Highlights & Basics
- Ascariasis is concentrated in developing countries of Asia, Africa, and Latin America.
- Acquired by ingesting eggs that are passed in human feces and mature in the soil.
- Diagnosis can be made in most cases by finding characteristic eggs in a stool sample.
- Treated with oral anthelmintic agents.
Quick Reference
History & Exam
Key Factors
travel to, or immigration from, endemic areas with poor sanitation, hygiene, and agricultural practices
Other Factors
asymptomatic
co-infection with other parasites
developmental delay
malnutrition
fever
cough
wheezing
dyspnea
hemoptysis
hypoxia
tachypnea
rhonchi, rales
retractions
urticarial skin lesions
abdominal pain
anorexia
dyspepsia
nausea
vomiting
diarrhea
constipation
abdominal distension
reduced or absent bowel sounds
hypotension
RUQ tenderness
hepatomegaly
jaundice
signs/symptoms of iron deficiency anemia or kwashiorkor
Diagnostics Tests
1st Tests to Order
stool microscopy
chest x-ray
abdominal x-ray
Other Tests to consider
sputum/gastric aspirate microscopy
CBC
contrast study
barium follow-through
abdominal ultrasound
abdominal CT
ERCP
Emerging Tests
antibodies to Ascaris lumbricoides
serum IgE
interleukin (IL)-4, IL-5, and IL-13
urine-based gas liquid chromatography
Treatment Options
acute
asymptomatic
anthelmintic
pneumonitis
symptomatic treatment
Definition
Vignette
Common Vignette 1
Common Vignette 2
Other Presentations
Epidemiology
Etiology
Pathophysiology
Images
Photograph of 2 Ascaris lumbricoides nematodes; the larger one on the left is female and that on the right is male. Adult females can grow to >12 in (30 cm) in length
A fertilized egg of the roundworm Ascaris lumbricoides at magnification x 400. Fertilized eggs are rounded, with a thick shell. Unfertilized eggs are elongated, are larger, have thinner shells, and are covered by a more visible mammillated layer, which is sometimes covered by protuberances
Diagram depicting the various stages in the life cycle of the intestinal nematode Ascaris lumbricoides
Photomicrograph depicting a fertilized egg of the parasite Ascaris lumbricoides
Laboratory technician holding a mass of Ascaris lumbricoides worms excreted by a child in Kenya
Diagnostic Approach
Clinical evaluation
Initial tests
Subsequent tests
Emerging tests
Risk Factors
History & Exam
Tests
Differential Diagnosis
Asthma
Differentiating Signs/Symptoms
- Patients present with repeated episodes of coughing, wheezing, chest tightness, and dyspnea. There may be an identifiable trigger (e.g., tobacco smoke, certain animals, or exercise).
Differentiating Tests
- Diagnosis is confirmed using PFTs. CXR may be normal or may show evidence of underlying infection.
Viral gastroenteritis
Differentiating Signs/Symptoms
- Self-limiting watery diarrhea, vomiting, or both, with or without fever, malaise, and anorexia, are common presenting symptoms. Diarrhea and vomiting are less common in ascariasis.
Differentiating Tests
- It is not usually necessary to perform stool exams on patients with viral gastroenteritis. However, a stool sample should be obtained if there is an outbreak, to identify the pathogen as quickly as possible. Stool culture is the most definitive diagnostic test in identification of viral pathogens, but this is not practical in most cases. Latex agglutination tests, PCR, microscopy, enzyme immunoassay (EIA), or serology allows rapid detection, but these are usually not necessary.
Amebiasis
Differentiating Signs/Symptoms
- Usual presentation is with diarrhea that lasts several days, abdominal pain, and weight loss. If there is hepatic infection, then jaundice, RUQ pain, and hepatomegaly may also be present.
Differentiating Tests
- Patients with amebiasis may have stool ova and parasites positive for characteristic trophozoites or cysts, or a positive serologic test for Entamoeba histolytica.
Salmonella infection
Differentiating Signs/Symptoms
- Presents with nausea, vomiting, and diarrhea. The patient may also complain of headaches, abdominal pain, fever, or myalgia. There may be history of the patient eating contaminated food (e.g., undercooked eggs or meat).
Differentiating Tests
- Stool or blood culture may grow Salmonella.
Strongyloides infection
Differentiating Signs/Symptoms
- Presents with abdominal pain, diarrhea or constipation, weight loss, skin changes such as dermatitis or pruritus, and pulmonary complaints such as wheezing or coughing.
