Round worms are parasite that cause infection to human

1. ROUNDWORMS
LUNGU BRIAN
S/TUTOR, RN, EN
6/18/2023
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2. INTRODUCTION:
 Good afternoon, I am Brian Lungu a fourth year
student from University of Zambia, School of
Medicine, and Department of Nursing Sciences.
With me is my supervisor Mrs. Mukwato a tutor at
the University of Zambia. She is going to be with us
throughout our discussion/lecture and help
whenever necessary.
 Today we are going to discuss worms in particular
Roundworms.
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3. introduction
 Ascariasis is an infection by the nematode Ascaris
Lumbricoides (intestinal roundworm).This is the
most common worm parasitizing human intestine,
with an estimated 1 billion infections worldwide. In
the United States, Ascariasis is most common in the
southeastern states and also in the tropical regions.
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4. intro cont…
 This disease is usually found in overcrowded areas
with poor sanitation. Contamination of the soil by
human faeces is a factor in its spread. Humans are
infected by the ingestion of the eggs in contaminated
raw vegetables and drinking water. Infection may be
contracted from eating raw vegetables when night
soil is used for fertilizer. Water pollution may cause
water transmission.
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5. General Objectives:
 At the end of the lecture student nurses should be
able to acquire a skill and knowledge on how to
manage roundworms (Ascariasis Lumbricoides).
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6. Specific Objectives
• At the end of the discussion/lecture students should
be able to:
• Define Ascariasis
 State the cause of Ascariasis
 Outline the mode of transmission of Ascariasis
 Describe the life cycle of roundworms
 State the risk factors of roundworms
 Explain the signs and symptoms including the
treatment of roundworms
 Outline the complication and preventive measure for
roundworms 6/18/2023
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7. ASCARIASIS (Round worm infestation)
 Ascariasis is an infection by the nematode Ascaris
Lumbricoides (intestinal roundworm).This is the
most common worm parasitizing human intestine,
with an estimated 1 billion infections worldwide. In
the United States, Ascariasis is most common in the
southeastern states.
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8. Cause of roundworms
 Ascaris Lumbricoides (largest roundworm,20-49 cm
long)
 Mode of transmission
 fecal oral route
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9. morphology
Adults:
 creamy white, roundworms
females: 20 - 49 cm long, 3 - 6 mm wide
 ovaries extensive, uteri with up to 27 million eggs
at a time, 200,000 laid/day
males: 15 - 31 cm long, 2 - 4 mm wide
 slender, with blunt, curved tail
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10. Male and female round worms
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11. Anterior end(mouth)
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12. Cross section of a male worm
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13. Cross section of a female worm
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14. round worms in the liver
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15. Massive Ascaris infection in a child
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16. Ascariasis - tangled mass of worms
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17. Ascariasis - Surgical specimen; gangrenous bowel
removed from patient suffering from intestinal
blockage
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18. Ascariasis - Adult in human kidney found
post mortem in a child in Papua, New Guinea.
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19. Life cycle of roundworms
 The eggs are passed into faeces from an infected human being.
 In water of moist soil of about 36-40% the embryo develops.
 The larva undergoes a moult before hatching.
 It is then transformed into second stage larva rhabditoid and
becomes infective.
 Through unwashed raw fruits, vegetables or soiled hands eggs
with infective larva is swallowed through the mouth.
 The egg shell is softened by the gastric juices and enzymes and
hatches in the small intestines.
 The rhabditiform larvae burrow through mucus membrane,
and enter the blood stream
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20. Life cycle cont..
 It passes via the liver and lungs (into the tissues
being expectorated and swallowed) and reaches the
alveolar capillaries where it has a blood bath the wall
of the alveoli and enters the respiratory tree.
 They remain in the small intestines-worms
sometimes obstruct the small intestines, the most
common site being at the ileocaecal valve and
continue to mature.
 Females will eventually grow up to 49 cm and males
are slightly smaller. The worms also occasionally
invade the appendix, or the bile duct,
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21. Life cycle cont…
 resulting in biliary obstruction and suppurative
cholangitis
 Eggs are sexually mature; females begin to producing
eggs that are passed through stool.
