Intestinal parasitosis

Intestinal parasitosis - a group of diseases caused by parasitism in the intestines of helminths and protozoa, intestinal parasitosis is very common in children, the peak incidence falls on the age of 7-12 years.

Causes. Among the causative agents of parasitic diseases are:

1. Helminthes, which are divided into three classes:
   • Nematoda (nematode) - round worms;
   • Trematoda (trematode) - flukes;
   • Cestoda (cestoda) - tapeworms.
2. Protozoa.

At present, about 200 species of helminths parasitizing in humans are described; 65 of them are found on the territory of Russia.

Pathogenesis. In the child's body, intestinal parasitosis causes:

• mechanical damage of organs and tissues with direct and neural-reflex disturbance of their functions;
• sensitization of the body by metabolic products with the development of allergic reactions;
• intoxication with decay products;
• immunopathological reactions.

Some types of helminths pass through the whole cycle of life development - from the egg to the mature parasite - in one host, others - in two or three hosts. The host, in which the helminth develops only to the larval stage, is intermediate. The owner, in which the helminth reaches the sexually mature stage, is called the final, or definitive.

Some children may have relatively "peaceful coexistence" of the parasite and macroorganism, which is associated with the individual features of immunity.

The classification of intestinal parasitosis distinguishes the following groups of helminthoses:

• bioglymintoses (diseases transmitted to humans with the participation of animals);
• Gelhelminthosis (diseases transmitted to humans through the external environment),
• contact helminthiases (diseases transmitted directly from the patient or through the surrounding objects).

Symptoms of intestinal parasitosis include signs of damage to the digestive tract (abdominal pain, dyspepsia), manifestations of sensitization (urticaria, dermatitis, etc.), signs of intoxication (lethargy, decreased appetite, etc.). A number of parasites have a specific damaging effect on the host's organism.

Diagnosis of intestinal parasitosis in children is based on clinical epidemiological and laboratory data, from which the discovery of eggs and larvae of parasites in feces, scrapings of perianal folds is important. Some types of parasites require special (X-ray, endoscopic, biochemical, immunological) methods of diagnosis

Differential diagnosis of intestinal parasitosis is carried out with other diseases of the intestine, pathology of the hepatobiliary zone, allergic diseases.

Treatment of intestinal parasitosis is carried out depending on the type of parasite and the disorders caused by it in the body.

Preparations used to treat parasitosis in children

Parasitosis	A drug	Daily dose	Multiplicity of reception	Course
Ascaridosis	Piperazine	75 mg / kg, not more than 3.5 g	In 2 reception inside	5 days
	Dekaris	5 mg / kg	Inside once	1 day
	Pirantele	11 mg / kg	Inside once	1 day
	Vermox	2.5-3 mg / kg, not more than 0.2 g	In 2 reception inside	3 days
Enterobiosis	Piperazine	75 mg / kg, not more than 3.5 g	In 2 reception inside	3 days
	Vankin	5 mg / kg	Inside once	1 day
	Combantrin	10 mg / kg	Inside once	1 day
	Vermox	2.5-3 mg / kg, not more than 0.2 g	Inside once	1 day
Diphyllobothriasis, shadows	Praziquantel	60 mg / kg	In 3 reception inside	1 day
Trichocephalosis	Mebendazole	2.5-3 mg / kg, not more than 0.2 g	In 2 reception inside	3 days
Lambliasis	Furazolidone	6 - 8 mg / kg	In 4 reception inside	10 days
	Metronidazole	15 mg / kg	In 3 reception inside	5 days
	Tinidazole	50 mg / kg, not more than 2 g	Inside once	1 day
	Paromomycin	25 - 30 mg / kg	In 3 reception inside	7 days
	Ornidazole	40 mg / kg, not more than 1.5 g	Inside once	1-2 days

Prevention of intestinal parasitosis in children includes improving the sanitary culture of the population, developing hygienic skills in children, careful processing of food, examination and timely de-worming of domestic animals.

