Ascariasis in Pregnancy: A Neglected Parasitic Infection

Dear Editor, I read with great interest the article by Alahmad and colleague on their observation of an intubated patient who coughed up an Ascaris worm after endotracheal removal.[1] I would like to share my own experience with a patient who had ascariasis. We had an 18-year-old pregnant woman who presented with symptoms of epigastric pain and nausea for two days. After several bouts of vomiting, the patient expelled an adult female Ascaris lumbricoides worm from her mouth. The presence of Ascaris lumbricoides ova in the stool sample confirmed the diagnosis of ascariasis. The patient was treated with oral albendazole to eliminate the remaining parasites. Ascariasis is a parasitic infection caused by Ascaris lumbricoides, a roundworm found in the human intestine. The World Health Organization estimates that over one billion people worldwide are infected with Ascaris lumbricoides, with the highest prevalence rates in areas of poor sanitation and hygiene.[2] Symptoms of ascariasis can vary from mild to severe and include abdominal pain, diarrhea, and malnutrition. In severe cases, the roundworms can cause blockages in the intestine, which can be life-threatening. Additionally, chronic infections can lead to long-term complications such as stunted growth and cognitive impairment. Diagnosis of ascariasis is typically done through stool examination, and treatment involves the use of anthelmintic drugs such as mebendazole and albendazole.[3] Children living in rural areas with poor sanitation are at a higher risk of contracting ascariasis than those living in urban areas. The lack of knowledge about proper hygiene practices is a significant factor contributing to the spread of the disease.[4] A study by Feleke et al. found that the prevalence of helminthic infection is high in pregnant women. The prevalence of intestinal parasites among pregnant women was 70.6%, and Ascaris lumbricoides (32.7%) was the predominant intestinal parasite species. Factors associated with a high incidence of intestinal parasitic infection during pregnancy included walking barefoot, living in a rural area, illiteracy, age below 21, the absence of proper latrine utilization, poor hand washing practices, and eating raw vegetables. Therefore, health education on hand washing and shoe wearing practices, as well as improvements in sanitary infrastructure, were key to long-term and sustainable reductions in helminth prevalence among pregnant women.[5] In conclusion, ascariasis remains a significant public health concern in many parts of the world. While effective treatment options are available, prevention through improved sanitation and hygiene remains the most effective way to control the spread of the disease. Further research is needed to explore the long-term efficacy of treatment options and the development of drug resistance, as well as the implementation of effective prevention measures in high-risk populations. In conclusion, ascariasis remains a significant public health concern in many parts of the world. While effective treatment options are available, prevention through improved sanitation and hygiene remains the most effective way to control the spread of the disease. Further research is needed to explore the long-term efficacy of treatment options and the development of drug resistance, as well as the implementation of effective prevention measures in high-risk populations. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.