Parasitic contamination of fresh vegetables sold in open markets: a public health threat / Contaminação parasítica de vegetais frescos vendidos em mercados abertos: uma ameaça para a saúde pública

Vegetables eating raw are a leading source of transmission of infective forms of pathogenic internal parasites among human beings. This research was conducted from April to October, 2017 to assess the parasitic contamination of vegetables sold at main vegetable markets in districts Lower Dir and Peshawar, Pakistan. Eight hundred specimens of different vegetables were purchased and soaked in physiological saline solution, shaken with a mechanical shaker for 20 minutes and processed by sedimentation concentration method. Results revealed that only 19.7% (n=158/800) of the vegetables were found to be contaminated with single or multiple parasite species. Ascaris lumbricoides (the large round worm) 12.3% (n=99/800) was the most commonly detected pathogen and Taenia saginata (the beef tapeworm) 1.62% (n=13/800) was the least frequently detected one. Interestingly, significant p value (p>0.05 at 95%CI) between the number of examined and contaminated for all the variables studied including education status of the vendors, markets location, type of vegetables, means of display, washed before display, washing source of water and market type. The findings of this study evidenced that consumption of raw vegetables possesses great risk of getting parasitic infections in Lower Dir and Peshawar districts, Pakistan. Instructing the sellers and the public about parasitic disease transfer and their hygiene can reduce the infection rate of parasites of human origin.

Os vegetais crus são a principal fonte de transmissão de formas infecciosas de parasitas internos patogênicos entre os seres humanos. Esta pesquisa foi realizada de abril a outubro de 2017 para avaliar a contaminação parasitária de vegetais vendidos nos principais mercados de vegetais nos distritos de Lower Dir e Peshawar, Paquistão. Oitocentos exemplares de diferentes vegetais foram adquiridos e embebidos em solução salina fisiológica, agitados em agitador mecânico por 20 minutos e processados pelo método de concentração por sedimentação. Os resultados revelaram que apenas 19,7% (n = 158/800) das hortaliças estavam contaminadas com uma ou várias espécies de parasitas. Ascaris lumbricoides (o verme redondo grande) 12,3% (n = 99/800) foi o patógeno mais comumente detectado e Taenia saginata (a tênia da carne) 1,62% (n = 13/800) foi o menos freqüentemente detectado. Curiosamente, valor de p significativo (p> 0,05 em IC de 95%) entre o número de examinados e contaminados para todas as variáveis estudadas incluindo escolaridade dos vendedores, localização dos mercados, tipo de vegetais, meios de exposição, lavado antes da exposição, fonte de lavagem de água e tipo de mercado. Os resultados deste estudo evidenciaram que o consumo de vegetais crus possui grande risco de contrair infecções parasitárias nos distritos de Lower Dir e Peshawar, no Paquistão. Instruir os vendedores e o público sobre a transferência de doenças parasitárias e sua higiene pode reduzir a taxa de infecção de parasitas de origem humana.

Complicaciones quirúrgicas de la ascaridiasis en la infancia / Surgical complications of childhood ascariasis

Introducción: La infestación por áscaris consttuye un problema de salud pública importante en áreas endémicas, provocando en algunos casos complicacionesque requieren la intervención del cirujano. El propósito del presente estudio es analizar las complicaciones quirúrgicas de la ascaridiasis,en nuestro medio.Diseño, lugar y partcipantes: se realizó un estudio descriptvo retrospectvo de los pacientes que presentaron complicaciones quirúrgicas debido a lainfestación por A. lumbricoides de enero de 1999 a marzo de 2015 que fueron tratados en la unidad de cirugía pediátrica del hospital general San Juande Dios.Resultados: Ingresaron 47 pacientes con infestación por áscaris, comprendidos en las edades de 1 a 13 años. Hubo 39 pacientes con obstrucción intestnal,7 con ascaridiasis en el colédoco y 1 con apendicits por áscaris. El diagnóstco de los 39 pacientes con oclusión intestnal por áscaris fue clínicoy con rayos X simple de abdomen, 19 resolvieron con tratamiento médico y 20 requirieron de tratamiento quirúrgico. Los pacientes con áscaris en elcolédoco fueron diagnostcados por USG a 1 se le logró extraer el áscaris por CPRE mientras que a los 6 restantes fue necesario la exploración de la víabiliar por laparotomía. El diagnóstco de la apendicits secundario a la obstrucción por áscaris se realizó trans operatoriamente. La morbilidad observadafue del 21% (10/47) de los pacientes: 8 presentaron respuesta infamatoria sistémica y 2 dehisencias de la anastomosis intestnal. La mortalidadfue del 2% (1/47): un paciente con fallo orgánico múltple por sepsis abdominal y desnutrición.Conclusiones: en este estudio, las complicaciones de la infestación por áscaris fueron la obstrucción intestnal, obstrucción de la vía biliar y apendicits...