Clinical follow-up after the sanation of most intestinal parasitosis is not required.

Ascariasis is a disease caused by a worm helminth class.

Infection of children occurs alimentary and contact ways. The larva penetrates through the portal system into the lungs, where it rises along the bronchial tree to be swallowed again to return to the intestine. Larvae can cause pneumonia, eosinophilic infiltrates in the lungs. In the intestinal phase, ascaridosis in children can mimic enterocolitis, appendicitis. Typical symptoms include abdominal pain, decreased appetite, nausea, irritability, poor sleep. The diagnosis is established by the detection of ascarids in the feces. For the treatment of piperazine, vermox, decaris, kombantrin.

Enterobiosis is a disease caused by pinworms. Infection occurs by contact. Pinworms parasitize in the lower part of the thin and in the large intestine, to deposit the eggs go into the anal area, which causes itching in the anus and promotes autorinvasion. The diagnosis is established on the basis of detection in perianal scrapings of pinworm eggs or in the visual determination of vegetative forms. Treatment primarily includes hygienic measures that prevent self-infection - washing hands, cutting nails, frequent changing of bed linen and bed linen, daily washing. Dehelminization should cover all members of the family and can be carried out by kombantin, vermox, decaris. Piperazine.

Diphyllobothriasis is a helminthiasis caused by a wide ribbon. It occurs mainly in the basins of large reservoirs. Infection of children occurs when using raw invasive fish in food. A wide ribbon parasitizes in the intestines of the child, attaching to the mucosa with its botryas and traumatizing it.

Disease in children manifested by unstable stool, abdominal pain, nausea, weakness, sometimes develops B12-deficiency anemia. The diagnosis is based on the discovery in the feces of egg lentets and scraps of strobila. Deworming is carried out by prazikvantel (biltricid).

Trichocephalus is a helminthiosis caused by a whipworm (geogelmint, a class of nematodes). Trichocephalosis is prevalent mainly among the population of a warm and temperate climate. A person becomes infected by eating raw vegetables, strawberries, drinking polluted water.

Vlasoglavy live in the large intestine, mainly in the caecum, penetrating the thin anterior end into the mucosa and submucosa. It feeds on vlasoglav surface layers of the mucous membrane and blood. In a day, one sycamore sucks up 0,005 ml of blood. The number of parasites in a patient can reach up to several hundred. The lifespan of the parasite is approximately 5 years. Mechanical irritation of the intestine, caused by invasion of vagal head, may be the cause of motor disorders of the stomach, intestine and gallbladder. Vlacoglav can be a trigger for allergic organism.

The most typical symptoms of trichocephalosis are decreased appetite, nausea, vomiting, abdominal pain, weight loss, pale skin, constipation, less frequent diarrhea, headache, dizziness, irritability, enlargement of the liver. In the analysis of blood in most patients, hypochromic anemia, leukopenia, is found, but eosinophilia for trichocephalosis is not characteristic. The diagnosis is based on the detection of helminth eggs in the feces. In the treatment, mebendazole is used.

Giardiasis is a disease caused by flagellated protozoa. Invasion occurs through food, water and by contact, family foci are possible. Parasitosis can occur with malabsorption, which develops as a result of damage to the mucosa of the upper parts of the small intestine, where the vegetative forms of lamblia parasitize and the cysts are found. Nervous reflex action on other organs is often the cause of dyskinesia of bile ducts, motor and secretory disorders of various parts of the gastrointestinal tract. Giardia in children have a pronounced sensitizing effect, contributing to the development of allergic reactions (urticaria, Quincke's edema, arthralgia). Diagnosis is established when parasites are detected and their cysts in feces or in duodenal contents. For the treatment of Giardiasis use one of the drugs. The course of therapy should be repeated after 10-14 days. With persistent relapsing giardiasis, it is necessary to examine and treat people surrounding the child.

[1], [2], [3], [4]