- There may be a history of travel to an endemic country (e.g., many tropical and subtropical regions worldwide, Appalachian region of the US, and certain Mediterranean regions, especially Catalonia, Spain).
Differentiating Tests
- Patients with strongyloidiasis may have larvae in stool or sputum, or a positive serology test for S stercoralis.
Pancreatitis
Differentiating Signs/Symptoms
- Abdominal pain is usually severe, epigastric, and radiating toward the back. It is usually accompanied by fever, nausea, and vomiting. There may also be voluntary abdominal guarding and mild abdominal rigidity with rebound tenderness.
Differentiating Tests
- Raised serum amylase and lipase are key to diagnosis.
Cholecystitis
Differentiating Signs/Symptoms
- Presents with RUQ pain, nausea, and a positive Murphy sign. There may be a history of previous similar episodes or of known gallstones.
Differentiating Tests
- Ultrasound of RUQ may show pericholecystic fluid, distended gallbladder, thickened gallbladder wall, or gallstones.
Acute appendicitis
Differentiating Signs/Symptoms
- Typically presents with constant mid-abdominal pain that moves to the RLQ. Pain worse on movement. Anorexia, nausea, and low-grade fever are common.
Differentiating Tests
- Diagnosis is usually clinical. However, a CBC could show mild leukocytosis. Further investigations, such as abdominal ultrasound or CT, are indicated in atypical presentations.
Ancylostomiasis
Differentiating Signs/Symptoms
- Patients with heavy hookworm infections (Ancylostoma duodenale or Necator americanus) may develop a cough characteristic of Loeffler syndrome.
- A patient may occasionally become host to A caninum or A braziliense, the dog and cat hookworms, and may also develop a cough characteristic of Loeffler syndrome. Exam also reveals itchy red papules consistent with a creeping eruption associated with this infection. As larvae migrate through the skin, pruritic serpiginous tracks are formed.
Differentiating Tests
- Stool studies may demonstrate hookworm eggs.
- Eggs are not noted in stool studies in patients who are host to the dog or cat hookworm.
- Patients with hookworm infection may demonstrate hypochromic microcytic anemia on CBC.
Differentiating Signs/Symptoms
- Also called whipworm infection. May present with abdominal pain, bloody diarrhea, and tenesmus. Chronic infection can lead to Trichuris trichiura colitis, which is similar to inflammatory bowel disease.
Differentiating Tests
- Stool studies reveal characteristic eggs. Anoscopy may also demonstrate worms on visualization of the rectum.
Screening
Adoption
Travelers
Treatment Approach
Anthelmintic therapy
Eosinophilic pneumonitis (Loeffler syndrome)
Intestinal obstruction
- Suspicion of peritonitis
- Suspicion of bowel strangulation
- Complete intestinal obstruction
- Presence of intraperitoneal free air on radiographic exams
- Lack of improvement after 24 hours of medical management.
Hepatobiliary and/or pancreatic involvement
- Biliary colic
- Acalculous cholecystitis
- Acute cholangitis
- Acute pancreatitis
- Hepatic abscess.
Treatment Options
asymptomatic
anthelmintic
Primary Options
- albendazole
children 12 months to 2 years of age: 200 mg orally as a single dose; children ≥2 years of age and adults: 400 mg orally as a single dose
- albendazole
- mebendazole
children ≥2 years of age and adults: 500 mg orally as a single dose, or 100 mg twice daily for 3 days
- mebendazole
- ivermectin
children ≥15 kg and adults: 150-200 micrograms/kg as a single dose
- ivermectin
Secondary Options
- pyrantel
children and adults: 11 mg/kg orally as a single dose, maximum 1000 mg/dose
- pyrantel
Comments
- Treatment with an anthelmintic is indicated when adult worms are passed or characteristic eggs are noted in the stool. First-line treatments in the US include albendazole, mebendazole, or ivermectin.[45] A chewable tablet formulation of mebendazole is available. Pyrantel is considered an acceptable alternative, but is rarely used in the US.