Introducton: In endemic areas, ascariasis is an important public health problem. In cases of severe infestaton, some cases need to be surgically treated.The aim of this study is to analyze surgical complicatons of childhood ascariasis in our insttuton.Design, Place and Partcipants: A retrospectve study of all patents with ascariasis, from 1999 to 2015, evaluated in the surgical pediatric unit at SanJuan de Dios General Hospital.Results: We analyzed 47 patents with ascariasis, age range 1 to 13 years old. There were 39 patents with intestnal obstructon due to ascariasis, 7 withcholedochal ascariasis and 1 with appendiceal ascariasis. Diagnosis of intestnal obstructon due to ascariasis was made with clinical evaluaton andplain abdominal radiography. Of the 39 patents with abdominal obstructon, 19 resolved with medical treatment and 20 required surgical interventon.Patents with choledochal ascariasis were diagnosed by ultrasonography. In one patent, extracton of the worm was possible with endoscopic retrogradecholangiopancreatography, in the remaining 6 patents, open common bile duct exploraton was required. Diagnosis of the appendiceal ascariasiswas made during appendectomy without previous clinical suspicion. Serious morbidity was 21% (10/47): 8 patents with severe infammatory responseand 2 anastomosis dehiscences. Mortality was 2% (1/47), a patent with multple organ failure, abdominal sepsis and malnourishment. Morbidity andmortality occurred only in patents with intestnal obstructon due to ascariasis. Conclusions: In this study, complicatons of ascariasis were intestnal obstructon, choledochal obstructon and acute appendicits...

Intestinal obstruction due to ascaris lumbricoides infestation in adult presenting as lump in right lliac fossa

Ascaris lumbricoides [AL] is a common resident of intestine especially in low socioeconomic areas of the world. Ascariasis can cause serious intra-abdominal complications such as intestinal obstruction, biliary obstruction, pancreatitis, acute appendicitis, intestinal perforation etc. We report an adult with intestinal obstruction due to entangled mass of AL, that presented as a lump in right iliac fossa, managed by laparotomy and milking the worms into colon without enterotomy

Áscaris lumbricoides en el corazón de una gestante / Presence of Ascaris lumbricoides in the heart of a pregnant woman

El áscaris es el nematodo de mayor tamaño que parasita al hombre; es un helminto dioico (sexos separados). Su prevalencia se debe fundamentalmente a la contaminación fecal del suelo y a la capacidad de supervivencia de los huevos. Los adultos de áscaris lumbricoides se localizan en el intestino delgado, aunque algunas veces puede haber migraciones erráticas de parásitos adultos a lugares como el hígado, peritoneo, riñones, etc. Describir la forma de presentación del parasitismo intestinal por áscaris lumbricoides en una embarazada, actualizar e informar sobre el parasitismo intestinal, mostrar la experiencia en el manejo de un caso de difícil diagnóstico y transmitir conocimientos, contribuir a la docencia médica, son los objetivos de esta presentación. Se realizó una revisión bibliográfica sobre el parasitismo intestinal, específicamente del áscaris lumbricoides partiendo de la existencia de un caso obstétrico portadora de manifestaciones cardiovasculares importantes y de difícil manejo, por lo que se revisó exhaustivamente la historia clínica de dicha paciente en los 2 hospitales en los cuales estuvo ingresada. Paciente portadora de una gestación de 12 sem que acude con manifestaciones respiratorias y cardiovasculares, la primera impresión diagnóstica fue de una miocarditis o miocardiopatías, después de concluir estudios pertinentes se concluye como portadora de áscaris lumbricoides en corazón derecho y además se complica con un tromboembolismo pulmonar. A pesar de ser infrecuente en nuestros días, debemos pensar en el parasitismo como una explicación a ciertas sintomatologías de extraña presentación clínica

