pyrantel-pamoate and Ascariasis

A man in his 40s who had made frequent visits abroad was admitted to our hospital complaining of epigastric pain. Ultrasonography (US) revealed an "inner tube sign" in the gallbladder, which suggested a diagnosis of ascariasis in the gallbladder. Pyrantel pamoate was directly injected into the gallbladder via a percutaneous transhepatic catheter. The worm was dead 10 minutes after the injection. US revealed reduction of the worm's length and then the disappearance of the worm from the gallbladder at both 13 days and 2 months after the injection. This method is less invasive than operation and therefore is possibly more safe. It is known that the number of cases of ascariasis may increase in Japan due to increased organic vegetable consumption and foreign travel. We need to consider this disease in the differential diagnosis of epigastric pain.

Topics: Adult; Antinematodal Agents; Ascariasis; Catheterization; Gallbladder; Gallbladder Diseases; Humans; Injections; Liver; Male; Pyrantel Pamoate; Ultrasonography

More than a quarter of the human population is likely infected with soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) in highly endemic areas. Preventive chemotherapy is the mainstay of control, but only 4 drugs are available: albendazole, mebendazole, levamisole, and pyrantel pamoate.. To assess the efficacy of single-dose oral albendazole, mebendazole, levamisole, and pyrantel pamoate against A lumbricoides, hookworm, and T trichiura infections.. A systematic search of PubMed, ISI Web of Science, ScienceDirect, the World Health Organization library database, and the Cochrane Central Register of Controlled Trials (1960 to August 2007).. From 168 studies, 20 randomized controlled trials were included.. Information on study year and country, sample size, age of study population, mean infection intensity before treatment, diagnostic method used, time between evaluations before and after treatment, cure rate (the percentage of individuals who became helminth egg negative following treatment with an anthelminthic drug), egg reduction rate, adverse events, and trial quality was extracted. Relative risk, including a 95% confidence interval (CI), was used to measure the effect of the drugs on the risk of infection prevalence with a random-effects model.. Single-dose oral albendazole, mebendazole, and pyrantel pamoate for infection with A lumbricoides resulted in cure rates of 88% (95% CI, 79%-93%; 557 patients), 95% (95% CI, 91%-97%; 309 patients), and 88% (95% CI, 79%-93%; 131 patients), respectively. Cure rates for infection with T trichiura following treatment with single-dose oral albendazole and mebendazole were 28% (95% CI, 13%-39%; 735 patients) and 36% (95% CI, 16%-51%; 685 patients), respectively. The efficacy of single-dose oral albendazole, mebendazole, and pyrantel pamoate against hookworm infections was 72% (95% CI, 59%-81%; 742 patients), 15% (95% CI, 1%-27%; 853 patients), and 31% (95% CI, 19%-42%; 152 patients), respectively. No pooled relative risks could be calculated for pyrantel pamoate against T trichiura and levamisole for any of the parasites investigated.. Single-dose oral albendazole, mebendazole, and pyrantel pamoate show high cure rates against A lumbricoides. For hookworm infection, albendazole was more efficacious than mebendazole and pyrantel pamoate. Treatment of T trichiura with single oral doses of current anthelminthics is unsatisfactory. New anthelminthics are urgently needed.

Topics: Albendazole; Ancylostomatoidea; Animals; Anthelmintics; Ascariasis; Ascaris lumbricoides; Hookworm Infections; Humans; Levamisole; Mebendazole; Pyrantel Pamoate; Soil; Trichuriasis; Trichuris

Topics: Animals; Antinematodal Agents; Ascariasis; Ascaris lumbricoides; Humans; Intestinal Diseases, Parasitic; Mebendazole; Prognosis; Pyrantel Pamoate

This article discusses strongyloidiasis, hookworm infection, trichostrongyliasis, ascariasis, trichuriasis (whipworm infection), and enterobiasis (pinworm infection). For each infection, the author describes the organism, the epidemiology and geographic distribution, symptomatology and pathogenesis, and diagnosis and treatment.

Topics: Adolescent; Adult; Age Factors; Animals; Ascariasis; Child; Child, Preschool; Female; Hookworm Infections; Humans; Infant; Intestinal Diseases, Parasitic; Male; Mebendazole; Nematode Infections; Oxyuriasis; Piperazines; Pyrantel Pamoate; Strongyloides; Strongyloidiasis; Thiabendazole; Trichostrongylosis; Trichuriasis

Diagnosis of soil-transmitted helminths (STHs) in developing countries is commonly based on microscopic detection of eggs in stool samples, using the Kato-Katz (KK) method, which has a poor sensitivity for detecting light intensity infections. We compared the performance of the KK method and real-time PCR in the framework of a randomized trial, which evaluated four novel treatments against Trichuris trichiura and concomitant STH infections.. Two stool samples obtained from 320 participants were examined at baseline and follow-up with quadruplicate KK and PCR analyses of one of the two samples using "bead-beating" for DNA extraction. At follow-up, 80 samples were negative according to both PCR and KK and 173 were positive with both methods for any of the STHs. Relative to PCR, the calculated sensitivity of KK at follow-up was 83.6%, 43.0% and 53.8% for T. trichiura, for hookworm and for Ascaris lumbricoides, respectively. The sensitivity of PCR compared with KK at this time point was 89.1% for T. trichiura, 72.7% for hookworm and 87.5% for A. lumbricoides. Cure rates (CRs) for T. trichiura and A. lumbricoides were slightly lower with the PCR method. For hookworm CRs with KK were mostly significantly lower, namely 36.7%, 91.1%, 72.2% and 77.8% for moxidectin, moxidectin in combination with tribendimidine, moxidectin in combination with albendazole and albendazole in combination with oxantel pamoate, respectively, whereas with PCR the CRs were 8.3%, 82.6%, 37.1% and 57.1%, respectively.. In conclusion, a single real-time PCR is as sensitive as quadruplicate KK for T. trichiura and A. lumbricoides detection but more sensitive for hookworm, which has an influence on the estimated treatment efficacy. PCR method with DNA extraction using the "bead-beating protocol" should be further promoted in endemic areas and laboratories that can afford the needed equipment. The study is registered at ISRCTN (no. 20398469).

Topics: Adolescent; Albendazole; Ancylostomatoidea; Animals; Anthelmintics; Ascariasis; Ascaris lumbricoides; Child; Diagnostic Tests, Routine; DNA, Helminth; Feces; Female; Hookworm Infections; Humans; Macrolides; Male; Phenylenediamines; Pyrantel Pamoate; Real-Time Polymerase Chain Reaction; Sensitivity and Specificity; Soil; Trichuriasis; Trichuris; Young Adult

Infections with soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) are widespread and often occur concomitantly. These parasitic-worm infections are typically treated with albendazole or mebendazole, but both drugs show low efficacy against T. trichiura. Albendazole is the drug of choice against hookworm.. In this double-blind trial conducted on Pemba Island, Tanzania, we randomly assigned children, 6 to 14 years of age, to receive one of four treatments: oxantel pamoate at a dose of 20 mg per kilogram of body weight, plus 400 mg of albendazole, administered on consecutive days; oxantel pamoate at a single dose of 20 mg per kilogram; albendazole at a single dose of 400 mg; or mebendazole at a single dose of 500 mg. We assessed the efficacy and safety profile of oxantel pamoate-albendazole when used in the treatment of T. trichiura infection (primary outcome) and concomitant soil-transmitted helminth infection (secondary outcome). Efficacy was determined by means of assessment of the cure rate and egg-reduction rate. Adverse events were assessed four times after treatment.. Complete data were available for 458 children, of whom 450 were infected with T. trichiura, 443 with hookworm, and 293 with A. lumbricoides. The cure rate of T. trichiura infection was significantly higher with oxantel pamoate-albendazole than with mebendazole (31.2% vs. 11.8%, P=0.001), as was the egg-reduction rate (96.0% [95% confidence interval {CI}, 93.5 to 97.6] vs. 75.0% [95% CI, 64.2 to 82.0]). The cure rate with albendazole (2.6%) and the egg-reduction rate with albendazole (45.0%; 95% CI, 32.0 to 56.4) were significantly lower than the rates with mebendazole (P=0.02 for the comparison of cure rates). Oxantel pamoate had low efficacy against hookworm and A. lumbricoides. Adverse events (mainly mild) were reported by 30.9% of all children.. Treatment with oxantel pamoate-albendazole resulted in higher cure and egg-reduction rates for T. trichiura infection than the rates with standard therapy. (Funded by the Medicor Foundation and the Swiss National Science Foundation; Current Controlled Trials number, ISRCTN54577342.).