- Although widespread use of benzimidazoles in children has not revealed specific safety issues, there are limited data in patients <2 years of age.[24][49] [50] The World Health Organization (WHO) considers these drugs to be safe in children aged 12 months and older when used at appropriate doses.[51] Pyrantel can be used in patients of all ages.[52]
- Risks and benefits of treatment should be weighed carefully before giving these drugs during pregnancy, particularly during the first trimester. If a woman in her first trimester of pregnancy is found to have ascariasis, she must wait until the second trimester to receive treatment. The WHO recommends the use of albendazole in the second and third trimesters of pregnancy.[51]
pneumonitis
symptomatic treatment
Comments
- Cough suppressants, antihistamines, bronchodilators, and corticosteroids may help control symptoms.[26] No anthelmintic has been shown to kill larvae during this migratory phase of infection.
gastrointestinal symptoms
no intestinal obstruction, hepatobiliary or pancreatic ascariasis
anthelmintic
Primary Options
- albendazole
children 12 months to 2 years of age: 200 mg orally as a single dose; children ≥2 years of age and adults: 400 mg orally as a single dose
- albendazole
- mebendazole
children ≥2 years of age and adults: 500 mg orally as a single dose, or 100 mg twice daily for 3 days
- mebendazole
- ivermectin
children ≥15 kg and adults: 150-200 micrograms/kg as a single dose
- ivermectin
Secondary Options
- pyrantel
children and adults: 11 mg/kg orally as a single dose, maximum 1000 mg/dose
- pyrantel
Comments
- Treatment with an anthelmintic is indicated when adult worms are passed or characteristic eggs are noted in the stool. First-line treatments in the US include albendazole, mebendazole, or ivermectin.[45] A chewable tablet formulation of mebendazole is available. Pyrantel is considered an acceptable alternative, but is rarely used in the US.
- Although widespread use of benzimidazoles in children has not revealed specific safety issues, there are no data in patients <2 years of age.[24][49] [50] The World Health Organization (WHO) considers these drugs to be safe in children aged 12 months and older when used at appropriate doses.[51]Pyrantel can be used in patients of all ages.[52]
- Risks and benefits of treatment should be weighed carefully before giving these drugs during pregnancy, particularly during the first trimester. If a woman in her first trimester of pregnancy is found to have ascariasis, she must wait until the second trimester to receive treatment. The WHO recommends the use of albendazole in the second and third trimesters of pregnancy.[51]
with intestinal obstruction
anthelmintic plus supportive care
Primary Options
- albendazole
children 12 months to 2 years of age: 200 mg orally as a single dose; children ≥2 years of age and adults: 400 mg orally as a single dose
- albendazole
- mebendazole
children ≥2 years of age and adults: 500 mg orally as a single dose, or 100 mg twice daily for 3 days
- mebendazole
Secondary Options
- pyrantel
children and adults: 11 mg/kg orally as a single dose, maximum 1000 mg/dose
- pyrantel
Comments
- Although piperazine is the preferred option for these patients, it is not available in the US. Physicians working in countries where it is available should seek to use this drug first. Albendazole, mebendazole, or pyrantel may also be used for intestinal obstruction; however, caution should be exercised when using other anthelmintics, as they may be associated with causing or worsening obstruction.[55] [56]
surgery
Comments
- Surgical intervention for removal of worm boluses is indicated if there is persistent abdominal pain, persistent tender abdominal mass, immobile abdominal mass after 24 hours of medical management, or signs of toxemia.[57]
- If the parasitic bundle cannot be manually moved toward the colon and expressed, an enterotomy may be necessary. In cases of gangrene or infarction, resection of affected bowel may be necessary.[52]
with hepatobiliary or pancreatic ascariasis
anthelmintic
Primary Options
- albendazole
children 12 months to 2 years of age: 200 mg orally as a single dose; children ≥2 years of age and adults: 400 mg orally as a single dose
- albendazole
- mebendazole
children ≥2 years of age and adults: 500 mg orally as a single dose, or 100 mg twice daily for 3 days
- mebendazole
- ivermectin
children ≥15 kg and adults: 150-200 micrograms/kg as a single dose
- ivermectin
Secondary Options
- pyrantel
children and adults: 11 mg/kg orally as a single dose, maximum 1000 mg/dose
- pyrantel
Comments
- Treatment with an anthelmintic is indicated when adult worms are passed or characteristic eggs are noted in the stool. First-line treatments in the US include albendazole, mebendazole, or ivermectin.[45] Pyrantel is considered an acceptable alternative, but is rarely used in the US.
