Human Ascariasis: An Updated Review.

IF 4.2 Q3 Pharmacology, Toxicology and Pharmaceutics
Alexander K C Leung, Amy A M Leung, Alex H C Wong, Kam L Hon
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引用次数: 17

Abstract

Background: Ascaris lumbricoides is the most common helminthic infection. More than 1.2 billion people have ascariasis worldwide.

Objective: This article aimed to provide an update on the evaluation, diagnosis, and treatment of ascariasis.

Methods: A PubMed search was conducted in February 2020 in Clinical Queries using the key terms "ascariasis" OR "Ascaris lumbricoides". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews published within the past 10 years. The search was restricted to English literature. The information retrieved from the above search was used in the compilation of the present article. Patents were searched using the key term "ascariasis" OR "Ascaris lumbricoides" in www.freepatentsonline.com.

Results: Ascaris lumbricoides is transmitted through the ingestion of embryonated eggs from fecal- contaminated material. Ascariasis has high endemicity in tropical and subtropical areas. Predisposing factors include poverty, poor sanitation, inadequate sewage disposal, and poor personal hygiene. The prevalence is greatest in children younger than 5 years of age. The majority of patients with intestinal ascariasis are asymptomatic. For those with symptoms, anorexia, nausea, bloating, abdominal discomfort, recurrent abdominal pain, abdominal distension, and intermittent diarrhea are not uncommon. Other clinical manifestations vary widely, depending on the underlying complications. Complications include Löeffler syndrome, intestinal obstruction, biliary colic, recurrent pyogenic cholangitis, cholecystitis, acalculous cholecystitis, obstructive jaundice, cholelithiasis, pancreatitis, and malnutrition. The diagnosis is best established by microscopic examination of fecal smears or following concentration techniques for the characteristic ova. Patients with A. lumbricoides infection warrant anthelminthic treatment, even if they are asymptomatic, to prevent complications from migration of the parasite. Albendazole and mebendazole are the drugs of choice for children and nonpregnant individuals with ascariasis. Pregnant women with ascariasis should be treated with pyrantel pamoate. Recent patents related to the management of ascariasis are also discussed.

Conclusion: The average cure rate with anthelminthic treatment is over 95%. Unfortunately, most treated patients in endemic areas become re-infected within months. Health education, personal hygiene, improved sanitary conditions, proper disposal of human excreta, and discontinuing the use of human fecal matter as a fertilizer are effective long-term preventive measures. Targeting deworming treatment and mass anthelminthic treatment should be considered in regions where A. lumbricoides is prevalent.

人类蛔虫病:最新综述。
背景:类蚓蛔虫是最常见的寄生虫感染。全世界有超过12亿人患有蛔虫病。目的:本文旨在提供蛔虫病的评估、诊断和治疗的最新进展。方法:于2020年2月在“临床查询”中检索PubMed,关键词为“蛔虫病”或“蛔虫”。检索策略包括荟萃分析、随机对照试验、临床试验、观察性研究和过去10年内发表的综述。搜索仅限于英国文学。从上述搜索中检索到的信息用于编写本文。在www.freepatentsonline.com.Results中使用关键词“蛔虫病”或“类蛔虫”进行专利检索:类蛔虫通过摄入受粪便污染物质的胚胎卵传播。蛔虫病在热带和亚热带地区有很高的地方性。诱发因素包括贫困、卫生条件差、污水处理不足和个人卫生状况差。患病率在5岁以下儿童中最高。大多数肠蛔虫病患者无症状。对于那些有症状的人,厌食、恶心、腹胀、腹部不适、反复腹痛、腹胀和间歇性腹泻并不罕见。其他临床表现差异很大,取决于潜在的并发症。并发症包括Löeffler综合征、肠梗阻、胆道绞痛、复发性化脓性胆管炎、胆囊炎、结石性胆囊炎、梗阻性黄疸、胆石症、胰腺炎和营养不良。诊断最好通过粪便涂片的显微镜检查或以下特征性卵子的浓缩技术来确定。即使无症状,蛔虫感染患者也需要驱虫治疗,以防止寄生虫迁移引起的并发症。阿苯达唑和甲苯达唑是儿童和非孕妇蛔虫病患者的首选药物。患有蛔虫病的孕妇应使用吡喃酯治疗。还讨论了与蛔虫病管理有关的最新专利。结论:采用驱虫药治疗,平均治愈率达95%以上。不幸的是,流行地区大多数接受治疗的患者在几个月内再次感染。健康教育、个人卫生、改善卫生条件、妥善处理人类排泄物和停止使用人类排泄物作为肥料是有效的长期预防措施。在蚓类蠓流行的地区,应考虑进行定向驱虫和大规模驱虫。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.90
自引率
0.00%
发文量
0
期刊介绍: Recent Patents on Inflammation & Allergy Drug Discovery publishes review articles by experts on recent patents in the field of inflammation and allergy drug discovery e.g. on novel bioactive compounds, analogs and targets. A selection of important and recent patents in the field is also included in the journal. The journal is essential reading for all researchers involved in inflammation and allergy drug design and discovery.
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