The ascaris is the higher nematode to parasitizes the man; it is dioecious helminths (having separate sexes). Its prevalence is due mainly to soil fecal contamination and to survival ability of eggs. The adult Ascaris lumbricoides are located in the small bowel, although some times may be erratic migrations of adult parasites to places like the liver, peritoneum, kidneys, etc. The aim of present paper is to describe the presentation way of intestinal parasitism by Ascaris lumbricoides in a pregnant woman, to update and to inform on the intestinal parasitism, to show the experience in the management of a case of difficult diagnosis and to transmit the knowledges, and to contribute to medical teaching. A bibliographic review on the intestinal parasitism was made, specifically of Ascaris lumbricoides from the existence of a obstetric case carrier of significant cardiovascular manifestations and of a difficult management, thus we made an exhaustive review of medical record of this patient in the two hospitals where she was admitted. A patient with 12 weeks pregnancy to come to consultation due to respiratory and cardiovascular manifestations, the first diagnostic impression was a myocarditis or myocardiopathies. After conclude the pertinent studies she is classified as a Ascaris lumbricoides carrier in right heart and that also it is complicated with a pulmonary thromboembolism. Despite this condition is infrequent nowadays, we must to think about the parasitism like an explanation for some symptomatology of a rare clinical presentation

Granulomatosis peritoneal por Ascaris lumbricoides: Presentación de un caso / Granulomatous peritonitis due to Ascaris lumbricoides: Case report

La ascariasis es una parasitosis ampliamente diseminada en el mundo, especialmente en los niños de los países en vías de desarrollo, ligada a condiciones de pobreza, desnutrición y mala higiene. Se acepta que es la geohelmintiasis más frecuente entre todas las parasitosis humanas. Dado el complejo ciclo de vida del parásito causal, se pueden producir muchas y variadas complicaciones intestinales y extraintestinales, entre ellas la peritonitis. El tratamiento oportuno y las medidas preventivas son factores importantísimos para evitar las muertes por esta enfermedad.Se presenta el caso de una niña de 3 años de edad, procedente de una zona rural colombiana quien presentó una peritonitis por áscaris, manifestada por diarrea persistente, dolor y masa abdominal, en quien se hizo el diagnóstico en forma casual mediante laparotomía y biopsia peritoneal, ante la sospecha de un linfoma.

Ascariasis is one of the most prevalent and widespread human helminthic infections, especially in children of the underdeveloped countries. It is related to conditions of poverty, malnutrition and poor hygiene. According to the complex life cycle of the parasite, several and different intestinal and extraintestinal complications can arise, including peritonitis. Appropriate treatment and preventive measures are very important factors to avoid deathscaused by this disease. We report the case of a 3 year-old girl, coming from arural area of Colombia, who presented peritonitis by Ascaris lumbricoides, preceded by persistent diarrhea, pain and abdominal mass. She was incidentally diagnosed by means of laparotomy and peritoneal biopsy, because an intestinal lymphoma was suspected.

Enclavamiento de Ascaris lumbricoides en vía biliar: presentación de un caso / Bolts of ascaris lumbricoides in via biliary: presentation of a case

La ascariasis es una parasitosis cosmopolita, frecuente en la población infantil a nivel mundial, dado que no requiere factores climáticos o ambientales especiales. Ingresa al organismo por ingesta de huevos, cumpliendo un ciclo hístico-tisular trans-alveolocapilar en su desarrollo para retomar al yeyuno como parásito adulto, etapa en la cual tiene una movilidad exagerada cuando se altera la homeostasis (sobre todo fiebre en los niños), pudiendo migrar a diferentes sitios originando diversas complicaciones entre las que destaca la migración a vía biliar y su enclavamiento. Presentamos el caso de una escolar de 8 años de edad, procedente de Beni, que consulta por dolor abdominal severisimo en flanco derecho de diez días de evolución, irradiado a epigastrio. Se interna en el Hospital de San Borja y al no ser controlado el cuadro, es remitido al Hospital del Niño de la ciudad de La Paz , donde se encuentran dos Ascaris móviles en interior de vesícula y colédoco en la ecografía. Se administra pamoato de pirantel, sin disminución inicial del dolor, mismo que por su intensidad, tiempo de evolución, se decide programarla para cirugía; ante ls atenuación del dolor se solicita control ecográfico en el que se evidencia la salida espontánea de los parásitos, por lo que se continua con una conducta conservadora, con buena evaluación.