- Although widespread use of benzimidazoles in children has not revealed specific safety issues, there are no data in patients <2 years of age.[24][49] [50] The World Health Organization (WHO) considers these drugs to be safe in children aged 12 months and older when used at appropriate doses.[51] Pyrantel can be used in patients of all ages.[52]
- Risks and benefits of treatment should be weighed carefully before giving these drugs during pregnancy, particularly during the first trimester. If a woman in her first trimester of pregnancy is found to have ascariasis, she must wait until the second trimester to receive treatment. The WHO recommends the use of albendazole in the second and third trimesters of pregnancy.[51]
endoscopic retrograde cholangiopancreatography (ERCP) or surgery
Comments
- Hepatobiliary and/or pancreatic involvement may present as one of the following syndromes: biliary colic, acalculous cholecystitis, acute cholangitis, acute pancreatitis, or hepatic abscess.
- If ERCP is not successful or available, surgery is the remaining alternative to relieve obstruction.[24]
analgesia
Primary Options
- morphine sulfate
children: 0.1 to 0.2 mg/kg intravenously/intramuscularly/subcutaneously every 2-4 hours when required, or 0.2 to 0.5 mg/kg orally (immediate-release) every 4-6 hours when required; adults: 2-15 mg intravenously/intramuscularly every 3-4 hours when required, or 10-30 mg orally (immediate-release) every 3-4 hours when required
- morphine sulfate
Comments
- Patients with pancreatic or biliary colic require appropriate analgesia.
broad-spectrum antibiotics
Comments
- Patients with acute cholangitis due to impacted Ascaris lumbricoides often have secondary bacterial infection and sepsis, and should be treated with broad-spectrum antibiotics and other supportive measures such as fluid and electrolyte replacement, in addition to the removal of ascarid worms.[52] Local sepsis guidelines should be followed; choice of antibiotics depends on local resistance and susceptibility patterns.
Emerging Tx
Prevention
Primary Prevention
Secondary Prevention
- Young children (aged 12-23 months), preschool-aged children (24-59 months), and school-aged children living in areas where the baseline prevalence of any soil-transmitted helminth infection is ≥20% in this patient group
- Nonpregnant adolescent girls (aged 10-19 years) and nonpregnant women of reproductive age (15-49 years) living in areas where the baseline prevalence of any soil-transmitted helminth infection is ≥20% in this patient group
- Pregnant women after the first trimester in areas where both the baseline prevalence of hookworm and Trichuris trichiura infection is ≥20% in pregnant women, and anemia is a severe public health problem with a prevalence of ≥40% in pregnant women.
Follow-Up Overview
Prognosis
Monitoring
Complications
Citations
World Health Organization. Soil-transmitted helminthiasis. Jan 2023 [internet publication].[Full Text]
Centers for Disease Control and Prevention. Parasites - ascariasis: resources for health professionals. May 2020 [internet publication].[Full Text]
World Health Organization. Preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups. September 2017 [internet publication].[Full Text]
Khuroo MS. Ascariasis. Gastroenterol Clin North Am. 1996;25:553-577.[Abstract]
1. Diemert DJ. Ascariasis. In: Guerrant RL, Walker DH, Weller PF, eds. Tropical infectious diseases: principles, pathogens and practice. 3rd ed. Edinburgh: W.B. Saunders; 2011:794-8.
