Ascariasis, trichuriasis and fatal non-transfusion

Blood transfusion for chronic anemia can lead to acute or decompensated heart failure in patients who have fluid overload as part of their compensatory response and/or have intrinsic heart disease, and then it could be fatal in such clinical scenarios. This is the report of a case of profound chronic anemia in a young male patient, who was not transfused and then developed confusion followed by terminal cardiopulmonary arrest. Autopsy revealed severe trichuriasis to be the cause of the anemia, along with severe ascariasis, but minimal intrinsic brain disease. This supports the conclusion that anemia was the cause of the confusion, and the lesson that confusion may be a sign that the benefit of blood transfusion outweighs the risk in a patient with severe chronic anemia.

Surveillance of soil-transmitted nematode infections in Zhenjiang City from 2006 to 2018 / 中国血吸虫病防治杂志

Objective To understand the epidemic trend of soil-transmitted nematodiasis in Zhenjiang City from 2006 to 2018, so as to provide evidence for formulating targeted control measures. Methods The permanent residents at ages of 3 years and greater and the immigrants who had lived in Zhenjiang City for more than one year were selected as the study subjects. Fecal samples were collected, and the soil-transmitted nematode eggs were detected in fecal samples with the modified Kato-Katz technique (three smears from one stool sample), while the children at ages of 12 years and lower were tested for Enterobius vermicularis eggs using the adhesive cellophane-tape perianal swab method. The prevalence and intensity of parasitic infections were estimated in Zhenjiang City each year from 2006 to 2018, and the data pertaining to the deworming for soil-transmitted nematode infections were collected during the study period. Results A total of 202 880 person-times were subjected to stool examinations in Zhenjiang City from 2006 to 2018, and 946 persons were detected with soil-transmitted nematode infections, with a mean prevalence of 0.47%. The overall prevalence of human soil-transmitted nematode infections appeared a decline tendency (P < 0.01), with a reduction from 1.10% in 2006 to 0.11% in 2018, and there was a region-specific overall prevalence (P < 0.01), with the highest prevalence seen in Runzhou District (1.65%) and the lowest detected in New District (0.04%). The mean prevalence of human Ascaris lumbricoides, hookworm and Trichuris trichiura infections was 0.33%, 0.09% and 0.04% in Zhenjiang City, respectively, and showed a decline tendency year by year from 2006 to 2018 (P < 0.01). Among all infections, mild infections were predominant. During the period from 2006 through 2018, a total of 45 427 children were examined in Zhenjiang City from 2006 to 2018, and 145 children were positive for E. vermicularis infections, with a mean prevalence of 0.32%. The prevalence of E. vermicularis infections decreased from 1.33% in 2006 to 0.22% in 2018 in children, and the overall prevalence appeared a decline tendency (P < 0.01). A single parasite infection was predominant in soil-transmitted nematode infections (97.46%), and mixed infection of two parasites were mainly detected before 2007. A total of 535 089 person-times received deworming in Zhenjiang City from 2006 to 2018, and the rate of adverse events was 0.002%. Conclusions Currently, the soil-transmitted nematode infection is at a low level in Zhenjiang City, and the overall prevalence of soil-transmitted nematode infections shows a decline tendency year by year. The surveillance and health education of soil-transmitted nematodiasis should be further intensified to consolidate the control achievements.

A First Case of Human Trichuriasis from a Roman Lead Coffin in France

A paleoparasitological study was carried out on 2 lead coffins recovered from the Roman site of Jaunay-Clan (near Poitiers, France). For the first time, this particular type of burial gave positive parasitological results, and eggs of the whipworm Trichuris trichiura were identified in 1 individual. In the present case, thanatomorphose associated with funerary practices may explain the scarcity of the recovered eggs. However, human whipworm has now been observed in 9 individuals dated to the Roman period. The very high frequency of Trichuris sp. eggs in Roman archaeological sites (up to 80%) suggests that fecal peril, hygiene, and waste management were problematic during this period. Finally, due to the fact that very few analyses have been conducted on human bodies dated to the Roman period, more analyses must be performed in the future to provide further information about diseases in the Roman world.

Tricuríase: atualidades / Trichuriasis: an update

A tricuríase - parasitose causada pelo nematódeo Trichuris trichiura - é uma das principais infecções por helmintos que afeta o homem. A enfermidade produzida por T. trichiura é mais comum em indivíduos que habitam países em desenvolvimento ou que vivem em situações de pobreza. A entidade mórbida pode afetar o desenvolvimento físico, intelectual e cognitivo e aumentar a suscetibilidade a outras doenças, como malária e tuberculose. Com base nessas considerações, no presente artigo é apresentada uma revisão sobre os aspectos mais relevantes da tricuríase.