Topics: Adolescent; Albendazole; Animals; Antinematodal Agents; Ascariasis; Ascaris lumbricoides; Child; Double-Blind Method; Drug Therapy, Combination; Female; Hookworm Infections; Humans; Male; Mebendazole; Pyrantel Pamoate; Trichuriasis; Trichuris

Appetite and growth were studied in primary schoolboys (6-10 years) infected with Ascaris lumbricoides (86%) and Trichuris trichiura (100%) who received a single dose of pyrantel pamoate (which has little or no effect on Trichuris trichiura) or a placebo. Boys were examined, allocated at random by descending Ascaris egg count to pyrantel (PR, n = 36) or placebo (PL, n = 36) groups, treated, and re-examined 3 and 7 weeks later. The 2 groups did not differ significantly before treatment in helminth infections, appetite, or growth. Three and 7 weeks after treatment, the PR group exhibited significantly greater increases than did the PL group in weight (0.2 kg and 0.4 kg more, respectively) and percentage weight-for-age (0.6% and 1.7% points more, respectively). Appetite increased significantly in the PR group at 3 and 7 weeks (P < 0.0005 and P < 0.01, respectively) but not in the PL group. The prevalence and intensity of A. lumbricoides infection were greatly reduced in the PR group at 3 and 7 weeks (both P < 0.0001) but not in the PL group. We conclude that treatment with pyrantel pamoate may improve appetite and growth in school children in areas where A. lumbricoides infections and poor growth are highly prevalent.

Topics: Animals; Appetite; Ascariasis; Ascaris lumbricoides; Child; Follow-Up Studies; Growth; Humans; Indonesia; Male; Multivariate Analysis; Parasite Egg Count; Pyrantel Pamoate; Schools; Students; Time Factors; Trichuriasis; Urban Population

Chewable pyrantel pamoate tablets were administered to children randomly assigned to three treatment groups. Individuals in each group were instructed either to swallow whole, to chew and swallow, or to swallow previously pulverized tablets. With respect to Ascaris, results of posttreatment stool examinations indicated no differences in cure rates and egg reduction rates between the different modes of treatment. However, for both hookworm and Trichuris, mean egg counts increased for both swallow and chew groups, but decreased in the pulverized group. In addition to the highest egg reduction rates, the most parasitological cures were also seen in the pulverized group for these two worms. The status of standards for chewable tablets is discussed. Until the standards are changed it is recommended that all chewable tablets be crushed before swallowing.

Topics: Adolescent; Ascariasis; Child; Hookworm Infections; Humans; Mastication; Nematode Infections; Pyrantel Pamoate; Tablets; Trichuriasis

A total of 166 cases were divided into 3 groups: group A comprised 55, group B 54 and group C 57 cases. Group A received ivermectin 0.1 mg/kg orally at a single dose, the cure rates were 100%, 3.8% and 50% for ascaris, hookworm and trichuris, infections respectively: group B received ivermectin 0.2 mg/kg orally at a single dose, the corresponding cure rates were 95.5%, 11.8% and 76.5% respectively; group C received pyrantel pamoate 10 mg/kg orally at a single dose, the corresponding cure rates were 95.5%, 29.6% and 31.6% respectively. Although the cure rates were very low for hookworm infection in both group A and B, however, a number of adult worms of Ancylostoma duodenale and Necator americanus were expelled aster medication; It indicates that ivermectin has some effects on these two species of human hookworm. Side effects were mild and transient in all groups.

Topics: Adolescent; Adult; Ancylostoma; Animals; Ascariasis; Hookworm Infections; Humans; Intestinal Diseases, Parasitic; Ivermectin; Necator americanus; Nematode Infections; Pyrantel Pamoate; Trichuriasis

The efficacy of broad-spectrum anthelmintics in current use was studied in Hengshan County, Hunan Province. The vermicides under study include albendazole (400mg, single dose), mebendazole composite (mebendazole 100 mg and levamisole 25mg bid x 3d), oxantel pyrantel pamoate composite (pyrantel pamoate 150 mg and oxantel pamoate 150 mg bid x 2d), and pyrantel pamoate composite (base 10 mg/kg, single dose). Therapeutic effect assessed 2 weeks after medication revealed Ascaris egg negative rates or cure rates (CR) of 97.5-100% for the former 3 regimens, and 80.9% for the latter one; while CR for hookworm infection were 95.4%, 78.6-100%, 96.7% and 83.3%, respectively. A follow-up survey pursued 4 weeks post treatment showed no significant difference in CR for the above regimens. Judging from CR in Trichuris trichiura infection, pyrantel pamoate composite was recommended as the drug of choice (89.3%), which was followed by mebendazole composite (64.6-83.8%) and albendazole (28.2-42.6%), whereas pyrantel pamoate was inefficacious. Obvious egg reduction rates were evidenced post application of the above drugs in trichuriasis treatment except pyrantel pamoate at single dose.

Topics: Albendazole; Anthelmintics; Ascariasis; Drug Combinations; Hookworm Infections; Humans; Mebendazole; Nematode Infections; Pyrantel Pamoate; Trichuriasis

In a trial involving 185 school children, pyrantel pamoate (Combantrin) at a dose of 20 mg/kg body weight for 1-3 days was found to be very effective against the Ascaris and moderately effective against the hookworm, with mean cure rates ranging from 93.3-96.7% and 53.3-73.3% respectively. No apparent action against the Trichuris was detected, a mean cure rate of between 34.2 and 46.1% being only slightly, but not significantly, better than the 33.8% cure for a placebo-treated control group. Single and multiple doses of the suspension and tablet formulations of the drug were well tolerated. From the series of randomized and controlled trials conducted, we recommend that, in this area, the appropriate dose of the drug to use for treating ascariasis is 10 mg/kg per day for 1 day, and for infections which include hookworm, 20 mg/kg per day for 3 days.

Topics: Adolescent; Ascariasis; Child; Clinical Trials as Topic; Female; Hookworm Infections; Humans; Male; Parasite Egg Count; Pyrantel; Pyrantel Pamoate; Trichuriasis

Topics: Anthelmintics; Ascariasis; Benzimidazoles; Child; Costs and Cost Analysis; Drug Administration Schedule; Female; Humans; Intestinal Diseases, Parasitic; Levamisole; Male; Mebendazole; Necatoriasis; Pyrantel; Pyrantel Pamoate; Trichuriasis

Levamisole (Decaris, Belgium) was tested in Iran, Brazil, and in Mississippi and Louisiana for its efficacy as a single-dose oral treatment for Ascaris infections. Subjects were children ages 2 to 15 years, and numbers treated with levamisole and comparative anthelmintics are as follows: 453 with levamisole; 461 with piperazine citrate; 17 with pyrantel pamoate; and 19 with a placebo. Cure rates and total reduction in mean egg counts observed were 92% and 98% respectively for levamisole and 66% and 90% for piperazine. Sixteen of 17 treated with pyrantel pamoate were cured. In none of the drugs were there notable side reactions, but in all four studies side effects were more frequent with piperazine than with levamisole. Levamisole was found to be a well-tolerated, highly effective single-dose ascaricide. It should prove to be particularly useful for mass chemotherapy in Ascaris control programs.

Topics: Adolescent; Antinematodal Agents; Ascariasis; Brazil; Child; Child, Preschool; Clinical Trials as Topic; Drug Evaluation; Female; Hookworm Infections; Humans; Intestinal Diseases, Parasitic; Iran; Levamisole; Louisiana; Male; Mississippi; Parasite Egg Count; Piperazines; Placebos; Pyrantel Pamoate; Trichuriasis

An analysis is presented of 10 clinical studies from various countries where levamisole 50--150 mg was compared to pyrantel, piperazine, and placebo in a total of 1,734 patients, mostly children (levamisole: 830, controls: 904), suffering from ascariasis either as a single infection or usually mixed with other nematode infections. Degree of infection and efficacy of treatment were determined by quantitative coproparasitological methods. Levamisole produced higher cure rates (91%) and egg reduction rates (98%) than pyrantel, piperazine, or placebo. The efficacy of levamisole was unrelated to the patients' sex and age, the severity of infection, the presence of another worm infection, the type of associated worm infections, or the egg-counting technique. The overall incidence of reported adverse reactions was lower after levamisole than after piperazine, pyrantel or placebo; abdominal pain and headache, the most frequent complaints after levamisole, were related to the initial severity of ascariasis. Follow-up examinations 6 months after treatment suggested that levamisole might delay reinfection.