The Ascaris is a cosmopolitan parasite, frequent in children inthe whole world, since it does not need any special climatic orenvironmental factors for its growth and development.It enters the organism by intake of eggs, completing a histicaltissuetransalveolar capillary cycle in its development returning tothe jejunum as adult parasite. In this stage it has an exaggeratedmobility when the homoeostasis is altered (principally fever inchildren), being able to migrate to different locations causing diversecomplications, among which the migration to bilious conducts standsout with the ascaris´ enclosure.We present the case of an 8 year-old school boy, who came from theBeni with extremely severe abdominal pain on the right side with anevolution of 10 days and irradiation to the epigastrium. The boy hadbeen admitted to the hospital of San Borja, and since his problemwas not solved, he was transferred to the Hospital del Niño in la Paz,where two mobile ascaris were found inside the gall bladder and thecholedoco in the echography. Pamoato of pirantel was administered,without initial decrease of the pain. Due to the intensity, and the timeof evolution of the pain, surgery was considered. When the pain wasattenuated an echographic control was made that showed thespontaneous exit of the parasites. For this reason, the conservativetreatment was continued with a positive evolution.

Non-operative management of intestinal obstruction due to Ascaris lumbricoides

To compare, evaluate and analyze three different non-operative modalities of treatment of intestinal obstruction due to ascaris lumbricoides. Design: A non-randomized, cohort and comparative study. Place and Duration of Study: Department of Pediatric Surgery, National Institute of Child Health, Karachi from March 2001 to October 2002. Patients and A total of 45 patients with the diagnosis of intestinal obstruction due to ascaris lumbricoides were included in the study. They were divided in 3 groups of 15 patients each. Group I patients were given I/V fluids only, group II patients were given hyoscinbutylbromide in infusion and group III patients were given hypertonic saline enema. The outcome of all groups was compared in terms of improvement in obstruction and hospital stay. The data was analyzed by SPSS 11.0 by using ANOVA and HSD Tuckey test for multiple comparisons. The non-operative treatment was successful in all of the patients. In group III improvement of intestinal obstruction occurred in 1.6 +/- 1.11 days [p value=0.001], whereas it was 2.6 +/- 1.11 days in group II and 3.4 +/- 1.35 days in group I. The mean hospital stay in group III was 4 +/- 1.69 days [p value=0.003], whereas it was 6.27 +/- 2.31 days in group II and 5.87 +/- 1.25 days in group I. We recommend that hypertonic saline enema is a better non-operative treatment modality of intestinal obstruction, due to ascaris lumbricoides, in patients who do not have peritonitis. It is associated with early improvement of obstruction coupled with reduced hospital stay

Antihelmínticos como factor de riesgo en la obstrucción intestinal por ascaris lumbricoides en niños / Anthelmintics as a risk factor of intestinal obstruction by ascaris lumbricoides in children

In a retrospective study the authors analyzed the clinical records of 199 children ages one month to 16 years hospitalized, with the diagnosis of intestinal ascariasis, in the Instituto Nacional de Pediatría of México from 1984 to 1999. The purpose of the study was to evaluate the use of anthelmintics drugs as a risk factor of intestinal obstruction by A. lumbricoides. Two groups were made for the study: group A (n=66) of children who presented intestinal obstruction, group B (n=133) children with no complications. A comparative analysis of clinical data of both groups was made by means of chi square with Yates correction and a stratified analysis by means of chi square. Possible confusing elements were overcrowding, age and the use of antiparasitic drugs. The calculus of risk factors for intestinal obstruction by A. lumbricoides was done by means of contingency tables of 2 x 2 and odds ratio with an IC of 95 percent. The significant risk factors were included in a model of logistic regression with an impact variable consting in the presence or absence of intestinal obstruction in order to establish a multivariate model of predictive risk at level of significance of p<0,05