Parasitic Infections Based on 320 Clinical Samples Submitted to Hanyang University, Korea (2004-2011)

We analyzed 320 clinical samples of parasitic infections submitted to the Department of Environmental Biology and Medical Parasitology, Hanyang University from January 2004 to June 2011. They consisted of 211 nematode infections, 64 trematode or cestode infections, 32 protozoan infections, and 13 infections with arthropods. The nematode infections included 67 cases of trichuriasis, 62 of anisakiasis (Anisakis sp. and Pseudoterranova decipiens), 40 of enterobiasis, and 24 of ascariasis, as well as other infections including strongyloidiasis, thelaziasis, loiasis, and hookworm infecions. Among the cestode or trematode infections, we observed 27 cases of diphyllobothriasis, 14 of sparganosis, 9 of clonorchiasis, and 5 of paragonimiasis together with a few cases of taeniasis saginata, cysticercosis cellulosae, hymenolepiasis, and echinostomiasis. The protozoan infections included 14 cases of malaria, 4 of cryptosporidiosis, and 3 of trichomoniasis, in addition to infections with Entamoeba histolytica, Entamoeba dispar, Entamoeba coli, Endolimax nana, Giardia lamblia, and Toxoplasma gondii. Among the arthropods, we detected 6 cases of Ixodes sp., 5 of Phthirus pubis, 1 of Sarcoptes scabiei, and 1 of fly larva. The results revealed that trichuriasis, anisakiasis, enterobiasis, and diphyllobothriasis were the most frequently found parasitosis among the clinical samples.

Predictors of intestinal parasitosis in school children of Kashmir : A prospective study.

Objectives: To identify the factors associated with intestinal parasitosis in rural and urban school children of Kashmir. Methods: Single fresh stool samples from rural and urban school children in three age groups: a)5 to < 8 years ,b) 8 to <11 years and c)11-14 years were taken .Various demographic characteristics considered were source of drinking water, type of toilet used and social classes as per the Kuppuswamy social scale. Personal hygiene was assessed by the visiting physician based on length of nails, hair and frequency of bathing. Stool samples were analyzed for detection of motile forms of E. histolytica and microscopic examination under low power detected eggs of intestinal helminths. Concentration methods were used if egg count was low. Results: 274 stool samples from rural school children and 240 samples were taken from urban school children respectively. 214 (46.7%) students had stool tests positive for parasitosis. Ascariasis was the most prevalent parasitosis ( 28%) followed by Giardiasis ( 7%) , Trichuriasis( 5%) and Taeniasis( 4%). There was higher prevalence of parasitosis among rural orphanage children compared to urban orphanage students (76% vs. 48% p <0.05). Highest prevalence of 70% was seen in the age group 8-11years. Students using river/stream water had higher rates of parasitosis compared to those who were using tap water. 202 students were found to have poor personal hygiene and parasitosis was higher in them compared to students with good personal hygiene (p<0.05). Conclusion: Poor environmental sanitation, personal hygiene, type of toilet and water used were associated with recurrent intestinal infestation besides socio economic status. Regular deworming programmes need to be adopted at school level especially in 8-11 years old children to check the surge of intestinal parasites and their subsequent morbidities.

Tricuríase / Trichuriasis

A tricuríase é uma doença parasitária causada pelo Trichuris trichiura, com importante impacto universal. No presente artigo é apresentada uma revisão sobre os aspectos mais relevantes da tricuríase.

Trichuris trichiura Infection Diagnosed by Colonoscopy: Case Reports and Review of Literature

Trichuris trichiura, commonly referred to as a whipworm, has a worldwide distribution, particularly among countries with warm, humid climates. In Korea, trichuriasis was a highly prevalent soil-transmitted helminthiasis until the 1970s. However, the nationwide prevalence decreased to 0.02% in 2004 as a result of national control activities and improvement in the socioeconomic status of Koreans. Most infected individuals have no distinct symptoms, if lightly infected. The diagnosis is typically confirmed by detection of T. trichiura eggs on examination of a stool sample; few reports have described detection of the parasite during colonoscopy. Recently, we managed 4 patients with trichuriasis who were diagnosed by detection of the parasite on colonoscopy, and we reviewed the literature on the colonoscopic diagnosis of T. trichiura in Korea. We suggest that colonoscopy might be a useful diagnostic tool, especially when infected by only a few male worms with no eggs in the stool.

Parasitismo intestinal en una escuela primaria de Bata, Guinea Ecuatorial / Intestinal parasitism in an elementary school in Bata, Equatorial Guinea

Con el objetivo de precisar el grado de parasitismo intestinal según la edad, así como identificar los parásitos intestinales más frecuentes en la escuela primaria "Amiguitos de Jesús" de la ciudad de Bata, Guinea Ecuatorial, en el periodo septiembre 2002 a Junio 2003, se realizó un estudio descriptivo y prospectivo. En el mismo se encontró que el grado de parasitismo intestinal fue de un 29.9 % del total de análisis realizados, predominando sobre todo en los menores de 6 años; un 44.7% de éstos estaban infestados. Se encontró un predominio de los vermes: el más frecuente fue Trichuris trichiura, para el 95.1 % del total de niños infestados, y el áscaris lumbricoides, con un 75.6% del total de 41 infestados. De los protozoos, el más frecuente fue la ameba, existiendo en un 17.07 % de los infestados. El grado de infestación encontrado es elevado, requiriéndose programas educativos para fomentar el cuidado de los hábitos higiénicos de los niños. El predominio de los parásitos encontrados podría deberse a la contaminación de la tierra con heces fecales y a la falta de un adecuado tratamiento de las aguas para el consumo, y de infraestructura sanitaria.

