Few local hospitals could have caught worm in brain, say experts

Had she lived in Kenya, a woman from whose brain doctors pulled out a living worm, would probably have died undiagnosed.

Australian medics on Monday said they pulled out an eight-centimetre parasitic roundworm from a 64-year-old woman, in the world’s first such case.

They documented the case in the September edition of the Journal Emerging Infectious Diseases.

Kenyan biomedical engineers said the discovery was made possible through CT scans and Magnetic Resonance Imaging (MRI) technology in Australia.

Engineer Millicent Alooh, the national secretary general of the Association of Medical Engineering of Kenya (Amek), said MRIs are the safest scans for the brain because they do not use any radiation.

“It creates detailed images of nearly every structure and organ inside the body. MRI uses magnets and radio waves to produce images that show organs, bones, muscles and blood vessels,” she said.

“But most public health facilities in Kenya do not have them because they are very expensive,” she said.

Neurosurgeons at the hospital in Australia said the 64-year-old woman was first admitted in late January 2021 after suffering three weeks of abdominal pain and diarrhoea, followed by a constant dry cough, fever and night sweats, according to the Guardian.

By 2022, her symptoms also included forgetfulness and depression, prompting a referral to Canberra hospital.

An MRI scan of her brain revealed that a motile helminth - a parasitic roundworm - was living in the right frontal lobe lesion of her brain.

Dr Sanjaya Senanayake, an infectious diseases physician at the Canberra hospital where the woman was admitted, said: “Neurosurgeons regularly deal with infections in the brain, but this was a once-in-a-career finding. No one was expecting to find that.”

Identified as a third-stage larva of the Ophidascaris robertsi nematode species, the case is unprecedented in medical history.

Typically, this parasitic worm lives in the digestive tracts of carpet pythons indigenous to the Australian state of New South Wales.

Medical professionals suspect the woman inadvertently ingested the worm's eggs by eating edible grasses that were tainted with snake faeces, however, the actual cause cannot be confirmed. One egg hatched into a worm and moved to the brain.

Engineer Alooh said advanced imaging facilities are important because of such increasing cases of diseases jumping from animals to people.

“It's important to have these imaging equipment our health facilities. They can detect tumours and abnormalities in internal organs including kidneys and livers. We also have ultra-sound. It’s a good investment and the government should not look back on these,”

She said most people who need scans have to travel long distances to towns. “We also need more biomedical engineers to maintain these equipmenr and empower them with factory trainings because the equipments are not made here in Kenya,” Eng Alooh said.

Kenyan neurosurgeons did not comment on the findings.

In Kenya, infections with the Taenia solium (pork tapeworm) are probably the best known for brain infection. When the infection reaches the brain, people develop neurocysticercosis, the most serious complication of the disease.

In 2020, researchers from Kenyatta University said in Thika — the top pork consumer in urban Kenya — 6.3 per cent of meat lovers are infected with pork tapeworm. Only a few have brain infection.

 Those infected are largely pork consumers who eat the undercooked version that is popular in urban areas.

“Majority of the cases were among participants who had lack latrine facilities and those who preferred fried pork,” researchers said in the study, published by the African Journal of Rural Development.

They are Peterson Warutere of KU’s Department of Environmental and Occupational Health, Purity Nguhiu and Lucy Kabuage of the Animal Science department, Kabui Kinyua from the Department of Zoological Sciences and Powell Kanina from Kiambu Level 5 Hospital.