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Hepatobiliary and pancreatic ascariasis.

M S Khuroo1

  • 1Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
|April 11, 2001
PubMed
Summary

Ascariasis, a global parasitic worm infection, affects billions, causing significant health issues like malnutrition and biliary disease, particularly in developing nations. Effective treatments like albendazole offer control through mass therapy.

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Area of Science:

  • Global Health
  • Infectious Diseases
  • Parasitology

Background:

  • Ascariasis is a widespread helminthic infection impacting over 1.4 billion people globally, predominantly in Asia and Latin America.
  • While many cases are asymptomatic, heavy worm loads cause severe Ascariasis-related clinical disease, leading to an estimated 1.2-2 million cases and 20,000 deaths annually in endemic regions.
  • Recurring infections in children contribute to stunting, cognitive impairment, and malnutrition, while in adults, it can cause biliary and pancreatic diseases.

Purpose of the Study:

  • To summarize the global impact, clinical manifestations, diagnostic methods, and treatment strategies for Ascariasis.
  • To highlight Ascariasis-associated biliary and pancreatic diseases (HPA) and their complications.
  • To review current diagnostic tools and effective therapeutic options for Ascariasis control.

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Main Methods:

  • Literature review of Ascariasis prevalence, clinical disease, diagnosis, and treatment.
  • Analysis of Ascariasis-related complications, including biliary and pancreatic involvement.
  • Evaluation of diagnostic modalities such as ultrasonography and ERCP.
  • Assessment of anthelmintic drugs for mass therapy.

Main Results:

  • Ascariasis affects over 1.4 billion people worldwide, with significant morbidity and mortality in endemic areas.
  • Hepatobiliary and pancreatic ascariasis (HPA) are significant complications, particularly in adult women, leading to conditions like acute pancreatitis and hepatic abscess.
  • Ultrasonography and ERCP are valuable for diagnosing and managing biliary and pancreatic Ascariasis.
  • Anthelmintics including pyrantel pamoate, mebendazole, albendazole, and levamisole are effective for treatment and mass drug administration.

Conclusions:

  • Ascariasis remains a major global health concern with diverse clinical presentations, from growth stunting in children to severe hepatobiliary complications in adults.
  • Early diagnosis and effective treatment are crucial for managing Ascariasis and its complications.
  • Mass therapy with effective anthelmintics is a viable strategy for controlling Ascariasis in endemic regions.