Ascaris Lumbricoides

Ascaris Lumbricoides

Giant round worm

Most common intestinal nematode
Soil-transmitted Helminth
Causes varying degrees of Pathology
a.) Tissue reaction to the invading larvae
b.) Intestinal irritation to the adult
c.) Other complications due to heavy infection and extraintestinal migration
Parasite Biology

Polymyarian type of somatic muscle arrangement

Whitish/Pinkish adult worms
Adult worms have a terminal mouth with three lips and sensory
papillae
Ascaris produces pepsin inhibitor 3 (PI-3) and phosphorylcholine
 Male Adult Female Adult
10 to 31cm 22 to 35cm
Ventrally curved posterior Paired reproductive organs in
with two spicules the posterior 2/3
Single, long, tortuous tubule
EGGS
Infertile Eggs

88 to 94 m by 39 to 44 m
Longer and narrower than fertile eggs
Thin shell and irregular mammilated coating filled with refractile
granules
May be difficult to identify
Found in 2/5 infections
Fertile eggs

45 to 70 m by 35 to 50 m
There is an outer, coarsely mammilated albuminous covering
Thick, transparent, hyaline shell with a thick outer layer
Has a vitelline, lipoidal, inner membrane
Has an ovoid mass of protoplasm which will
develop into larvae after 14 days
Life Cycle of Ascaris Lumbricoides
Pathogenesis and Clinical
Manifestations

Majority of Ascaris infections are asymptomatic

The varied pathology of ascariasis includes the reaction of
tissues to invading larvae, irritation of intestine of adult, other
complications due to parasites extraintestinal migration
10-20 worms may not show symptoms, may only be discovered
in stool examinations
Most frequent complaint of patients is vague abdominal pain
Heavy infections are likely to cause bowel obstruction
 During lung migration, patients may experience asthma, edema
of lips and difficulty breathing
Fatal effects of ascariasis are due to erratic migration of adult
worms
Patients with biliary ascariasis experience sever colicky
abdominal pain
Diagnosis

Direct Fecal Smear is less sensitive compared to Kato thick and

Kato- Katz technique
Kato- Katz technique and Kato thick smear are good for mass
screening
Kato- Katz provides quantitative diagnosis in epg (eggs per
gram)
Treatment

Albendazole
Mebendazole
Pyrantelpamoate
Epedemiology

About 1.2 billion people have ascariasis and about 2,000 people
die annually (as of 2011)
Children ages 5 to 15 years have the highest intensities of
infection
Ascaris Lumbricoides is also known to be able to survive in
colder temperatures compared with Trichiuris and hookworm
Prevention and Control

Using Kato-Katz method, monitoring is recommended every 2

years
Prevention and control measures involve provision of WASHED
(Water, Environmental Sanitation, Hygiene, Education,
Deworming)