Ascaris egg profiles in human faeces: biological and epidemiological implications

Since 2 morphological forms (fertilized and unfertilized) of egg can be produced by Ascaris, infected humans can release in their faeces fertilized eggs only (FEO), unfertilized eggs only (UEO) or both fertilized and unfertilized eggs (FUE) (designated herein as the 3 different egg profiles). Epidemiologically, fertilized eggs are of significance as they enable effective transmission of the parasite. This study, for the first time, characterizes the Ascaris egg profiles in human faeces in an endemic region of China, explores possible host- and parasite-factors related to these profiles, and discusses the biological and epidemiological implications of the findings. The 3 egg profiles were recorded throughout the study period of 2 years, and the overall percentages of people with FEO, FUE and UEO profiles were approximately 41-47%, 32-42% and 17-21%, respectively. The overall number of unfertilized eggs for the entire population accounted for approximately 6-9% of all eggs excreted. The different Ascaris egg profiles showed no correlation to host gender, but they did relate to age and worm burden of the host and to the sex ratio and developmental status of the parasite. While an annual universal anthelmintic treatment resulted in some fluctuation in the values of individual egg profiles, the general features of these profiles remained similar throughout the study period. The findings of this study should have significant implications for understanding transmission patterns of Ascaris and for the implementation of control measures against ascariasis in endemic regions.