 12. Diagnosis <ul><li>Stool examination </li></ul><ul><ul><li>Kato-Katz fecal smear </li></ul></ul><ul><ul><li>McMaster method </li></ul></ul><ul><li>Ultrasonography and endoscopy </li></ul><ul><ul><li>ECRP </li></ul></ul>Photo extracted from http://www.lnrcancernetwork.nhs.uk/images/ERCP.jpg
  13. 13. Treatment <ul><li>Drug therapy </li></ul><ul><ul><li>Adult worms only! </li></ul></ul><ul><li>Benzimidazole anthelminthic drugs </li></ul><ul><ul><li>Albendazole = DOC </li></ul></ul><ul><ul><li>Mebendazole </li></ul></ul><ul><li>During pregnancy </li></ul><ul><ul><li>Pyrantel pamoate </li></ul></ul>Albendazole http://commons.wikimedia.org/wiki/File:Albendazole_structure.png
  14. 14. Treatment <ul><li>Paralyzing vermifuges </li></ul><ul><ul><li>pyrantel pamoate </li></ul></ul><ul><ul><li>Piperazine </li></ul></ul><ul><ul><li>ivermectine </li></ul></ul><ul><li>Nitazoxanide </li></ul><ul><ul><li>Primariliy for protozoal infection </li></ul></ul><ul><li>Vitamin A supplements </li></ul>Pyrantel pamoate http://commons.wikimedia.org/wiki/File:Pyrantel_pamoate.png
  15. 15. Surgery <ul><li>Deworming </li></ul><ul><ul><li>Should be done first </li></ul></ul><ul><li>Intestinal or Bilial surgery </li></ul><ul><ul><li>ECRP </li></ul></ul><ul><ul><li>Cholecystectomy </li></ul></ul>Photo extracted from http://www.medscape.com/viewarticle/451597_3
  16. 16. Prevention <ul><li>Community control </li></ul><ul><ul><li>Difficult to achieve </li></ul></ul><ul><li>Health education </li></ul><ul><ul><li>Along with sanitation programs </li></ul></ul><ul><li>Mass treatments </li></ul><ul><ul><li>They do not seem to decrease transmission rates </li></ul></ul><ul><li>Vaccine in progress </li></ul><ul><ul><li>Nasally administered 16-kd secretory protein </li></ul></ul>
  17. 17. References <ul><li>Bethony, S.B., et al. (2006). Soil transmitted helminth infections: ascariaisis, trichuriasis, and hookworm. The lancet 2006; 367, 1521-1532. </li></ul><ul><li>Fincham, J.E., et al. (2007). Ascaris , co-infection and allergy: the importance of analysis based on immunological variables rather than egg excretion. Transactions of the Royal Society of Tropical Medicine and Hygiene; 101, 680-682. </li></ul><ul><li>Haburchak, D.R.. (2008, September 12). Ascariasis. Emedicine. Retrieved September 18, 2009 from http://emedicine.medscape.com/article/212510 </li></ul><ul><li>Peng, W., Zhou, X., & Gasser, R.B.. (2003). Ascaris egg profiles in human faeces: biological and epidemiological implications. Parasitology; 127, 283-290. </li></ul><ul><li>Sherman, S.C., & Weber, J.M.. (2005). Visual Diagnosis in Emergency Medicine: The CT diagnosis of ascariasis. The Journal of Emergency Medicine; 28, 4, 471-472. </li></ul><ul><li>Shultz, M.G.. (1982). Ascariasis: nutritional Implications. Review of Infectious Diseases; 4, 815-820. </li></ul><ul><li>Williams, D., Burke, G., & Hendley, O.J.. (1974) Brief Clinical and Laboratory Observations: Ascariasis: A family disease. The Journal of pediatrics; 853-854 </li></ul>
  18. 18. The hygiene hypothesis <ul><li>Enhanced TH2 response </li></ul><ul><ul><li>Susceptibility versus protection </li></ul></ul><ul><li>“ Soil transmitted helminths are though to survive within the host not just by warding off the immune attack, but instead by aggressively subverting the host immune response…” (2006, Bethony et al) </li></ul>
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×