Topics: Adolescent; Adult; Age Factors; Aged; Ascariasis; Child; Child, Preschool; Clinical Trials as Topic; Female; Humans; Levamisole; Male; Middle Aged; Parasite Egg Count; Piperazines; Placebos; Pyrantel Pamoate; Sex Factors

The effect of pyrantel pamoate, levamisole, mebendazole, thiabendazole and bephenium hydroxynaphthoate on various intestinal helminths were evaluated among the inhabitants of four villages in the Dezful area southwest of Iran. A total number of 328 persons, all infected simultaneously with Ascaris and hookworm (Ancylostoma duodenale) and 49.2% with Trichostrongylus spp., were randomly divided into six groups. One group was kept as the control and the other five were each treated with one compound. Follow-up examinations showed that all of the drugs used were highly effective on Ascaris, and the differences in the cure rate were not statistically significant except for bephenium hydroxynaphthoate which showed a lower cure rate. For hookworm, cure rates of 100, 90, and 85% were observed with levamisole, pyrantel pamoate and bephenium hydroxynaphthoate, respectively. Cure rates observed with mebendazole and thiabendazole were 35 and 51%, respectively. For Trichostrongylus, the highest cure rate was achieved with levamisole, followed by thiabendazole and mebendazole. While the percentage of people showing side-effects was rather low for all drugs, thiabendazole and bephenium hydroxynaphthoate produced a higher, and levamisole a lower, percentage of side effects.

Topics: Adolescent; Adult; Ancylostomiasis; Anthelmintics; Ascariasis; Bephenium Compounds; Child; Child, Preschool; Clinical Trials as Topic; Drug Evaluation; Feces; Follow-Up Studies; Helminthiasis; Humans; Infant; Intestinal Diseases, Parasitic; Iran; Levamisole; Mebendazole; Parasite Egg Count; Pyrantel Pamoate; Thiabendazole; Trichostrongylosis

Topics: Ascariasis; Child; Child, Preschool; Female; Humans; Infant; Male; Pyrantel; Pyrantel Pamoate; Tetramisole

Soil-transmitted helminths infect 1.5 billion people worldwide. Treatment with anthelminthics is the key intervention but interactions between anthelminthic agents and the gut microbiota have not yet been studied. In this study, the effects of four anthelminthic drugs and combinations (tribendimidine, tribendimidine plus ivermectin, tribendimidine plus oxantel-pamoate, and albendazole plus oxantel-pamoate) on the gut microbiota were assessed. From each hookworm infected adolescent, one stool sample was collected prior to treatment, 24 h post-treatment and 3 weeks post-treatment, and a total of 144 stool samples were analyzed. The gut bacterial composition was analyzed using 16S rRNA gene sequencing. Tribendimidine given alone or together with oxantel-pamoate, and the combination of albendazole and oxantel pamoate were not associated with any major changes in the taxonomic composition of the gut microbiota in this population, at both the short-term post-treatment (24 h) and long-term post-treatment (3 weeks) periods. A high abundance of the bacterial phylum Bacteroidetes was observed following administration of tribendimidine plus ivermectin 24 h after treatment, due predominantly to difference in abundance of the families Prevotellaceae and Candidatus homeothermaceae. This effect is transient and disappears three weeks after treatment. Higher abundance of Bacteroidetes predicts an increase in metabolic pathways involved in the synthesis of B vitamins. This study highlights a strong relationship between tribendimidine and ivermectin administration and the gut microbiota and additional studies assessing the functional aspects as well as potential health-associated outcomes of these interactions are required.

Topics: Adolescent; Albendazole; Anthelmintics; Ascariasis; Bacteria; Bacteroidetes; Biotin; DNA, Bacterial; Drug Therapy, Combination; Feces; Gastrointestinal Microbiome; Hookworm Infections; Humans; Ivermectin; Metabolic Networks and Pathways; Parasite Egg Count; Phenylenediamines; Pyrantel Pamoate; RNA, Ribosomal, 16S; Trichuriasis

Ascaris lumbricoides infection is rare among children in developed countries. Although large numbers of adult Ascaris in the small intestine can cause various abdominal symptoms, this infection remains asymptomatic until the number of worms in the intestine considerably increases in most cases. Ascaris causing bilious vomiting suggesting ileus is rare, especially in developed countries. A 6-year-old boy who lived in Japan, presented with abdominal colic, bilious vomiting at the pediatric emergency room. He appeared pale, and had no abdominal distention, tenderness, palpable abdominal mass, or findings of dehydration. He experienced bilious vomiting again during a physical examination. Laboratory tests showed mild elevation of white blood cells and C-reactive protein levels. Antigens of adenovirus, rotavirus, and norovirus were not detected from his stool, and stool culture showed normal flora. Ultrasonography showed multiple, round-shaped structures within the small intestine, and a tubular structure in a longitudinal scan of the small intestine. Capsule endoscopy showed a moving worm of Ascaris in the jejunum. Intestinal ascariasis should be considered as a cause of bilious vomiting in children, even at the emergency room in industrial countries. Ultrasound examination and capsule endoscopy are useful for diagnosis of pediatric intestinal ascariasis.

Topics: Animals; Antinematodal Agents; Ascariasis; Ascaris lumbricoides; Capsule Endoscopy; Child; Emergency Service, Hospital; Humans; Intestinal Diseases, Parasitic; Intestinal Pseudo-Obstruction; Japan; Jejunum; Male; Predictive Value of Tests; Pyrantel Pamoate; Treatment Outcome; Ultrasonography; Vomiting

Ascaris lumbricoides is the most common parasite affecting humans, especially in countries and regions with lower socio-economic conditions. A 2-year-old female child underwent right pulmonary angioplasty using cardiopulmonary bypass. Serious hyperthermia continued after surgery, and, therefore, a re-exploration of the mediastinum was performed because mediastinitis was suspected. No evidence of wound infection was revealed. Ascaris lumbricoides was subsequently isolated from her stool. The patient had no further hyperthermia throughout her hospitalization and was discharged uneventfully on post-operative day 12. The probable origin of the fever was an A. lumbricoides infection and ascariasis may cause the occurrence of serious hyperthermia during the perioperative period. Ascaris lumbricoides infection may, therefore, cause high-grade fever after cardiac surgery.

Topics: Animals; Antinematodal Agents; Ascariasis; Ascaris lumbricoides; Cardiac Surgical Procedures; Child, Preschool; Feces; Female; Fever; Humans; Pyrantel Pamoate; Treatment Outcome

Infestation with Ascaris lumbricoides in children has a varied manifestation, but encephalopathy is a very rare presentation. This report describes a case of ascariasis-associated encephalopathy in a child. An 18-month-old boy was admitted with altered sensorium. He had a history of vomiting and was passing Ascaris worms in the vomitus. The cerebrospinal fluid analysis did not reveal any abnormality. The patient was treated with an antihelminthic drug and he recovered completely. Worm encephalopathy should be considered as a differential diagnosis for unexplained encephalopathy in tropical areas.

