358 collection is best done in the morning prior to a bath and/ or washing the periana J region like in defecation. Specific drugs must be administered. Personal hygiene like proper hand washing and keeping finger nails short must be advocated. Contaminated linens and clothing of the patient must be properly sterilized t J,rough boiling. SOIL-TRANSMITTED PARASITES Some para. sites. ire p11ssed out into tl1e soil, where they undergo further development until they become inf~tive. These parasites remain as major public health problem not only in the Philippines but in many tropical and subtropical countries as well. Children who live in areas where there is unsanitary human fecal disposal are often infected by soil-transmitted parasites. Ascaris lumbricoides This is also known as the giant intestinal roundworm. Adult roundworms live in the small intestines. Fertilized and unfertilized eggs are passed out by tbe female ascaris. ln about two weeks, fertilized eggs develop in the soil into embryonated stage which is the infective stage. Soil is commonly contaminated in areas where there ax-e no sanitary toilet facilites or where human fe:ces is used as fertilizer in vegetable gardens. Man acquires infection when these infectiveeg. gsare swallowed mainly via contaminated food. Upon ingestion, the larva is released from the eggs and then undergoes lung migration. During this larval migration, the patient will usually manifest pulmonary symptoms like chest pain, cough and fever. Toe parasite will then settle in the small intestines to develop into the adult stage (See Illus. 15. 3). With the presence of adult' ascaris, the most common SYffiptom is vague abdominal pain. At times patients may harbor a high number ofwormsresulting to intestinal obstruction. Some vomit out these :1dult wom1s as well. There are reported cases when adult worms undergo em:itic migration to other organs like the liver and even the common bile duct. Ascariasis is established ·when adult wonns are expelled by the patient. However, expulsion of the adults does not happen all the time, so in the laboratory, stool e.-:amination is done to determine the presence of fertilized or unfertilized eggs. Techniqu es recommended include the d. irect fee. al smear and the Kato thick smear preparation. To determine the intensity of infection, tbe Kato-Katz (which is n quantitative metl1od) is recommended. Tho patient must be properly treated periodically with broad spectrum anthelmintic, because rapid re-infection bas been reported. Stools should be properly disposed and sbou Id not be used !IS fertilizer. Proper hand washing must also beencou raged. Vegetables that are usually eaten raw must be thoroughly washed before consumption. 