Association Between Age, Sex, Religion and Helminthic Infection Among Children Aged Between 5 to 13 Years: An Institutional Based Study

Background: Worm infestation is a major Health problem inchildren of developing countries, its effective prevention andcontrol requires identification of local risk factors particularlyamong high risk groups. The present study was conducted tostudy t various factors like age, sex, religion and helminthicinfection among children aged between 5 to 13 years.Material and Methods: A cross-sectional study on 352children at Govt. Primary school, Rajapur was conducted fromJanuary 2007 to June 2008. Children were interviewed usingpre-tested proformas to identify the risk factors and prevalenceof Helminthic infestation. Stool examination was done by usingthe formal ether concentration technique in microbiologylaboratory at M. R. Medical College. Statistical analysis wasdone by using the percentage, chi-square, SPSS statisticalsoftware.Results: Out of 352 children 162 tested positive for variousintestinal helminth’s in the age group 5 to 13 years. The overallprevalence of Helminthic infestation was 46.02% thepredominant parasites were Ascaris Lumbricoides 48.77%followed by Hymenolepsis Nana 27.16% Ancylostomaduodenale 11.73%, Trichuris Trichiura 9.88% & Enterobiusvermicularis 2.46%. 4.94% cases were of mixed infection.Helminthic infestation among males was 48.33% and females43.60%. Religion, Sex, Type of family were not significantlyassociated with Helminthic infestation (p>0.05). Theassociation between prevalence of Helminthic Infestation andKAP of children was also found to be Significant.Conclusion: This study concluded that the prevalence ofHelminthic infestation among primary school children were highand need to be addressed.

Differentiating the morphology of infective larvae between two human hook-worms / 中国血吸虫病防治杂志

The morphological differentiation of the infective larvae between human Ancylostoma duodenale and Necator ameri-canus is of great significance for the epidemiological survey of hookworm diseases and human parasitology teaching.Understand-ing of features of the oral spear and transverse lines on the tunica vaginalis is able to accurately differentiate the infective larvae between these two human hookworms.

Anemia crónica grave por Ancylostoma duodenale en Ecuador: diagnóstico por duodenoscopia / Chronic and severe anemia caused by Ancylostoma duodenale in Ecuador: diagnosis by duodenoscopy

Resumen Durante 11 años un varón de 38 años de edad, residente en una región subtropical de Ecuador, había sido diagnosticado de anemia crónica y tratado con transfusiones de sangre en un hospital de la provincia de Cotopaxi, Ecuador. Fue transferido a Quito por una anemia grave, con hemoglobina de 4 g/dL. Se realizó una duodenoscopia en que se observaron nemátodos adultos, identificados posteriormente como Ancylostoma duodenale. El paciente fue tratado exitosamente con albendazol durante cinco días consecutivos y transfusiones de sangre. En el seguimiento a los ocho meses, no se encontró anemia ni huevos de anquilostomas en el examen de heces.

For 11 years, a 38-year-old male residing in a subtropical region of Ecuador, was repeatedly diagnosed with chronic anemia, and treated with blood transfusions in a hospital of province of Cotopaxi, Ecuador. He was transferred to Quito for severe anemia, having hemoglobin of 4 g/dL. Duodenoscopy was performed and adult nematodes, identified later as Ancylostoma duodenale, were observed. The patient was successfully treated with albendazole for five consecutive days and given blood transfusions. In the control visit at eight months, without anemia and no hookworm ova in the stool examined were found.

Hookworm Infection: A Neglected Cause of Overt Obscure Gastrointestinal Bleeding

Hookworm infections are widely prevalent in tropical and subtropical areas, especially in low income regions. In the body, hookworms parasitize the proximal small intestine, leading to chronic intestinal hemorrhage and iron deficiency anemia. Occasionally, hookworms can cause overt gastrointestinal bleeding, but this is often ignored in heavily burdened individuals from endemic infectious areas. A total of 424 patients with overt obscure gastrointestinal bleeding were diagnosed by numerous blood tests or stool examinations as well as esophagogastroduodenoscopy, colonoscopy, capsule endoscopy or double-balloon enteroscopy. All of the patients lived in hookworm endemic areas and were not screened for hookworm infection using sensitive tests before the final diagnosis. The patients recovered after albendazole treatment, blood transfusion, and iron replacement, and none of the patients experienced recurrent bleeding in the follow-up. All the 31 patients were diagnosed with hookworm infections without other concomitant bleeding lesions, a rate of 7.3% (31/424). Seventeen out of 227 patients were diagnosed with hookworm infections in the capsule endoscopy (CE), and 14 out of 197 patients were diagnosed with hookworm infections in the double balloon enteroscopy (DBE). Hookworm infections can cause overt gastrointestinal bleeding and should be screened in patients with overt obscure gastrointestinal bleeding (OGIB) in endemic infectious areas with sensitive methods. Specifically, the examination of stool specimens is clinically warranted for most patients, and the proper examination for stool eggs relies on staff's communication.