Topics: Animals; Antinematodal Agents; Ascariasis; Ascaris lumbricoides; Central Nervous System Helminthiasis; Diagnosis, Differential; Humans; Infant; Male; Pyrantel Pamoate; Ultrasonography

Topics: Abdominal Pain; Aged; Anemia; Animals; Antinematodal Agents; Ascariasis; Ascaris lumbricoides; Gastrointestinal Hemorrhage; Humans; Jejunum; Male; Melena; Pyrantel Pamoate

Ascariasis is a helminthic infection of humans caused by the nematode Ascaris lumbricoides. Biliary ascariasis is one of the most common and well described entities caused by ascaris. In endemic areas pregnant women are prone to develop biliary ascariasis. Its management poses a great challenge to both the attending surgeon and the endoscopist. Between January 1993 and March 2003, 15 cases of biliary ascariasis were seen in pregnant patients in our institution. Ultrasonography was used as the main investigative tool. Treatment involved management by conservative, endoscopic, and surgical methods, taking due care of both the mother and the fetus. Ten patients (66.6%) were in the third trimester of pregnancy, and 10 (66.6%) patients were in their third pregnancy. Ultrasonography proved to be the best tool for diagnosing and monitoring worms inside the biliary ductal system. Nine (60%) patients responded to the conservative treatment; endoscopic extraction was successful in 4 (66.6%) patients. Surgical treatment was required in 2 (13.3%) patients. One (6.6%) patient had had spontaneous abortion at 12 weeks gestation, and one (6.6%) patient had a premature labor. The remaining patients had normal pregnancies. Management of biliary ascariasis in pregnancy is a challenge for both the attending surgeon and the endoscopist. Safe and effective management requires special attention to the gestational age and accurate recognition of the specific pathology in the patient. The majority of patients respond to conservative treatment, but endoscopic extraction may be needed in nonresponsive cases. Lead shielding of the fetus and limitation of the total fluoroscopic exposure during therapeutic endoscopy can minimize the teratogenic risk of ionizing radiation. Failures of endoscopic extraction may lead to surgical intervention, which carries risks of fetal wastage and premature labor. Routine worming of women in the child-bearing years is recommended in endemic areas of ascariasis. Though ascariasis is a problem in developing countries, because of increased travel and population migration, clinicians elsewhere should be aware of the problems associated with ascariasis.

Topics: Adult; Ampicillin; Anti-Infective Agents; Ascariasis; Biliary Tract Diseases; Cholangiopancreatography, Endoscopic Retrograde; Female; Humans; Metronidazole; Pregnancy; Pregnancy Complications, Parasitic; Pyrantel Pamoate; Ultrasonography

To compare the structures of natural and re-established populations of Ascaris in humans, universal (mass) chemotherapy was carried out at the beginning and the end of the study year using pyrantel pamoate. Worms expelled within 48 h of treatment were collected, their sex determined, and measurements made of length, width and weight. Length was used as the criterion for estimating the developmental stage of the worms. In comparison with the natural population, the reestablished population displayed similar sex ratio as well as distribution patterns among individuals and age groups of the host. However, the mean worm burden of the re-established population was significantly decreased, with a reduction of burdens in children aged 5-9 years. Also, the re-established population showed significant changes in population structure and worm measurements in that it comprised more immature and less fertile males, less fertile and more senile females, smaller and lighter males, larger (but not heavier) females than the natural population. The results suggested that the reestablished Ascaris population did not restore to its original status in relation to mean density, composition and fecundity. Therefore, universal treatment once a year should decrease the transmission of Ascaris in humans. Combined with previous results for the same study sites, the present findings also indicated that caution is warranted to avoid misleading conclusions when using prevalence and faecal egg counts as parameters for evaluating the success of control programmes.

Topics: Adolescent; Adult; Aging; Animals; Anthelmintics; Ascariasis; Ascaris lumbricoides; Biometry; Body Weight; Child; Child, Preschool; China; Female; Host-Parasite Interactions; Humans; Infant; Infant, Newborn; Male; Middle Aged; Pyrantel Pamoate; Rural Population; Sex Characteristics

Resistance to Ascaris suum infections was investigated in 8- and 15-week-old Iberian pigs. Groups of 3 or 5 pigs were immunized weekly for 6 weeks with antigens of adult A. suum: a 97 kDa body wall (BW) fraction, a 42 kDa fraction of pseudocoelomic fluid (PF) or a 14 kDa PF-fraction; or were inoculated with increasing doses of infective eggs (500-20,000), with or without abbreviation by pyrantel pamoate. All immunized pigs and unimmunized control pigs, were challenged with 10,000 infective eggs 7 days after the last immunization. The number of liver lesions and lung larvae was substantially lower in the older pigs than in the younger ones 7 days after challenge, but the resistance in immunized pigs of both age groups was similar in comparison to the challenge controls of the same age. The highest degree of resistance against lung larvae was observed in pigs immunized with A. suum eggs (97-99%). The pigs immunized with the 14 kDa and 42 kDa PF-fractions were also well protected (67-93%), while no protection was produced by the 97 kDa BW fraction (0-49%). The reduction of white spots following immunization was less evident, with a maximum of 82% reduction in egg-inoculated young pigs.

Topics: Age Factors; Animals; Antigens, Helminth; Antinematodal Agents; Ascariasis; Ascaris suum; Female; Immunization; Liver; Lung; Ovum; Pyrantel Pamoate; Random Allocation; Statistics, Nonparametric; Swine Diseases

A 74-year-old man was admitted to our hospital with frequent right flank pain. The multiple multilocular hepatic abscesses were revealed by computed tomography. Radiographs following a barium meal showed a linear filling defect in the ileum consistent with ascariasis. One day after treatment with pyrantel pamoate, an Ascaris was passed in the stool. The pyogenic hepatic abscesses gradually healed with both antibiotics and continuous drainage. After 2 months, he was discharged. In this case, the pyogenic hepatic abscesses were thus considered to have been caused by an inflammation which spread through the portal vein.

Topics: Aged; Animals; Antinematodal Agents; Ascariasis; Ascaris lumbricoides; Cefoperazone; Cephalosporins; Drug Therapy, Combination; Feces; Humans; Ileal Diseases; Intestinal Diseases, Parasitic; Liver Abscess; Male; Pyrantel Pamoate; Tomography, X-Ray Computed

The effect of anthelmintic treatment of pigs on the embryonation and infectivity of Ascaris suum eggs isolated from expelled worms was investigated. Four groups of two naturally infected pigs were dosed with albendazole, pyrantel pamoate, ivermectin or piperazine dihydrochloride, respectively. Following worm expulsion, the eggs were removed from the uteri of female worms and embryonated in sulphuric acid. The infectivity of the embryonated eggs was tested through mouse inoculation. Egg development appeared normal in cultures from worms of the piperazine. pyrantel and ivermectin treated groups. In the albendazole cultures, egg development was largely arrested at the one-cell stage (81%). Where development occurred, irregular cell division was observed and only 7% of the eggs in the culture developed into fullgrown larvae. Following mouse inoculation with 2500 embryonated eggs, significantly lower lung larval counts on day 8 post inoculation (p.i.) were observed for mice in the piperazine and pyrantel treated groups (P < 0.01) compared to untreated controls. The larvae that developed in the eggs from ivermectin and albendazole treated groups appeared fully infective for mice. It was concluded that ovicidal activity of albendazole in vivo inhibits subsequent A. suum egg development in vitro; albendazole is, therefore, not suitable to obtain worms for egg embryonation to produce experimental inoculums. The anthelmintic treatment of pigs with ivermectin had only a limited effect on both embryonation and infectivity of A. suum eggs isolated from expelled worms.

Topics: Albendazole; Animals; Antinematodal Agents; Ascariasis; Ascaris suum; Embryonic Induction; Feces; Female; Ivermectin; Lung; Mice; Mice, Inbred BALB C; Ovum; Parasite Egg Count; Piperazine; Piperazines; Pyrantel Pamoate; Swine; Swine Diseases

Ascaris lumbricoides worm counts were examined as the outcome products of exposure proxy variables. A survey of 663 children, 4-10 yr old, living in southeastern Madagascar revealed prevalences of 93% for A. lumbricoides, 55% for Trichuris trichiura, and 27% for hookworm. Worm expulsions were conducted on 428 of these children; the data revealed an overdispersed distribution of A. lumbricoides, with an arithmetic mean of 19.2 worms per child. A concurrent socioeconomic household survey was conducted by visitation and interview. Exposure to infection was assessed by environmental, demographic, behavioral, and socioeconomic indicators. Ascaris lumbricoides aggregations were associated with gender, housing style, ethnicity, and agricultural factors. The results suggest that exposure and infection are ubiquitous in this child population, and that A. lumbricoides intensity is influenced by gender-related behavioral and environmental factors that contribute to exposure.

