Ascaris lumbricoides is the most common helminthic infection. More than 1.2 billion people have ascariasis worldwide.

A new study published in Recent Patents on Inflammation & Allergy Drug Discovery aimed to provide an update on the evaluation, diagnosis and treatment of ascariasis.

This was a review of meta-analyses, randomized controlled trials, clinical trials, observational studies and reviews published in PubMed, over the past 10 years. Clinical Queries used the key terms "ascariasis" OR Ascaris lumbricoides.

The findings revealed that ascaris lumbricoides is transmitted through the ingestion of embryonated eggs from fecal-contaminated material. Ascariasis has high endemicity in tropical and subtropical areas. Predisposing factors include – poverty, poor sanitation, inadequate sewage disposal and poor personal hygiene. The prevalence is greatest in children younger than five years of age; majority of patients with intestinal ascariasis are asymptomatic. For those with symptoms, anorexia, nausea, bloating, abdominal discomfort, recurrent abdominal pain, abdominal distension and intermittent diarrhea are not uncommon. Other clinical manifestations vary widely—depending on the underlying complications. Complications include – Löeffler syndrome, intestinal obstruction, biliary colic, recurrent pyogenic cholangitis, cholecystitis, acalculous cholecystitis, obstructive jaundice, cholelithiasis, pancreatitis and malnutrition. The diagnosis is best established by microscopic examination of fecal smears or following concentration techniques for the characteristic ova.

Patients with A. lumbricoides infection require anthelminthic treatment even when asymptomatic—to prevent complications from migration of the parasite. The average cure rate with anthelminthic treatment is over 95%. Unfortunately, most treated patients in endemic areas become re-infected within months. Health education, personal hygiene, improved sanitary conditions, proper disposal of human excreta and discontinuing the use of human fecal matter as a fertilizer are effective long-term preventive measures. Furthermore, targeting deworming treatment and mass anthelminthic treatment should be considered in regions where A. lumbricoides is prevalent.

Source: Recent Patents on Inflammation & Allergy Drug Discovery. 2020 Jul 5. doi: 10.2174/1872213X14666200705235757.