With the aim of defining exactly the grade of intestinal parasitism according to age, as well as identifying the most frequent intestinal parasites in "Amiguitos de Jesús" Elementary School in Bata City, Equatorial Guinea, during septembre 2002 to June 2003, a descriptive, prospective study is carried out. In the study it was found that the parasitism grade was 29.9% from the total of the analysis performed, predominating in those under 6 years of age: 44.7% of these cases were infected. A prevalence of vermes was observed, Trichuris trichiuria was the most frequent species found, representing 95,1% from the total of infected children and Ascaris lumbricoides 75,6% from the total of 41 infected. Among protozoa, amoeba was the most frequent specie observed, being present in 17,07% of infected cases. A high-grade infection was found, requiring educative programs for increasing hygienic habits in children. The prevalence rate of parasites should be caused by the ground pollution with stools, as well as the lack of a proper treatment of drinking water and health infrastructure.

Frecuencia de helmintiasis intestinal y su asociación con deficiencia de hierro y desnutrición en niños de la región occidente de México / Frequency of intestinal helminthiasis and its association with iron deficiency and malnutrition in children from western Mexico

Objetivo: Determinar la frecuencia de helmintiasis intestinal y su asociación con desnutrición y deficiencia de hierro. Material y métodos: Se realizó un estudio transversal analítico en el municipio de Comala, Colima, México. A todos los niños, se les determinó coproparasitoscópico seriado de tres días con la técnica de Kato-Katz. Para evaluar el grado de desnutrición; se establecieron los siguientes índices antropométricos: mediana y puntajes Z para peso/ talla, talla/edad y peso/edad. Se consideró que había deficiencia de hierro severa, moderada o leve con ferritina ≤ 12 ng/ ml, de 12 a 18 ng/mL y de 19 a 24 ng/mL respectivamente. Resultados: Se estudiaron 243 niños con una edad promedio de 65.3 ± 8.7 meses. El 60.9 % (n = 148) y el 2.5 % (n = 6) de los niños presentaron disminución de la ferritina y anemia respectivamente. El 16 % (n = 39) mostró trichuriasis, el 6.9 % (n = 17) ascariasis y el 5.3 % (n = 13) ambas. La infección por Trichuris trichiura se asoció a desmedro (OR 11.0, IC 3.9-30.8; p < 0.001) y a deficiencia de hierro con puntos de corte de < 24 ng (OR 2.0, IC 1.0-3.9, p = 0.02) y < 18 ng/dL (OR 2.2, IC 1.2-4.2, p = 0.009). La infección por ascaris no se asoció con desnutrición o deficiencia de hierro. Conclusiones: La infección de T. trichiura se asoció con desmedro y deficiencia de hierro grado leve y moderado.

OBJECTIVE: To determine intestinal helminthiasis frequency and its association with malnutrition and iron deficiency. Material and METHODS: An analytical cross-over study was carried out on children in the municipality of Comala, Colima, Mexico. Coproparasitoscopic exams in series of three using the Kato-Katz technique were performed in all children. To evaluate the degree ofmalnutrition, the following anthropometric indices were determined: means and z-scores for weight/height, height/age, weight/age. Severe, moderate and minimal iron deficiency was considered when ferritin was: < or = 12 ng/ml, 12 to 18 ng/mL and 19 to 24 ng/mL, respectively. RESULTS: 243 children were studied with an average age of 65.3+/-8.7 months. 60.9% (n = 148) of the children showed a decrease in ferritin levels and 2.5% (n = 6) had anemia. 16% (n = 39) had trichuriasis, 6.9% (n = 17) ascariasis and 5.3% (n = 13) had both parasites. Trichiura infection was associated with declining health (OR 11.0, CI 3.9-30.8; p<0.001) and with iron deficiency, with cut-off points of <24 ng (OR 2.0, CI 1.0-3.9, p = 0.02) and <18 ng/ dL (OR 2.2, CI 1.2-4.2, p= 0.009). Ascaris infection was not associated with malnutrition or iron deficiency. CONCLUSIONS: Trichiura infection was associated with declining health and slight and moderate degrees of iron deficiency.

Colonoscopic Diagnosis of Whipworm Infection / 대한소화기내시경학회지

Trichuriasis is an intestinal infection of human beings caused by Trichuris trichiura, more commonly known as whipworm because of its whip-like appearance. It is characterized by the invasion of the colonic mucosa by the adult trichuris. It is prevalent throughout the world, especially in tropical areas. Diagnosis is made typically by the identification of characteristic barrel-shaped eggs in the feces, although adult worms may be seen rarely at sigmoidoscopy or colonoscopy. We report five cases of whipworm infection that was diagnosed on colonoscopic examination.