 Then the cycle starts again.
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22. LIFE CYCLE
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23. Risk factors of roundworms
 Living in and visiting a warm, tropical climate.
 Poor sanitation.
 Poor personal hygiene.
 Crowded conditions such as day care or institutional
settings.
 Weakened immune system.
 Malnutrition
 Eating undercooked meat.
 Contact with animal faeces.
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24. Signs and Symptoms of roundworms
 There are three main categories
 The worm in the lung and bronchi-there will be
fever, cough and wheezing, also bronchitis.
 In the intestines-usually there may be no
symptoms, abdominal discomfort, there can be
intestinal obstruction.
 General symptoms- passing of the worm, weight
loss, abdominal distension, anorexia(no appetite)
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25. S/S CONT…
 Sometime there can be severe abdominal pain
 Vomiting(worms)
 Chills
 Dyspnea
 Pneumonia
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26. Treatment for roundworms
 Mebendazole
 Group - antihelminthic agent.
 Presentation- Vermox tablet chewable 100mg,
500mg.
 suspension 100mgs/5mls, 500mg/5mls.
 Action - A benzimidazole derivative that blocks
glucose uptake by many intestinal and tissues
nematodes and some cestodes.
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27. Treatment cont…
 Dose Mebendazole (Vermox).
 Adult and children 100mg twice a day for 3 days repeated
after 3 weeks if infection persists
 Contraindications for Mebendazole (Vermox).
 Known hypersentivity, pregnancy due to its tetratogenic
potential
 Adverse Effects Mebendazole (Vermox).
 Transient gastrointestinal discomfort, headache, fever
Diarrhoea.
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28. Nursing Implication for Mebendazole
(Vermox).
 Drug to be taken before meals, crush or allow
patient to chew tablets if patient has difficulty
tolerating ingestion
 Store in tightly closed container
 Administer the drug to all family members as
prescribed to decrease the risk of spreading the
infection
 No dietary restrictions, laxatives or enemas are
necessary
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29. nsg implication cont…
 The drug should be put out of children’s reach.
 Advise patient that the infested person should sleep
alone, wash bed linen in hot water, change and wash
under wear daily.
 Advise patient to clean toilet daily with disinfectant
and wash hands after using toilet.
 Tell patient to wear shoes, wash all fruits and
vegetables well before eating.
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30. Treatment cont…
 Pyrantel Parmoate (Combatrin)
Dosage
 adults and children over 2 years 11mg/kg per oral as
a single dose(maximum dosage 1g) repeated in 2
weeks.
 Side Effects - Pyrantel parmoate
 Mild Gastro intestinal tract disturbance, headache,
dizziness, drowsiness, insomnia, rash (occasionally
reported), abdominal cramps, fever, weakness,
anorexia, nausea, vomiting.
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31. Contraindication - Pyrantel parmoate
 Known hypersensitivity
 Precautions - Pyrantel parmoate
(combantrin)
 Lower doses should be administered in liver function
impairment
 Should not be used in the first trimester of pregnant
women
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32. Nursing Implication - Pyrantel parmoate
 It is vital to swallow the drug on an empty stomach
for efficiency.
 The drug should be taken as prescribed.
 Keep drug out of reach of children.
 No restriction, laxative or enemas needed.
 Caution must be taken when administering the drug
to severe malnourished and anemic patients or in
patient with hepatic dysfunction.
 Other drug, albendazole 400mg stat.
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33. Complications of roundworms
 Intestinal obstruction due to a mass of worms
 Malnutrition due to malabsorption
 Blockage of bile and pancreatic duct leading to
obstructive jaundice.
 Anemia.
 Obstruction of appendix by adult worms
 Nephritis
 Brain abscess
 Death may result
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34. Prevention of roundworms
 Personal hygiene
 Proper disposal of excreta(faeces)
 Health education
 Treat the whole family
 Mass treatment of infected population
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35. THE END
GOD BLESS MWAMI
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