Topics: Animals; Antinematodal Agents; Ascariasis; Ascaris lumbricoides; Child; Child, Preschool; Drug Therapy, Combination; Educational Status; Feces; Female; Health Behavior; Housing; Humans; Madagascar; Male; Mebendazole; Prevalence; Pyrantel Pamoate; Risk Factors; Rural Population; Sanitation; Sex Factors; Social Class

It has recently been shown using genetic markers that Ascaris in humans and pigs in Central America comprise reproductively isolated populations. We present a similar analysis for a region of China in which close association between pigs and humans has been the norm for thousands of years, and agricultural practices will result in frequent exposure to eggs from both sources. DNA fragments from selected regions of mitochondrial and ribosomal DNA were amplified by PCR and allelic forms identified following digestion with a panel of restriction enzymes, using DNA from a total of 115 individual worms from both people and pigs from 2 neighbouring villages. Significant frequency differences in both mtDNA haplotypes and the rDNA spacer were found between the 2 host-associated populations, indicating that they represented reproductively isolated populations. Mitochondrial haplotype frequencies were different from those observed in Guatemala and also from other Asian Ascaris populations, suggesting low levels of gene flow between populations. However, we found no evidence for significant heterogeneity in the genetic composition of Ascaris infrapopulations in either humans or pigs, possibly indicative of agricultural practices in China which have resulted in a random distribution of alleles within the parasite populations.

Topics: Animals; Antinematodal Agents; Ascariasis; Ascaris; Child; Child, Preschool; China; DNA Restriction Enzymes; DNA, Helminth; DNA, Mitochondrial; DNA, Ribosomal; Electrophoresis, Agar Gel; Feces; Genetic Variation; Genetics, Population; Guatemala; Haplotypes; Humans; Polymerase Chain Reaction; Prevalence; Pyrantel Pamoate; Rural Population; Swine; Swine Diseases

Intestinal nematode infections are considered highly endemic in the Chinese province of Jiangsu. In May 1997, the prevalence of intestinal nematodes infections was determined among all of the inhabitants aged 5 to 65 of the southern Jiangsu village of Yaojiakon (Wujiang County) and the northern Jiangsu village of Jianmiao (Pizhou County). It was determined that the prevalence of ascariasis, trichuriasis and hook worm infection was greatly reduced compared to when it was last measured in 1990. The reduction was noted to be particularly impressive in Yaojiakon village where the prevalence of ascariasis and trichiuriasis fell to 2% and 1.5% respectively. Much of this reduction was attributed to improvements in economic development which have occurred in southern Jiangsu Province at a rapid pace. In contrast, the reduction in nematode infections among villagers living in northern Jiangsu was more modest. The most striking reduction in both villages was in school-aged children who since 1988 have received yearly treatments with anthelminthic drugs. The intensity of nematode infections was investigated for hookworm where 70% of hookworm-infected Yaojiakon villagers were found to harbor light infections (< 400 eggs per gram) compared to 83% of hookworm-infected Jianmiao villagers. Necator americanus was the predominant hookworm in Yaojiakon village (South), whereas Ancylostoma duodenale predominated in Jianmiao village (North). The majority (76%) of hookworm-infected patients developed IgG antibodies against N. americanus antigen, although 20% of uninfected patients living in the village also had circulating antibodies. Intestinal nematode infections continue to be a significant public health problem in Jiangsu Province although their prevalence has decreased since 1990.

Topics: Adolescent; Adult; Animals; Antibodies, Helminth; Antinematodal Agents; Ascariasis; Ascaris; Child; Child, Preschool; China; Enzyme-Linked Immunosorbent Assay; Hookworm Infections; Humans; Middle Aged; Necator americanus; Parasite Egg Count; Prevalence; Pyrantel Pamoate; Trichuriasis; Trichuris

A retrospective clinical study to evaluate the effects of paralyzing vermifuges on the course of intestinal obstructions complicating ascariasis was performed. Forty-two patients, 26 patients with partial and 16 patients with complete intestinal obstructions, were treated over 7 years. Although 24 patients have not received any medications two patients with partial obstructions received flaccid paralyzing agent before referral. However, 12 of 16 patients with complete obstruction received spastic paralyzing agent, and the remaining patients received flaccid paralyzing agent before referral. Paralyzing agents, especially those causing spastic paralysis, should be avoided in patients with abdominal symptoms presumed to be related to ascariasis because of the risk of causing complete obstruction and making surgery more complex.

Topics: Anthelmintics; Ascariasis; Child; Child, Preschool; Female; Humans; Intestinal Diseases, Parasitic; Intestinal Obstruction; Male; Piperazines; Pyrantel Pamoate; Retrospective Studies

Topics: Animals; Anthelmintics; Ascariasis; Ascaris lumbricoides; Bile Duct Diseases; Butylscopolammonium Bromide; Child; Drug Therapy, Combination; Female; Humans; Pyrantel Pamoate

1. The third therapeutic scheme should be used in the hospital. 2. The second and third therapeutic scheme may be used in mass treatment. 3. The 4th-6th therapeutic scheme is to be considered, reviewed, and evaluated. 4. Model and technology of permanent worms control is to be studied. 5. The treatment and control of Ascaris were simple. Cure with low reinfection rate and long reinfection period was remarkable. 6. The prevalence rate and reinfection rate of Trichiuris was high, and not so sensitive to any antelmintics. 7. The reinfection rate in the second group was not superior to the first group and the third group. This revealed no effectiveness of ovicidal and larvicidal on the helminthiasis. 8. Reinfection rate in the third therapeutic scheme was the least group. 9. Toxicity and side effect were not found in any anthelmintics. 10. Broad Spectrum Anthelmintics are necessary in mass treatment or blind treatment.

Topics: Albendazole; Anthelmintics; Ascariasis; Child; Hookworm Infections; Humans; Intestinal Diseases, Parasitic; Mebendazole; Pyrantel Pamoate; Treatment Outcome; Trichuriasis

A 64-year-old female aborigine presented with acute cholangitis and obstructive jaundice for three days. Abdominal ultrasonography showed dilatation of the common bile duct, intrahepatic ducts and a linear tubular structure in the common bile duct. Duodenoscopy showed a live Ascaris protruding through the papilla of Vater, which was retracted endoscopically. Cholangitis improved dramatically after worm extraction and nasobiliary drainage. Endoscopic retrograde cholangiography revealed another worm retained in the common bile duct. It disappeared spontaneously from the common bile duct one week later. The barium study of the intestine showed multiple filling defects in the terminal ileum. A total of five worms passed into the stool after treatment with pyrantel pamoate.

Topics: Ascariasis; Biliary Tract; Cholangitis; Duodenoscopy; Female; Humans; Middle Aged; Pyrantel Pamoate; Taiwan

Reinfection with hookworm (Necator americanus) following chemotherapy was studied over 2 years in a rural village in Madang Province, Papua New Guinea. The prevalence of hookworm infection had returned to pre-treatment levels after 2 years, and the geometric mean hookworm burden had returned to 58% of the pre-treatment value. The rate of acquisition of adult worms was independent of host age, and was estimated as a geometric mean of 2.9-3.3 worms/host/year (arithmetic mean 7.9-8.9 worms/host/year). There was significant predisposition to hookworm infection; the strength of this predisposition did not vary significantly between age or sex classes.

Topics: Age Factors; Animals; Ascariasis; Causality; Female; Humans; Incidence; Male; Necator americanus; Necatoriasis; Papua New Guinea; Pyrantel Pamoate; Recurrence; Sex Factors; Time Factors; Trichuriasis

Intestinal helminths are among the most common and widespread of human infections. Because it is typical to find that most worms are aggregated in a few potential hosts it has been suggested that some individuals are predisposed to heavy infections and that morbidity could be controlled by the treatment of heavily infected individuals only. We have studied the prevalence and intensity of reinfection with the intestinal nematode Ascaris lumbricoides among people living in Dhaka, Bangladesh. 880 people were treated with pyrantel pamoate three times at six month intervals, and on each occasion they collected all their stools for 48 h after treatment. Worms expelled by each subject were counted and weighed. The prevalence of infection at round 1 of treatment was 89% and the mean burden was 18.5 worms. Reinfection was rapid and at rounds 2 and 3 the prevalence was 82% and 80%, respectively, with mean burdens of 14.0 and 11.5 worms. The intensity of reinfection was not random: more subjects than expected became heavily reinfected (greater than or equal to 15 worms) and more subjects than expected remained lightly infected (less than or equal to 14 worms) (p less than 0.001). Worms were highly aggregated at each round of treatment but although just over 10% of all subjects were heavily infected at each and every round of treatment, over 60% of all subjects were heavily infected at least once. The findings show that some individuals seem to be susceptible to heavy infection whereas others are not, that deworming has a greater effect on the intensity of infection than on the prevalence, and that mass chemotherapy is likely to be a more effective means to control morbidity than is selective treatment of heavily infected individuals only.

