Intestinal Ascariasis in Nigerian Children by N. E. N. AGUGUA, * Consultant Paediatric Surgeon

Ascaris lumbricoides (roundworm) is the commonest intestinal parasite. It affects patients of all ages and most systems of the body. Though the infestation is world-wide, it is more prevalent in tropical countries and especially under conditions of poor personal hygiene and soil pollution. There is now increasing awareness among parents in our environment of the harmful effects on children of this intestinal parasite. Many symptoms such as abdominal colics and cramps, failure to thrive, visible peristalsis, grinding of teeth, anorexia, intestinal noises, offensive stools, etc. have been associated with these worms, and parental medication of child with vermifuge has consequently become a common practice. This review highlights the danger of the one-dose vermifuge in the patient with a high population of intestinal ascarids, and attempts to explain the age prevalence of the infestation in children. Methods and Management Records were obtained of 150 children with estab-lished intestinal ascariasis seen at the University of Nigeria Teaching Hospital (UNTH) between January 1976 and December 1979. One hundred and ten children were treated as out-patients, and 40 patients were hospitalized Patients treated and discharged from the casualty department have been excluded from the series as most of them did not conform to the criteria set below. Excluded also were cases of incidental findings of the nematode in the intestine of patients being treated for other conditions. Patients included in the series were those with abdominal symptoms (Fig. 1) in whom a diagnosis of the intestinal worm was made according to any one of the following criteria: (i) Vomiting of ascand worm, (ii) Passage of ascarid in faeces, (iii) Palpation of worms in the rectum on digital examination. (iv) Microscopic diagnosis of the ova of ascarid in stool. The cases were analysed with respect to the age incidence, symptomatology, and surgical manage-ment