ASCARIASIS AND GUINEA WORM

DISEASE

TOPIC
 ASCARIASIS
Ascariasis is an infection
of small intestine caused
by ascaris lumbricoides, a
large round worm .
CAUSATIVE AGENT
Ascaris lumbricoides causes
ascariasis.
Ascaris lumbricoides lives in
small intestine of infected
individual.
HOST FACTORS
 Man is the only reservoir of infection.
Children are infected more than adults.
The most common age group affected is
3-8 years.
The eggs are excreted in feces.
Infected person is communicable until all
fertile females are destroyed and stools
are negative.
LIFE CYCLE OF ASCARIASIS
LIFE CYCLE OF ASCARIASIS
1 Adult worms live in the lumen of the small intestine.A
female may produce approximately 2,00,000 eggs per
day,which is passed with the feces .
2 fertile eggs embroyonate and become infective after 18
days to several weeks.
3 After infective eggs are swallowed.
4 the larvae hatch .
5 Invade the intestinal mucosa.
6 reached into the lungs via the poral system .
7 upon reaching the small intestine they develop into adult
worm.
Main reason for spread of
infection

The eggs excreted out in the soil along with

faeces remain viable for months or
years .Clay soil is the most favourable for
the development of ascariasis eggs .
Open air defaecation habit of human is
responsible for wide spread distribution of
ascariasis.
EPIDEMIOLOGICAL TRIAD OF
ASCARIASIS

AGENT-
Ascaris
lumbricoid
es
ENVIRON
MENT – Host –
open air common in
defecation 3- 8 years
Clinical features of ascariasis
Pulmonary and hypersensitivety manifestations
Intestinal symptoms
Intestinal obstruction
Hepatobiliary and pancreatic symptoms
1 pulmonary and hypersensitivety
manifestations

Transient respiratory symptoms can occur in sensitised

hosts
during the stage of larval migration through the lungs.
Urtricaria and other symptoms related to
hypersensitivety usually occur toward the end of the
period of migration through the lungs.
2 Intestinal symptoms
Abdominal discomfort
Anorexia
Nausea
Diarrhea
Abdominal cramps
Abdominal swelling
3 Intestinal obstruction
A mass of worms can obstruct the bowel lumen in
heavy ascariasis infection leading to acute intestinal
obstruction.
The obstruction occurs most commonly at the
ileocecal valve.
4 Hepatobiliary and pancreatic symptoms
When migrate to the biliary tree
Abdominal pain
Biliary colic
Acalcalous cholecystitis
Ascending cholangitis
Bile duct perforation with peritonitis
DIAGNOSTIC EVALUATION
 MICROSCOPY- characteristic eggs may be seen on direct
examination of faeces. If an ascaris worm is found in the faeces,
a stool specimen can be checked for eggs to document whether
or not additional worms are present prior to instituting therapy.
 EOSINOPHILIA- Peripheral eosinophilia can be found
particularly during the phase of larval migration through the
lungs but also sometimes at the other stages of ascaris infection.
Serum levels of IgG and IgE are also often elevated during early
infection.
 IMAGING-Large collection of worms may be detctable on
plain film of the abdomen.The worms also sometimes ingest
barium IN which case the alimentary canal appears as a white
thread bissecting the length of the worms body.
CONTINUE....
ULTRASOUND-it can help to diagnose
 PREVENTION AND CONTROL
PRIMARY PREVENTION
Provision for safe drinking water.
Proper disposal of excreta.
Provision of toilets
HEALTH EDUCATION
Avoid contact with soil that may be contaminated with
human feces.
Cont.....
Wash hands with soap and water before cooking
handling food
Cont..
Wash all raw vegetables and fruits before cooking
protect food from soil.
Cont...
Trim nails.
Cont...
Scrub hands thoroughly with soap and water before
eating ,feeding children.
Wash hands with soap and water after visiting the
toilets.
Secondary prevention
Cases are diagnosed by stool examination
Infected persons are treated with –
PIPERAZINE -75mg per kg body weight x 2 days
with maximum dose of 3.5gm for 2 days.
MEBENDAZOLE- 100mg BD x 3days.
LEVAMISOLE- 2.5mg per kg body weight maximum
dose of 150mg.
PYRANTEL- 10mg per kg body weight –a single
maximum dose of 1gm.
 MASS TREATMENT
Periodic deworming at intervals of 2-3
months is recommended to reduce the
worm load in the community,
DRACUNCULIASIS ( GUINEA
WORM DISEASE)
INTRODUCTION
Today dracunculiasis more commonly known as
guinea worm diseases,is only found in 13 countries in
sub saharan Africa.It is caused by a nematode or
flatworm, dracunculiasis medinensis, which infects
small crustaceans, called cyclops.Human because
infected if they drink from an unfiltrated water
supply,which contains infected water fleas.
 Definition
worm that is marked by painful blisters
Disease caused by the guinea especially
on the lower legs or feet from which one
or more mature female guinea worms
slowly emerge is known as
dracunculiasis.
Epidemiological Triad
Agent-
dracunculi
asis
medinensis
Environme
Host –all nt-water
ages, both contaminat
sexes ed with
cyclops
HOST FACTORS
It affects both sexes and all age
groups.
Repeated infections can occur in
person.
ENVIRONMENTAL FACTORS
Using contaminated water for washing
and bathing.
Using step wells.
Peak transmission occurs during the
dry season ( march –may).
TRANSMISSION
GUINEA WORM DISEASE IS TRANSMITTED
THROUGH CONSUMPTION OF WATER
CONTAMINATED WITH INFECTED CYCLOPS.
INCUBATION PERIOD – 10- 14 months.
PREVENTION
Continuous survillence to detect every case
within 24 hours of worm emergence.
Adequate treatment to infected people to prevent
transmission .
Regular cleaning and bandaging of the affected skin
area until the worm is completely expelled out.
Advice the patient to avoid wading into water.
Ensure access to improved drinking water to prevent
infection.
Cont..
Water drawn from open water bodies should be filtered
before drinking.
Promote and implement vector control
Create awareness through health education.
conclusion
Primary preventive measures are provision for safe
drinking water, proper disposal of excreta, provision
of toilets, and health education.
Periodic deworming at intervals of 2-3 months is
recommended to reduce the worm load in community.
THANK YOU