Topics: Adolescent; Adult; Animals; Ascariasis; Ascaris; Bangladesh; Child; Child, Preschool; Disease Susceptibility; Feces; Female; Humans; Intestinal Diseases, Parasitic; Male; Middle Aged; Parasite Egg Count; Pyrantel Pamoate; Recurrence

Different periodic selective chemotherapeutic schemes were used to control hookworm and other soil-transmitted helminthiases in eight villages in five counties in Zhejiang Province, China, 1985-1988. The results showed that the prevalence rates of hookworm, ascariasis, and trichuriasis decreased from 35.0-74.4%, 47.0-.76% and 22.9-47.5% to 3.2-15.8%, 9.9-47.8%, and 3.5-31.2%, respectively, using pyrantel pamoate (10 mg/kg for 1-2 days) or albendazole (400 mg for 1-2 days, once or twice a year for 2-3 years). The eggs per gram of feces of hookworm and Trichuris trichiura also dropped markedly after control. Moreover, the mean hemoglobin levels of sampled populations increased after several treatments. The authors recommend periodic selective chemotherapy as the main method to control soil-transmitted helminthiases, especially hookworm infections.

Topics: Agriculture; Albendazole; Animals; Ascariasis; Ascaris; Child; China; Female; Hemoglobins; Hookworm Infections; Humans; Larva; Male; Pyrantel Pamoate; Trichuriasis

Topics: Aged; Ascariasis; Humans; Male; Myasthenia Gravis; Neurologic Examination; Pyrantel Pamoate

Analysis of egg and worm counts of Ascaris recorded at various intervals following a mass anthelmintic treatment programme in a South Indian fishing community is presented. Three indices of infection in the community are compared, namely the prevalence and intensity of egg output (at 2, 6 and 11 months following treatment) and the number of worms expelled following an 11 month period of reinfection. Detailed examination of these measurements revealed significant associations with patient sex and age. The age-prevalence profile of Ascaris infection changed little over time (except immediately following treatment) with the peak prevalence found in the 5-9 year age group. Although 85% of both males and females harboured Ascaris initially, the prevalence following 11 months reinfection was decreased, due to a significantly lower proportion of males being reinfected. By the 11th month of reinfection, the age-intensity profiles of egg output were similar to those observed at initial treatment in the older age groups (10 years and above) and in male children (less than 10 years). However, a dramatic increase in the egg output of female children, greatly exceeding the initial mean, was observed within a 6 month period of reinfection. The intensity of egg output did not accurately reflect the abundance of Ascaris recovered via drug-induced expulsion following an 11 month period of reinfection. Although the egg output attained preintervention levels, the average worm intensity reached only half the initial value. The trends in the sex- and age-intensity profiles were consistent at the two sampling dates and showed similar patterns to the egg output curves. The relevance of the results to helminth control and the monitoring of reinfection is discussed.

Topics: Adolescent; Adult; Age Factors; Ascariasis; Child; Child, Preschool; Feces; Female; Humans; India; Infant; Intestinal Diseases, Parasitic; Male; Middle Aged; Parasite Egg Count; Pyrantel; Pyrantel Pamoate; Recurrence; Sex Factors

Topics: Adolescent; Adult; Albendazole; Antinematodal Agents; Ascariasis; Benzimidazoles; Child; Child, Preschool; Female; Humans; Male; Mebendazole; Oxyuriasis; Pyrantel Pamoate; Pyridinium Compounds

Conventional chemoprophylaxis of canine toxocariasis is based upon the treatment of young puppies. It is proposed that physiological considerations and the complexity of the host-parasite relationship in the case of Toxocara canis demand that anthelmintic evaluation should properly be conducted in such animals rather than in adolescent or adult dogs. A screening model using the critical trial technique in early weaned pups gave variable results even with compounds known to be of high efficacy in older dogs. Circumstantial evidence suggested that this inconsistency may be related to the rate of passage of ingesta through such young animals. More satisfactory results were obtained by pairing unweaned naturally infected puppies by weight and sex and treating one of each pair with the test compound. Natural in utero and transmammary infection was found to give fairly consistent worm-burdens within each litter and a good indication of efficacy could therefore be estimated by comparing post mortem worm-counts. On this basis, the apparent efficacies of pyrantel pamoate (5 mg kg-1) and piperazine (100 mg kg-1) were found to be 83.5 and 82.5%, respectively. This method was extended to evaluate a prophylactic programme in which anthelmintic therapy was given to pups when aged 10, 20 and 30 days. Intestinal T. canis populations were reduced, at 35 days of age, by between 94.2% and 98.0%. This programme increased overall weight gains between 10 and 30 days of age by 18% (P less than 0.05) although there was great variation between litters. The biggest response was observed in male pups between 20 and 30 days old.

Topics: Animals; Animals, Suckling; Anthelmintics; Ascariasis; Body Weight; Dog Diseases; Dogs; Drug Administration Schedule; Feces; Female; Male; Parasite Egg Count; Phenyl Ethers; Piperazine; Piperazines; Pyrantel; Pyrantel Pamoate; Thiocyanates; Toxocariasis

Studies of patterns of reinfection with four species of intestinal nematodes (Ascaris, hookworm, Trichuris and Enterobius) in 174 individual patients following chemotherapeutic treatment revealed statistical evidence for predisposition to heavy or light infection (relative to the average level in the overall population). Analyses of associations between the abundances of the four species of nematodes within a combined sample of 525 worm burdens showed significant correlations between 5 out of the 6 possible pair-wise comparisons between species. The relevance of these results to the design of control programmes based on chemotherapeutic application is discussed.

Topics: Adolescent; Adult; Age Factors; Animals; Ascariasis; Child; Child, Preschool; Disease Susceptibility; Feces; Female; Hookworm Infections; Humans; India; Infant; Male; Mathematics; Oxyuriasis; Parasite Egg Count; Pyrantel Pamoate; Trichuriasis

The study design of a project to investigate the epidemiology, population dynamics and control of intestinal nematode infections in fishing village communities in Southern India is described. The paper focuses on Ascaris lumbricoides infection and describes changes in prevalence and intensity (worm burdens) with host age, the aggregated frequency distributions of parasite numbers per person, a density-dependent relationship between parasite fecundity and worm burden and rates of reinfection following chemotherapeutic treatment. The age-intensity of infection profile is convex in form, where maximum worm burdens are attained in children in the age range five to nine years. On the basis of juvenile to adult worm ratioos, the life expectancy of Ascaris in man is estimated to be of the order of one year. Rates of reacquisition of worms after chemotherapy are shown to be dependent on host age. Wormy individuals with heavy infections are shown to be predisposed to this state such that they reacquire heavier than average worm burdens following treatment.

Topics: Adolescent; Adult; Age Factors; Aged; Ascariasis; Ascaris; Child; Child, Preschool; Feces; Female; Humans; India; Infant; Intestinal Diseases, Parasitic; Male; Middle Aged; Parasite Egg Count; Pyrantel; Pyrantel Pamoate; Recurrence

Topics: Animals; Anthelmintics; Ascariasis; Dog Diseases; Dogs; Drug Combinations; Hookworm Infections; Pyrantel; Pyrantel Pamoate; Toxocariasis; Trichuriasis

A mixture of 150 mg mebendazole and 30mg pyrantel pamoate was given on 3 consecutive or near-consecutive days to 70 children infected with one or more of Necator americanus, Ascaris lumbricoides, Strongyloides stercoralis, S. fuelleborni-like and Trichuris trichiura. This treatment had an efficacy of 95 per cent for N. americanus infections, 100 per cent for A. lumbricoides, 57 per cent for Strongyloides spp., and 75 per cent for T. trichiura. The results indicate that the treatment given is effective against the infections of N. americanus and A. lumbricoides but is only partially effective for Strongyloides and T. trichiura infections.