Hookworm Infection Caused Acute Intestinal Bleeding Diagnosed by Capsule: A Case Report and Literature Review

Hookworm infections are rare causes of acute gastrointestinal bleeding. We report a middle aged man with primary nephrotic syndrome and pulmonary embolism. During the treatment with steroids and anticoagulants, the patient presented acute massive hemorrhage of the gastrointestinal tract. The results of gastroscopy showed red worms in the duodenum. Colonoscopy and CT angiogram of abdomen were unremarkable. Capsule endoscopy revealed fresh blood and multiple hookworms in the jejunum and ileum. Hookworms caused the acute intestinal bleeding. The patient responded well to albendazole. Hematochezia was markedly ameliorated after eliminating the parasites. Hence, hookworm infection should be considered in the differential diagnosis of a patient with obscure gastrointestinal bleeding. Capsule endoscopy may offer a better means of diagnosis for intestinal hookworm infections.

Occurrence of Intestinal Parasitic Infections and its correlation with haemotological Parameters in a tertiary care centre.

Intestinal parasitic infections are highly prevalent among the general population in developing countries and these infections can lead to a number of adverse effects. This study was done to determine the predominant intestinal parasitic infestations with haematological correlation among all age groups of patients attending tertiary care hospital. A total of 238 stool & blood samples were collected from the patients for examination and haematological analysis. Out of 238 stool samples, 52 (21.8%) showed presence of ova/cysts of Protozoa or helminths. Helminthic eggs were 14.3% and Protozoal cysts or trophozoites were found in 7.5% of them screened for the parasites. Among these Ancylostoma duodenale was found predominant with 10.5% followed by Entamoeba histolytica with 5.5% of total patients. In our study parasitic infestations was predominant in 41-60 yrs. The study showed a relationship between parasitic infestation and Hb, Platelet count, PCV and MCHC which was decreased in protozoal infestations. Their occurrence is quite low compared to other studies which suggests an improved awareness of hygiene. Prevalence of helminths was higher than protozoa in the present study. Hence, it is recommended that appropriate steps be taken at the district level to prevent such infections among pediatric and adult age groups in rural Devanahalli.

A Case of Parasite Invasion of the Intestinal Tract: A Missed Diagnosis in Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause. As the clinical manifestations are very diverse and associated with nonspecific symptoms, research seeking to identify organic causes to rule out IBS and to enable differential diagnosis is required. A 24-year-old man was referred to our hospital for specialized management of IBS. He had a 7-month history of intermittent epigastric and lower abdominal pain. On the basis of clinical examination, he was diagnosed with IBS and administered medication at a primary clinic. However, his symptoms did not improve after treatment. We performed capsule endoscopy at our hospital and identified a parasite (Ancylostoma duodenale) in the proximal jejunum. We therefore report a case of parasitic infection found by additional examination while evaluating symptoms associated with a previous diagnosis of refractory IBS.

Molecular Detection of Ancylostoma duodenale, Ancylostoma ceylanicum, and Necator americanus in Humans in Northeastern and Southern Thailand

The 2 principal species of hookworms infecting humans are Necator americanus and Ancylostoma duodenale. Case studies on zoonotic hookworm infections with Ancylostoma ceylanicum and/or Ancylostoma caninum are known mainly from Asian countries. Of these 2 zoonotic species, only A. ceylanicum can develop to adulthood in humans. In the present study, we report a molecular-based survey of human hookworm infections present in southern and northeastern Thailand. Thirty larval hookworm samples were obtained from fecal agar plate cultures of 10 patients in northeastren Thailand and 20 in southern Thailand. Partial ITS1, 5.8S, and ITS2 regions of the ribosomal DNA genes were amplified using PCR. The amplicons were sequenced, aligned, and compared with other hookworm sequences in GenBank database. The results showed that, in Thailand, N. americanus is more prevalent than Ancylostoma spp. and is found in both study areas. Sporadic cases of A. ceylanicum and A. duodenale infection were seen in northeastern Thailand.

