PREPARED BY: TJ A. ADDUN JR.

, RMT

NEMATODES

Also known as roundworms: elongated and

cylindrical in shape with bilateral
symmetry.
They have complete digestive tract and a
muscular pharynx that is characteristically
trirardiate.
Have sensory organs in the anterior and
posterior ends of the worm: amphids &
phasmids.

o Angiostrongylus & hookworms Strongylida

o Strongyloides Rhabditida
o Enterobius Oxyurida
o Filarial worms - Spirurida

NEMATODES

The phasmid worms belong to several

orders in the scientific taxonomic
classification of the worms.
o Ascaris Ascaridida

NEMATODES

The
most
common
intestinal
nematode of man.
Soil- transmitted helminth
Which occurs most frequently in the
tropics.
It is estimated that more than 1 billion
individuals are infected, 70% of whom
are from Asia.
Disease of poverty

NEMATODES

Whitish or pinkish in color

polymyarian type of somatic muscle
arrangement in which cells are numerous
and project well into the body cavity.
Males measuring 10 to 31 cm
Females measuring 22 to 35 cm
The worms have a terminal mouth with
three lips and sensory papillae.

NEMATODES

Female worms have paired reproductive

organs in the posterior two-thirds
Male worms have single, long, tortous
tubule.

INFERTILE EGGS
88 to 94 um by 39 to 44
um
Longer and narrower
than the fertile eggs
With a thin shell and
irregular mammilated
coating filled with
refractile granules

FERTILE EGGS

EMBRYONATED OVA

45 to 70 um by 35 to 50 Infective stage
um
Has an outer coarsely,
mammilated
albuminous covering
Has a thick, transparent,
hyaline shell with a
thick outer layer and a
delicate vitelline,
lipoidal, inner
membrane, which is
highly impermeable

NEMATODES

 The usual infection of 10 to 20 worms may

not show symptoms.

NEMATODES

CAUSES VARYING DEGREES OF PATHOLOGY

1. Tissue reaction to the invading larvae
2. Intestinal irritation to the adult
3. Complications due to extraintestinal
migration

NEMATODES

During lung migration, the larvae may

cause host sensitization such as lung
infiltration, asthmatic attacks, and edema
of the lips.
Abdominal pain most frequent complaint
of patients.
Eosinophilia
Lactose intolerance moderate infections
in pre-school children
Bowel obstruction heavy infections

NEMATODES

Fatal effects of ascariasis are due to erratic

migration of adult worms.
Worms may invade bile ducts through the ampulla
of Vater and enter the gallbladder or liver.
Patients with biliary ascariasis experience severe
colicky abdominal pain
Acute appendicitis
Pancreatitis
Peritonitis
Intestinal volvulus
Intussusception
High fever
Intestinal obstruction

NEMATODES

The clinical diagnosis of ascariasis should be

confirmed or established by microscopic
examination of a stool sample.
The disease should be highly suspected
when the worm is passed out with the
feces.

Qualitative method
Recommended for mass examination

Kato-katz technique
Quantitative method
Can be used to determine the intensity of
Ascaris infection.

NEMATODES

Direct fecal smear

Kato technique or cellophane thick smear
method

Drug of choice
400 mg single dose (200 mg for children
under 2 years old)

Mebendazole
500mg single dose

Pyrantel pamoate
10 mg/kg (max. 1 gm)

NEMATODES

Albendazole

NEMATODES

Albendazole, mebendazole and pyrantel

pamoate have cure rates close to 100%.
Adverse reactions are rare, mild, and
transient.
These drugs are teratogenic.

NEMATODES

Endemic areas:
Southeast Asia
Africa
Central and South America
Over 1 billion globally are estimated
to have Ascariasis

NEMATODES

The risk of infection exists wherever fecal

disposal is improper.
Children are vulnerable to ascariasis due to
playing in soil contaminated with human
feces.
Ascaris are common in warm countries and
prevalent in areas where sanitation is poor.

- Refers to the
people
infected
with the parasite
and show signs
and symptoms of
the disease.

NEMATODES

- Refers to the
presence of Ascaris
eggs in the feces
of individuals with
or without signs
and symptoms.

NEMATODES

High density of human population

Involvement in agriculture
Illiteracy
Poor sanitation
Other factors
Socio-demographic
Poor health education
Community hygiene

NEMATODES

Sanitary disposal of
human feces
Health education
Mass chemotherapy