Topics: Ascariasis; Benzimidazoles; Child, Preschool; Drug Therapy, Combination; Humans; Infant; Mebendazole; Necatoriasis; Nematode Infections; Papua New Guinea; Pyrantel; Pyrantel Pamoate; Strongyloidiasis; Trichuriasis

A study was carried out to find out the incidence of helminthic infections in hospitalized patients at Sher-e-Bangla Medical College, Barisal and to determine the comparative efficacy of pyrantel pamoate, levamisole, and mebendazole. It was observed that 76.2 per cent of total hospitalized patients were infected with intestinal helminths. Polyparasitism (52.6 per cent) was more frequent than single infection (21.8 per cent). Amongst these, 47.5 per cent was suffering from Asearis lumbricoides (AL), 42.5 per cent from Hookworm (H.W) and 65.8 per cent from trichuris trichura (TT). Out of 255 cases examined separately, 40 per cent was suffering from Enterobious vermicularis (EV) infection. The comparative study showed that mebendazole produced egg negative stool in 90.9 per cent of AL, 95.6 per cent of HW and 86.8 per cent of TT after eight days of treatment. On the other hand, pyrantel pamoate cured AL in 93.3 per cent, HW in 78.5 per cent and TT in 34.2 per cent eases. Levamisole cured 75 per cent AL, 4.1 per cent H.W. and 22.2 per cent TT within the same period.

Topics: Adolescent; Adult; Ascariasis; Bangladesh; Benzimidazoles; Drug Therapy, Combination; Hookworm Infections; Humans; Levamisole; Mebendazole; Pyrantel; Pyrantel Pamoate; Trichuriasis

The results are presented of a horizontal epidemiological survey of intestinal infections of children aged between six months and 15 years in three adjacent villages in northern Bangladesh. On the basis of 203 stool sample examinations, the prevalence of Ascaris lumbricoides, Trichuris trichiura, hookworm and amoebic infections was estimated as 68, 56, 53 and 19%, respectively. Age-specific prevalence data indicated that approximately 90% of the children were harbouring patent Ascaris infections by the time they were four years old and there was some evidence to suggest differences in the pattern of age-prevalence between male and female children. The intensity of Ascaris infection was found to rise to its maximum value within the first four years of life. No significant differences were detected in the mean worm burdens of children aged between four and 15 years. Each child in this age-group harboured on average 10 worms. The frequency distribution of numbers of A. lumbricoides per host was found to be overdispersed, with a value of the negative binomial parameter, k, of 0.44. The degree of aggregation was found to be approximately the same for each age-class of the population between one and 15 years (0.26 less than or equal to k less than or equal to 0.82). No evidence was found to suggest a density-dependent reduction in the weight of either male or female Ascaris within the range one to 43 worms per host.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Ascariasis; Bangladesh; Child; Child, Preschool; Dysentery, Amebic; Escherichia coli Infections; Feces; Hookworm Infections; Humans; Infant; Intestinal Diseases, Parasitic; Parasite Egg Count; Pyrantel Pamoate; Trichuriasis

Adults of Ascaris lumbricoides were recovered from 252 persons in the village of Jazin near Esfahan, Iran after treatment with pyrantel pamoate. This horizontal study provides information on age-specific prevalence rates, intensities of infection, frequency distributions, sex ratios and eggs per gram of stool at different parasite intensities. Recruitment of A. lumbricoides was then monitored at 7, 30, 60, 90 and 365 days after treatment in 110 persons. A separate sample population was examined at monthly intervals and, in addition, the stool of each member of a nine-person family was examined for 10 consecutive days. These data are analysed and used to describe the dynamics of transmissions and recruitment of A. lumbricoides in Jazin. The population dynamics of ascariasis are discussed in the context of R the basic reproductive rate of the parasite. The relationships of R with frequency distributions, prevalencies and worm burdens are discussed. Because of the considerable potential of A. lumbricoides to re-infect man in endemic areas, it is shown that it will be difficult to eradicate ascariasis by the use of chemotherapy, even when drugs with a high efficacy are used repeatedly.

Topics: Adolescent; Adult; Ascariasis; Ascaris; Child; Child, Preschool; Host-Parasite Interactions; Humans; Infant; Iran; Middle Aged; Models, Biological; Parasite Egg Count; Pyrantel Pamoate

Topics: Adolescent; Adult; Antinematodal Agents; Ascariasis; Benzimidazoles; Child; Child, Preschool; Costs and Cost Analysis; Cyclopropanes; Female; Hookworm Infections; Humans; Infant; Liberia; Male; Mebendazole; Pyrantel Pamoate; Trichuriasis

A mixture of oxantel-pyrantel pamoate was given to 147 primary school children. A single daily dose of 15 mg per kg body weight was administered to cases with Ascaris lumbricoides and Trichuris trichiura infections. The same single daily dose was given for three consecutive days to 10 cases with hookworm infections. The cure rate was 93.7% for ascariasis and the egg reduction rate was 98.2%. A cure rate and an egg reduction rate for trichuriasis was 70.2% and 86.5% respectively. All cases with hookworm infection were cured. Side effects were light and did not cause any anxiety.

Topics: Adolescent; Ascariasis; Child; Drug Therapy, Combination; Humans; Indonesia; Necatoriasis; Parasite Egg Count; Pyrantel; Pyrantel Pamoate; Trichuriasis

Topics: Ascariasis; Child; Child, Preschool; Humans; Infant; Intestinal Obstruction; Levamisole; Mebendazole; Pulmonary Eosinophilia; Pyrantel Pamoate; Thiabendazole

Topics: Adolescent; Adult; Antinematodal Agents; Ascariasis; Benzimidazoles; Child; Child, Preschool; Drug Administration Schedule; Drug Combinations; Drug Therapy, Combination; Female; Humans; Intestinal Diseases, Parasitic; Male; Mebendazole; Necatoriasis; Nematode Infections; Pyrantel; Pyrantel Pamoate; Trichuriasis

Topics: Adult; Ascariasis; Ascaris; Female; Humans; Ovum; Pyrantel; Pyrantel Pamoate; Trichuriasis

Over a period of several years the use of pyrantel embonate in the control of helminth infections on three equine establishments was monitored by the examination of faecal samples collected immediately before each anthelmintic treatment. With a monthly interval between treatments for three years the faecal egg output of the horses remained at a very low level. One one establishment this was maintained when the treatment interval was extended to one-and-a-half months after treating monthly for two years. If a treatment interval of one-and-a-half months was used continuously for a number of years there was a cumulative effect, and the benefits, in terms of reduced faecal egg output of the horses, were more apparent during the second year of the control programme.

Topics: Animals; Ascariasis; Feces; Female; Horse Diseases; Horses; Male; Nematode Infections; Parasite Egg Count; Pyrantel; Pyrantel Pamoate; Strongyle Infections, Equine

Topics: Ancylostomiasis; Animals; Ascariasis; Dog Diseases; Dogs; Pyrantel; Pyrantel Pamoate; Toxocariasis

Topics: Adult; Antinematodal Agents; Ascariasis; Child, Preschool; Drug Evaluation; Humans; Mebendazole; Oxyuriasis; Piperazines; Pyrantel Pamoate; Pyrvinium Compounds

Oral inoculation of mice with 340 embryonated eggs of the nematode, Baylisascaris procyonis, proved uniformly fatal as early as 13 days after inoculation and as late as 48 days. Mice given either 0.5% or 0.25% of pyrantel tartrate in dry feed were protected from cerebral migrations of the worm for 55 days. Treatment with pyrantel pamoate in the feed at the concentration of 0.2% given 7 days before inoculation and 5 days after inoculation also protected mice from migrations throughout the 55-day experiment. Embryonated eggs stored in 0.5% formalin in a 4-C refrigerator for 9 years have proved fatal to mice given doses of 340 eggs each.