Differential diagnosis of Trichostrongylus and hookworm eggs via PCR using ITS-1 sequence

Trichostrongylus eggs observed in cellophane-thick smears are difficult, in practice, to distinguish from hookworm eggs. In order to overcome these limitations, a molecular approach was conducted. A Trichostrongylus colubriformis adult worm was obtained from a human in Laos, which was identified morphologically. ITS-1 sequence of this worm was determined, and found to be most similar with that of T. colubriformis among the Trichostrongylus spp. reported so far. Then, this sequence was compared with those of human hookworm species, Ancylostoma duodenale and Necator americanus, and species-specific oligonucleotide primers were designed. Polymerase chain reaction (PCR) using these primers evidenced specifically amplified PCR products of Trichostrongylus sp., A. duodenale and N. americanus from the eggs of each (520 bp, 690 bp, and 870 bp, respectively). A species-specific PCR technique can be developed in order to study the epidemiology of Trichostrongylus spp. and hookworms in endemic areas.

Differential diagnosis of Trichostrongylus and hookworm eggs via PCR using ITS-1 sequence

Trichostrongylus eggs observed in cellophane-thick smears are difficult, in practice, to distinguish from hookworm eggs. In order to overcome these limitations, a molecular approach was conducted. A Trichostrongylus colubriformis adult worm was obtained from a human in Laos, which was identified morphologically. ITS-1 sequence of this worm was determined, and found to be most similar with that of T. colubriformis among the Trichostrongylus spp. reported so far. Then, this sequence was compared with those of human hookworm species, Ancylostoma duodenale and Necator americanus, and species-specific oligonucleotide primers were designed. Polymerase chain reaction (PCR) using these primers evidenced specifically amplified PCR products of Trichostrongylus sp., A. duodenale and N. americanus from the eggs of each (520 bp, 690 bp, and 870 bp, respectively). A species-specific PCR technique can be developed in order to study the epidemiology of Trichostrongylus spp. and hookworms in endemic areas.

Revisión de Tema: Nemátodos intestinales de importancia médica en Colombia ¿un problema resuelto? / intestinal nematodes of medical importance in Colombia: a solved problem?

Las enteroparasitosis, en general, constituyen un gran problema de salud pública en el mundo. De éstas, las nematodosis figuran entre las más destacadas en Colombia. Debido a que estos parásitos pueden ingresar al organismo por vía oral o por la piel, los hábitos higiénico-sanitarios deficientes, entre ellos el fecalismo, facilitan su transmisión y conservación.Entre las nematodosis más prevalentes en nuestro país tenemos aquéllas causadas por Ascaris lumbricoides, Trichuris trichiura (tricocéfalo), uncinarias (Necator americanus y Ancylostoma duodenale) y Strongyloides stercoralis. Cuando la carga de dichos parásitos es considerablemente alta o se acompaña de alteraciones en las defensas del hospedero, se pueden producir complicaciones que comprometen seriamente la salud del paciente.En la actualidad se sabe que el control farmacológico de estas nematodosis es efectivo y seguro. No obstante, sin autocuidado y mantenimiento sostenible de buenas condiciones higiénico-sanitarias, no es posible su erradicación.Por lo anterior, esta revisión dirigida al personal de la salud, especialmente a los médicos generales, discutirá los aspectos más relevantes de estas nematodosis y de sus complicaciones, haciendo énfasis en su biología, fisiopatología, manifestaciones clínicas, diagnóstico, tratamiento y algunos datos epidemiológicos.

Abstract Intestinal parasites, in general, constitute a great worldwide, public health problem. Of them, nematodes are among the most outstanding in Colombia. Because these parasites can enter into the organism either by ingestion or through the skin, faulty hygienic-sanitary habits facilitate their transmission and conservation. Among nematodosis the more frequent in Colombia are those caused by Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm), hookworms (Necator americanus and Ancylostoma duodenale) and Strongyloides stercoralis. When the burden of these parasites is considerably high and/or is accompanied by alterations in host defenses, complications can take place that seriously affect health. Presently it is known that pharmacological control of these nematodosis is effective and safe. Nevertheless, without selfcare, and maintenance of good hygienic-sanitary conditions, their eradication will not be feasible. This review of outstanding aspects of nematodosis, with emphasis on their biology, physiopathology, clinical manifestations, diagnosis, treatment, and some epidemiologic data, intends to update physicians as a basis for adequate management of this problem.

SCANNING ELECTRON MICROSCOPIC OBSERVATIONS ON THE COPULATORY SPICULES OF THE MALE NECATOR AMERICANUS AND ANCYLOSTOMA DVODENALE / 中国寄生虫学与寄生虫病杂志

Scanning electron microscopic observations were made on the morphological structures of the two copulatory spicules of the male Necator americanus and Ancylostoma duodenale. In both species,one of the two copulatory spicules was in the shape of a concave groove and the other, in the shape of an oblate tube. Owing to the difference in the concavity of the groove shaped copulatory spicule between the two species as shown by the cross sections, Necator americanus usually appear to have only one copulatory spicule whereas Ancylostoma duodenale usually show two separate copulatory spicules in appearance (Figs 1 -10).