2. Pullan RL, Smith JL, Jasrasaria R, et al. Global numbers of infection and disease burden of soil transmitted helminth infections in 2010. Parasit Vectors. 2014 Jan 21;7:37.[Abstract][Full Text]
3. Jourdan PM, Lamberton PHL, Fenwick A, et al. Soil-transmitted helminth infections. Lancet. 2018 Jan 20;391(10117):252-65.[Abstract]
4. Holland C, Sepidarkish M, Deslyper G, et al. Global prevalence of Ascaris infection in humans (2010-2021): a systematic review and meta-analysis. Infect Dis Poverty. 2022 Nov 18;11(1):113.[Abstract][Full Text]
5. Khuroo MS, Rather AA, Khuroo NS, et al. Hepatobiliary and pancreatic ascariasis. World J Gastroenterol. 2016;22:7507-7517.[Abstract][Full Text]
6. Lapid O, Krieger Y, Bernstein T, et al. Airway obstruction by Ascaris, roundworm in a burned child. Burns. 1999;25:673-675.[Abstract]
7. Hajizadeh M, Rahimi MT, Spotin A, et al. A rare cause of dysphagia: pharyngeal ascariasis. J Parasit Dis. 2016;40:1411-1413.[Abstract]
8. Chauhan A, Rastoqi P, Trikha S, et al. Esophageal ascariasis with retrosternal chest discomfort. J Assoc Physicians India. 2016;64:93.[Abstract]
9. Blumenthal DS, Schultz MG. Incidence of intestinal obstruction in children infected with Ascaris lumbricoides. Am J Trop Med Hyg. 1975;24:801-805.[Abstract]
10. de Silva NR, Chan MS, Bundy DA. Morbidity and mortality due to ascariasis: re-estimation and sensitivity analysis of global numbers at risk. Trop Med Int Health. 1997;2:519-28.[Abstract]
11. de Silva NR, Guyatt HL, Bundy DA. Morbidity and mortality due to Ascaris-induced intestinal obstruction. Trans R Soc Trop Med Hyg. 1997;91:31-36.[Abstract]
12. World Health Organization. Soil-transmitted helminthiasis. Jan 2023 [internet publication].[Full Text]
13. Cooper PJ. Interactions between helminth parasites and allergy. Curr Opin Allergy Clin Immunol. 2009;9:29-37.[Abstract][Full Text]
14. Krause RJ, Koski KG, Pons E, et al. Ascaris and hookworm transmission in preschool children in rural Panama: role of subsistence agricultural activities. Parasitology. 2016;22:1-12.[Abstract]
15. Lamberton PH, Jourdan PM. Human Ascariasis: Diagnostics Update. Curr Trop Med Rep. 2015;2(4):189-200.[Abstract][Full Text]
16. Schwartzman JD. Intestinal nematodes that migrate through lungs (Ascariasis). In: Strickland GT, ed. Hunter's tropical medicine. 7th ed. Philadelphia, PA: W.B. Saunders Company; 1991:696-700.
17. Galvani AP. Age-dependent epidemiological patterns and strain diversity in helminth parasites. J Parasitol. 2005;91:24-30.[Abstract]
18. Stephenson LS. The contribution of Ascaris lumbricoides to malnutrition in children. Parasitology. 1980;81:221-233.[Abstract]
19. Zhou C, Li M, Yuan K, et al. Pig Ascaris: an important source of human ascariasis in China. Infect Genet Evol. 2012 Aug;12(6):1172-7.[Abstract][Full Text]
20. Bieri FA, Gray DJ, Williams GM, et al. Health-education package to prevent worm infections in Chinese schoolchildren. N Engl J Med. 2013;368:1603-1612.[Abstract][Full Text]
21. Freeman MC, Clasen T, Brooker SJ, et al. The impact of a school-based hygiene, water quality and sanitation intervention on soil-transmitted helminth reinfection: a cluster-randomized trial. Am J Trop Med Hyg. 2013;89:875-883.[Abstract]
22. Hotez PJ. Parasitic nematode infections. In: Feigin RD, Cherry JD, Demmler-Harrison GJ, et al, eds. Textbook of pediatric infectious diseases. 6th ed. Philadelphia, PA: Saunders Elsevier; 2009:2981-2996.
23. Leung AKC, Leung AAM, Wong AHC, et al. Human ascariasis: an updated review. Recent Pat Inflamm Allergy Drug Discov. 2020;14(2):133-45.[Abstract][Full Text]
24. American Academy of Pediatrics; Committee on Infectious Diseases. In Kimberlin DW, Barnett ED, Lynfield R, et al, eds. Red Book: 2021-2024 Report of the Committee on Infectious Diseases. 32nd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2021.[Full Text]
25. Cappello M, Hotez PJ. Intestinal nematodes. In: Long SS, Pickering LK, Prober CG. Principles and practice of pediatric infectious diseases. 2nd ed. New York, NY: Churchill Livingstone; 2003:1331-1339.