Topics: Animals; Ascariasis; Ascaris; Female; Locomotion; Mice; Pyrantel; Pyrantel Pamoate; Pyrantel Tartrate; Raccoons; Rodent Diseases

The anthelminthic efficacy of pyrantel pamoate (Combantrin) in a single dose of 10 mg/kg body weight was compared with that of thiabendazole (Mintezol) in two doses each of 25 mg/kg body weight in a controlled trial. Follow-up examination, 6 weeks after treatment with Combantrin gave cure rates of 93.8%, and 29.1% for infection with Ascaris and the Hookworm respectively, and 44.3% and 27.3% in those treated with Mintezol. The reduction in hookworm egg counts was higher in patients treated with Combantrin than with Mintezol, and Combantrin was better tolerated. Neither drug was effective against the Trichuris. The results are compared with those from other parts of the world.

Topics: Adolescent; Ascariasis; Child; Hookworm Infections; Humans; Intestinal Diseases, Parasitic; Pyrantel; Pyrantel Pamoate; Strongyloidiasis; Thiabendazole; Trichuriasis

Pyrantel pamoate at dosage of 10 mg per kilogramme body weight was given to each villager at 4-6 weeks intervals for three times. The infection rates of hookworms among those who received and did not received the drug decreased from 60.5% pre-treatment to 19.6% after the third treatment and then increased to 32.4% one year after the third treatment. Infection rates of A. lumbricoides and Strongyloides spp. among the villagers who received and did not received the drug decreased from 27.5% pre-treatment to 2.2% after the third treatment and then increased to 20.1% one year later for the former, while the latter decreased from 6.5% pre-treatment to 2.3% after the third treatment and 0.4% one year later. The infection rate of T. trichiura was found to increase as pyrantel pamoate had no effect on this nematode. The authors suggested that to obtain more satisfactory results the anthelmintic drug used must likewise be effective against T. trichiura particularly in areas where this nematode is a public health problem. It was also suggested that the duration of treatment should be prolonged.

Topics: Adolescent; Adult; Aged; Ascariasis; Child; Child, Preschool; Female; Helminthiasis; Humans; Infant; Male; Middle Aged; Parasite Egg Count; Pyrantel; Pyrantel Pamoate; Soil Microbiology; Strongyloidiasis; Trichuriasis

In six villages near Isfahan in central Iran 1,455 persons were examined for intestinal parasites. Those with Ascaris infection were treated with pyrantel pamoate in a single dose of 10 mg/kg body weight and all stools passed during 48 hours after treatment were collected in plastic pans and screened for worms which were then sexed and measured. Ascaris infection rates, 87--95% in the six villages before treatment, were reduced to 1--8% (average 5%) and the mean number of eggs in the feces was reduced from 19/mg to less than 1/mg. All age groups and both sexes were about equally infected, and the average number of worms expelled by treatment ranged from 16 per infected person below 5 years of age to 31 per person 20--39 years of age. Mature and immature worms together were expelled from persons treated at all seasons, indicating that worms were acquired and lost continuously throughout the year. Fecal examination at 2, 4, 6, and 12 months after treatment showed that the prevalence at 12 months had returned to the original level (87% vs. 91%) but the average intensity as reflected in egg-counts had not (10 vs. 19/mg feces). The findings confirm the necessity of repeated treatment at 2- to 3-month intervals.

Topics: Adolescent; Adult; Age Factors; Ascariasis; Ascaris; Child; Child, Preschool; Female; Humans; Iran; Male; Parasite Egg Count; Pyrantel Pamoate; Sex Factors

Topics: Ascariasis; Child; Child, Preschool; Female; Hookworm Infections; Humans; Intestinal Diseases, Parasitic; Nematode Infections; Oxyuriasis; Pyrantel Pamoate; Socioeconomic Factors; Strongyloidiasis; Trichuriasis; United States

Topics: Adolescent; Adult; Ancylostomiasis; Anthelmintics; Ascariasis; Child; Female; Fumarates; Humans; Intestinal Diseases, Parasitic; Male; Mebendazole; Nematode Infections; Netherlands; Parasite Egg Count; Pyrantel Pamoate; Strongyloidiasis; Suriname; Thiabendazole; Trichuriasis

The efficacy of mebendazole and pyrantel pamoate was studied in two groups of 59 and 58 cases, respectively, of patients with polyparasitosis. Mebendazole had a cure rate of 96%, 82.2%, 71.4% and 66.6% in A. lumbricoides, hookworm, T. trichiura and S. stercoralis, respectively, while the corresponding figures for pyrantel pamoate were 92.6%, 85.7%, 19.4% and 0%. Pyrantel pamoate is considered to have no significant effect on T. trichiura and S. stercoralis. None of the drugs had any effect on T. saginata. Both drugs have been found to be equally effective against enterobiasis by various authors. It is recommended that pyrantel pamoate be the drug of choice in cases of multiple parasitic infections excluding T. trichiura and S. stercoralis whereas those with one or both of these in addition to others should be treated with mebendazole. Mebendazole can be prescribed for patients with clinical evidence of helminthic infections even where stool examination is not possible as it covers almost the whole range of common helminthic infections. The only limitation for poorer patients however is its cost. Pyrantel pamoate has a wider applicability for the poorer patients in spite of the fact that it is ineffective against trichurids and S. stercoralis.

Topics: Adolescent; Adult; Ascariasis; Benzimidazoles; Child; Female; Hookworm Infections; Humans; Male; Mebendazole; Middle Aged; Pyrantel; Pyrantel Pamoate; Strongyloidiasis

Topics: Ascariasis; Child, Preschool; Female; Humans; Levamisole; Mebendazole; Piperazines; Pyrantel Pamoate

Topics: Amebicides; Anti-Inflammatory Agents; Antimalarials; Ascariasis; Benzenesulfonates; Cestode Infections; Echinococcosis; Entamoebiasis; Hookworm Infections; Humans; Malaria; Niclosamide; Niridazole; Oxyuriasis; Parasitic Diseases; Paromomycin; Pyrantel Pamoate; Schistosomiasis; Strongyloidiasis; Tartrates; Tetrachloroethylene; Tetracycline; Thiabendazole; Toxocariasis; Trichinellosis

Topics: Ascariasis; Child; Hookworm Infections; Humans; Intestinal Diseases, Parasitic; Mebendazole; Nematode Infections; Oxyuriasis; Piperazines; Pyrantel Pamoate; Strongyloidiasis; Tetrachloroethylene; Thiabendazole; Trichinellosis; Trichuriasis

Eleven dogs dosed at approximately the recommended rate of 1.029 mg of pyrantel pamoate/kg of body weight were used. The efficacy against Ancylostoma in the 11 dogs was 99% (av; min-max, 94-99%). In 4 dogs with both Toxocara and Ancylostoma, average efficacy against Toxocara was 96%, and in 5 dogs with both Toxoscaris and Ancylostoma, efficacy against Toxascaris was 93%. Only 2 dogs of the 11 were infected with the 3 species; the average efficacy was 90%. There appeared to be no activity against the Trichuris found in one dog and the Dipylidium found in another. Treated dogs did not vomit or have other noticeable ill effects.

Topics: Ancylostomiasis; Animals; Ascariasis; Dog Diseases; Dogs; Nematode Infections; Pyrantel; Pyrantel Pamoate; Toxocariasis

The most common worm infection in children in the United States is pinworm infection. In second place is roundworm infection. Agents that are effective against these nematodes in a high proportion of cases are available. In hookworm disease, generally seen in older children, tetrachloroethylene treatment is being supplanted by use of drugs less likely to have adverse side effect. Visceral larva migrans is difficult to diagnose and to treat, and our best hope for control lies in prevention.

Topics: Animals; Ascariasis; Bephenium Compounds; Cats; Child; Dogs; Female; Hookworm Infections; Humans; Larva Migrans, Visceral; Nematode Infections; Oxyuriasis; Piperazines; Pyrantel Pamoate; Tetrachloroethylene; Thiabendazole; Trichuriasis

Topics: Administration, Oral; Adolescent; Adult; Aged; Ascariasis; Child; Child, Preschool; Feces; Female; Helminthiasis; Humans; Infant; Intestinal Diseases, Parasitic; Liver Diseases, Parasitic; Male; Middle Aged; Models, Biological; Philippines; Protozoan Infections; Pyrantel Pamoate