In a dutch oven or large saucepan, brown ground beef and onions. Add garlic and cook an additional minute until fragrant.
Stir in salt, pepper, worcestershire, mustard, chili powder, ketchup.
Add uncooked macaroni, water, cream cheese and sour cream. Bring to a low simmer. Cover and cook for about 15 minutes until macaroni is cooked, stirring halfway through.
Remove pasta from heat and stir in cheddar cheese. Sprinkle with fresh parsley and serve immediately.