26. Gelpi AP, Mustafa A. Ascaris pneumonia. Am J Med. 1968:44:377-389.[Abstract]
27. Lübbert C, Schneitler S. Parasitic and infectious diseases of the biliary tract in migrants and international travelers. Expert Rev Gastroenterol Hepatol. 2016 Nov;10(11):1211-25.[Abstract][Full Text]
28. Crompton DW. Ascariasis and childhood malnutrition. Trans R Soc Trop Med Hyg. 1992;86:577-579.[Abstract]
29. Stephenson LS, Crompton DW, Latham MC, et al. Evaluation of a four year project to control Ascaris infection in children in two Kenyan villages. J Trop Pediatr. 1983;29:175-184.[Abstract]
30. Bethony J, Brooker S, Albonico M, et al. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet. 2006;367:1521-1532.[Abstract]
31. Guyatt H. Do intestinal nematodes affect productivity in adulthood? Parasitol Today. 2000;16:153-8.[Abstract]
32. Garcia LS, Arrowood M, Kokoskin E, et al. Laboratory Diagnosis of Parasites from the Gastrointestinal Tract. Clin Microbiol Rev. 2018 Jan;31(1):e00025-17[Abstract][Full Text]
33. Coulibaly JT, Ouattara M, Becker SL, et al. Comparison of sensitivity and faecal egg counts of Mini-FLOTAC using fixed stool samples and Kato-Katz technique for the diagnosis of Schistosoma mansoni and soil-transmitted helminths. Acta Trop. 2016 Dec;164:107-16.[Abstract][Full Text]
34. Nikolay B, Brooker SJ, Pullan RL. Sensitivity of diagnostic tests for human soil-transmitted helminth infections: a meta-analysis in the absence of a true gold standard. Int J Parasitol. 2014 Oct 1;44(11):765-74.[Abstract][Full Text]
35. Crompton DW. Ascaris and ascariasis. Adv Parasitol. 2001;48:285-375.[Abstract]
36. Mahmood T, Mansoor N, Quraishy S, et al. Ultrasonographic appearance of Ascaris lumbricoides in the small bowel. J Ultrasound Med. 2001;20:269-274.[Abstract]
37. Ferreyra NP, Cerri GG. Ascariasis of the alimentary tract, liver, pancreas and biliary system: its diagnosis by ultrasonography. Hepatogastroenterology. 1998;45:932-937.[Abstract]
38. Beitia AO, Haller JO, Kantor A. CT findings in pediatric gastrointestinal ascariasis. Comput Med Imaging Graph. 1997;21:47-49.[Abstract]
39. Reeder MM. The radiological and ultrasound evaluation of ascariasis of the gastrointestinal, biliary, and respiratory tracts. Semin Roentgenol. 1998;33:57-78.[Abstract]
40. Baillie J. Endoscopic therapy in acute recurrent pancreatitis. World J Gastroenterol. 2008;14:1034-1037.[Abstract][Full Text]
41. Hall A, Romanova T. Ascaris lumbricoides: detecting its metabolites in the urine of infected people using gas-liquid chromatography. Exp Parasitol. 1990;70:35-42.[Abstract]
42. Petney TN, Andrews RH. Multiparasite communities in animals and humans: frequency, structure and pathogenic significance. Int J Parasitol. 1998 Mar;28(3):377-93.[Abstract][Full Text]
43. Seltzer E, Barry M, Crompton DWT. Ascariasis. In: Guerrant RL, Walker DH, Weller PF, eds. Tropical infectious diseases: principles, pathogens and practice. 2nd ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2006:1257-1264.
44. Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. May 2023 [internet publication].[Full Text]
45. Centers for Disease Control and Prevention. Parasites - ascariasis: resources for health professionals. May 2020 [internet publication].[Full Text]
46. Conterno LO, Turchi MD, Corrêa I, et al. Anthelmintic drugs for treating ascariasis. Cochrane Database Syst Rev. 2020 Apr 14;4:CD010599.[Abstract][Full Text]
47. World Health Organization. WHO model list of essential medicines - 22nd list. Sep 2021 [internet publication].[Full Text]
48. Moser W, Schindler C, Keiser J. Efficacy of recommended drugs against soil transmitted helminths: systematic review and network meta-analysis. BMJ. 2017 Sep 25;358:j4307.[Abstract][Full Text]