Ascaris lumbricoides infestation: a cause of recurrent epigastric pain

Ascaris lumbricoides infestation has a variety of clinical presentations. This case report describes the history of a young lady presenting with recurrent epigastric pain with no positive signs and normal investigations except moderate degree of eosinophilia. Barium meal outlined the worms in the stomach which were vomited out after levamisole therapy. Helminthiasis should be considered in the differential diagnosis of abdominal pain in a country like Pakistan

Controle de enteroparasitores em puérperas do município do Rio de Janeiro / Control of eneroparasites in puérperas of district of Rio de Janeiro

De março a outubro de 1994 estudou-se a importância das enteroparasitores no puerpério e sua correlação com a gestação e condições de nascimento, através da análise de prevalência da infecção em 123 mulheres internadas no Serviço de Obstetrícia do Hospital Universitário Pedro Ernesto (Hupe), Rio de Janeiro. Exames coproparasitológicos foram realizados pelos métodos de Kato-Katz, Faust e Baermann-Moraes. Foram encontrados 56,1 por cento de positividade, sendo o Ascaris lumbricoides o parasito mais freqüente (26 por cento). Não foi observada correlação estatística entre enteroparasitoses e ganho ponderal, hematócrito, idade gestacional e peso do recém-nascido. Verificou-se que 87,5 por cento das mulheres parasitadas no pré-natal tornaram-se mães parasitadas (p<0,05) e que o tratamento antiparasitário, apesar de prescrito em 35,7 por cento das gestantes, não foi acompanhado com controle parasitológico posterior. Concluímos que o controle das enteroparasitores não é prioritário na gestação e no puerpério.

Abscesos hepáticos por áscaris lumbricoides / Hepatic abscesses by ascaris lumbricoides

Se describen dos niños con absceso hepático por áscaris lumbricoides: una niña de 14 meses de edad, quien se internó por síndrome febril prolongado y un varón de 20 meses, quien ingresó por distensión abdominal, fiebre y eliminación de áscaris en materia fecal. Se promovió búsqueda de la localización abdominal extraintestinal de los niños parasitados por áscaris con síndrome febril. La ultrasonografía fue el método de gran utilidad

Biliary ascariasis

Out of 38 patients who were operated for obstructive jaundice during a 4 years period Ascaris lumbricoid was found in the bile ducts of 3 patients. In one patient who responded to conservative management, there was strong evidence that the obstructive jaundice was due to the presence of round worm in the bile duct. This makes a total of 4 cases of biliary ascariasis in 39 patients of obstructive jaundice, a high prevalence rate of 10.26%

Geohelmintosis intestinales en el hombre y animales domésticos de sectores ribereños de la cuenca del río Valdivia Chile / Intestinal geohelminthosis in man and domestic animals in riverside sectors of Valdivia river basin, Chile

In march - october 1987 were analyzed 1295 coprological specimens in a sample of the human population who lives in riverside localities in the Valdivia river basin, Chile. A 23,6 for percent of examined persons presented infection by one or more helminth species. The prevalence of infection by ascaris lumbricoides, trichuris trichiura and trichostrongylidae gen. sp were 15,5; 12,7 and 0,2 for percent, respectively. The prevalence of human ascariosis and trichuriosis were greater in pre-school and school children. The sex of the host and prevalence of geohelminthosis did not show any relationship. Prevalences of ascariosis and trichuriosis were higher in persons from houses no sanitary fecal and water disposal. Over 35 for percent and 20,7 for percent of family groups showed infection by A. lumbricoides and T. trichiura, respectively in over 40 for percent of the members of each group. Fecal samples from domestic mammals revealed the following prevalences rates helminth infections: in dogs 19,0 and 15,2 for percent for toxocara canis and uncinaria stenocephala respectively, in cats 65,1 for percent for toxocara cati, and in pigs 25,4 and 3,2 for percent for ascaris suum and trichuris suis respectively. Some of these species are clearly demostrated agents of zoonoses

Ascaris lumbricoides. an unusual foreign body in the ear

This is a report of an unusual case of Ascaris presenting through ear, Although ascariasis is very common in our country but presentation through ear is rare