49. The Medical Letter, Inc. Drugs for parasitic infections. Med Lett Drugs Ther. 2007;5:e1-e15.
50. Biddulph J. Mebendazole and albendazole for infants. Pediatr Infect Dis J. 1990;9:373.[Abstract]
51. World Health Organization. Preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups. September 2017 [internet publication].[Full Text]
52. Khuroo MS. Ascariasis. Gastroenterol Clin North Am. 1996;25:553-577.[Abstract]
53. Spillmann RK. Pulmonary ascariasis in tropical communities. Am J Trop Med Hyg. 1975 Sep;24(5):791-800.[Abstract]
54. Gangopadhyay AN, Upadhyaya VD, Gupta DK, et al. Conservative treatment for round worm intestinal obstruction. Indian J Pediatr. 2007;74:1085-1087.[Abstract]
55. Vásquez Tsuji O, Gutiérrez Castrellón P, Yamazaki Nakashimada MA, et al. Anthelmintics as a risk factor in intestinal obstruction by Ascaris lumbricoides in children [in Spanish]. Bol Chil Parasitol. 2000;55:3-7.[Abstract]
56. Salman AB. Management of intestinal obstruction caused by ascariasis. J Pediatr Surg. 1997;32:585-587.[Abstract]
57. Hefny AF, Saadeldin YA, Abu-Zidan FM. Management algorithm for intestinal obstruction due to ascariasis: a case report and review of the literature. Ulus Travma Acil Cerrahi Derg (Turkish J Trauma Emerg Surg). 2009;15:301-305.[Abstract][Full Text]
58. Moser W, Coulibaly JT, Ali SM, et al. Efficacy and safety of tribendimidine, tribendimidine plus ivermectin, tribendimidine plus oxantel pamoate, and albendazole plus oxantel pamoate against hookworm and concomitant soil-transmitted helminth infections in Tanzania and Côte d'Ivoire: a randomised, controlled, single-blinded, non-inferiority trial. Lancet Infect Dis. 2017 Nov;17(11):1162-1171.[Abstract]
59. Khuroo MS. Ascariasis. Gastroenterol Clin North Am. 1996;25:553-577.[Abstract]
60. Stephenson LS, Crompton DW, Latham MC, et al. Relationships between Ascaris infection and growth of malnourished preschool children in Kenya. Am J Clin Nutr. 1980;33:1165-1172.[Abstract]
61. Willett WC, Kilama WL, Kihamia CM. Ascaris and growth rates: a randomized trial of treatment. Am J Public Health. 1979;69:987-991.[Abstract]
62. Awasthi A, Peto R, Pande V, et al. Effects of deworming on malnourished preschool children in India; an open-labelled, cluster-randomized trial. PLoS Negl Trop Dis. 2008;2:e223.[Abstract][Full Text]
63. Ochoa B. Surgical complications of ascariasis. World J Surg. 1991;15:222-227.[Abstract]
64. World Health Organization. Schistosomiasis and soil-transmitted helminthiases: number of people treated in 2016. Wkly Epidemiol Rec. 2017;92:749-60.[Full Text]
65. World Health Organization. Ending the neglect to attain the sustainable development goals: a road map for neglected tropical diseases 2021-2030. May 2020 [internet publication].[Full Text]
66. Taylor-Robinson DC, Maayan N, Donegan S, et al. Public health deworming programmes for soil-transmitted helminths in children living in endemic areas. Cochrane Database Syst Rev. 2019 Sep 11;9:CD000371.[Abstract][Full Text]
67. Salam RA, Das JK, Bhutta ZA. Effect of mass deworming with antihelminthics for soil-transmitted helminths during pregnancy. Cochrane Database Syst Rev. 2021 May 17;5(5):CD005547.[Abstract][Full Text]
68. Awasthi S, Peto R, Read S, et al. Population deworming every 6 months with albendazole in 1 million pre-school children in north India: DEVTA, a cluster-randomised trial. Lancet. 2013;381:1478-1486.[Abstract][Full Text]
69. Jia TW, Melville S, Utzinger J, et al. Soil-transmitted helminth reinfection after drug treatment: a systematic review and meta-analysis. PLoS Negl Trop Dis. 2012;6:e1621.[Abstract][Full Text]
70. Yap P, Du ZW, Wu FW, et al. Rapid re-infection with soil-transmitted helminths after triple-dose albendazole treatment of school-aged children in Yunnan, People's Republic of China. Am J Trop Med Hyg. 2013;89:23-31.[Abstract]
71. Strunz EC, Addiss DG, Stocks ME, et al. Water, sanitation, hygiene, and soil-transmitted helminth infection: a systematic review and meta-analysis. PLoS Med. 2014;11:e1001620.[Abstract][Full Text]
Key Articles
Other Online Resources
Referenced Articles
Guidelines
Diagnostic
Summary
Information on transmission of the worms, clinical presentation and diagnosis.Published by
Centers for Disease Control and Prevention
Published
2023