Table of contents:
- What is scraping for enterobiasis
- Enterobiasis analysis
- In what cases is the study assigned?
- Causes of the disease
- Symptoms of enterobiasis
- What groups should be examined for enterobiasis
- Preparation for the procedure
- Analysis technology
- Decoding of the obtained results
- Analysis preparation time
- The most common mistakes in the analysis
- Why pinworms are rarely detected in feces
- What is the reason for such a diagnostic search
- Is it possible to fence material at home
- Other methods for the diagnosis of enterobiasis infection
- Treatment and prevention of enterobiasis
Analysis of feces (scraping) for enterobiasis - detection of pinworm eggs (helminths, the clinical manifestations of which are itching in the anal area and intestinal disorders). General analysis of feces is not suitable for diagnosing this disease due to the morphobiological characteristics of pinworms. Scraping for enterobiasis is the most informative diagnostic method; it can be carried out in the shortest possible time.
The content of the article:
- 1 What is scraping for enterobiasis
- 2 Enterobiasis analysis
- 3 In what cases is the study assigned?
- 4 Causes of the disease
- 5 Symptoms of enterobiasis
- 6 What groups should be examined for enterobiasis
- 7 Preparation for the procedure
- 8 Technology of delivery of analysis
- 9 Decoding of the results obtained
- 10 Timing of preparation of analysis
- 11 The most common mistakes in the analysis
- 12 Why pinworms are rarely detected in feces
- 13 What is the reason for such a diagnostic search
- 14 Is it possible to take material at home
- 15 Other methods of diagnostics of enterobiasis infection
- 16 Treatment and prevention of enterobiasis
What is scraping for enterobiasis
Enterobiasis is a disease caused by small parasitic worms - pinworms. The pinworms do not exceed 1 cm in length. Usually one end of this worm is pointed (hence the name), and the other is rounded.
The color of parasites can vary from whitish or yellow to dark or even black. Live pinworms can crawl or wriggle. Pinworms are nocturnal: it is at night that females enter the rectum and onto the skin around the anus, causing discomfort and itching, lay eggs in the folds of the skin and die.
Infection occurs through dirty hands or contaminated objects. A child, scratching or touching the skin in the perineum, contaminates the hands with eggs of worms. Infection can also occur when the hands are contaminated from bedding or underwear, where eggs get from the body of a sick person. Flies and cockroaches have been proven to play a role in transferring pinworm eggs.
Re-infections through the anus are possible, when individuals matured to the larval stage move from the skin to the intestines. Enterobiasis is very common and is considered the most common infection in the world. In some children's groups, up to 100% of children are infected with pinworms.
The analysis of feces for enterobiasis should be taken from three different sites so that the result is as accurate as possible. The collected material is immediately delivered to the laboratory. In order to deliver the feces to the laboratory, from where it will be sent for research, you need to purchase a special plastic container with a lid. Feces should be donated several times, since it is not always possible to find parasite eggs in it. In order for the analysis to be as accurate as possible, before collecting feces. do not wash away.
Additionally, a blood test is performed, which is able to show anemia and eosinophilia in the presence of helminths. How is the test taken: blood sampling is carried out strictly on an empty stomach in the morning, you can drink only a little water.
Even if you know how to correctly take an analysis for enterobiasis, and how to collect feces for this analysis, the results may not be enough to establish an accurate diagnosis. In such cases, if the patient has all the signs characteristic of worm infestation, an analysis is made for enterobiasis using PCR. Girls and women may be assigned an examination by a gynecologist to exclude inflammation in the genitals.
But the most reliable of all is the study of fresh scraping for enterobiasis. It is recommended to pass scraping for enterobiasis at least three times with an interval of two weeks between them.
In what cases is the study assigned?
Scraping on the egg-leaf allows to establish the fact of invasion with a probability of 50%. To get a more accurate result, experts recommend passing the study several times with a short break.
Taking a scraping for enterobiasis is mandatory in such cases:
- employment in enterprises whose activities are related to products;
- upon admission to a preschool or school educational institution;
- upon admission to the hospital;
- when opening a medical card;
- before visiting the public pool.
Causes of the disease
Various types of parasites can be found in adults and children. This disease is very common among children under the age of 10, which is associated with non-compliance with many rules of personal hygiene. Enterobiasis is characterized by damage to the small and large parts of the intestine, as a result of which the whole organism becomes allergic. In case of severe infection, pinworms in women can be found even in the uterus, vagina or pelvic cavity.
Infection usually occurs through the fecal-oral route when interacting with a sick person. This is due to the fact that a child or adult infected with helminths may not wash their hands after using the toilet and spread the eggs of parasites on household items. In an open environment, these worms do not die immediately and are highly resistant to disinfectants.
You can get infected through any objects or things:
- someone else's linen;
Symptoms of enterobiasis
It is possible to suspect infection with helminths almost immediately (especially in young children), since the disease is accompanied by pronounced characteristic signs.
In some cases, all symptoms may be erased or completely absent, but most often the sick person is worried about the following symptoms:
- severe itching in the anus;
- stomach ache;
- scratching in the anal area;
- severe fatigue;
- losing weight;
- increased appetite.
In addition, nighttime urinary incontinence, nausea, loose stools, vomiting, and bloating sometimes occur. A child with enterobiasis becomes very lethargic and capricious, falls asleep poorly and begins to grind his teeth in his sleep.
Additional complaints may include rumbling, flatulence, headache or dizziness. Prolonged helminthic invasion may be accompanied by signs of dysbiosis, discomfort in the perineal region in girls, and inflammatory gynecological diseases.
In the absence of treatment and a long course of the disease, the following consequences occur:
- Memory impairment.
- Decreased immunity.
To establish the diagnosis of enterobiasis, you need to undergo a medical examination, which includes examination for parasite eggs, analysis - scraping for enterobiasis, blood donation for enterobiasis testing (antibodies to worms). An analysis for enterobiasis is prescribed by the attending physician, how to take such an analysis correctly, he will tell you.
For a disease such as enterobiasis, examination is necessary before admission to the hospital, admission to a kindergarten or school, and also before issuing a certificate for classes in the pool. The doctor must inform the patient and explain to him what an analysis for enterobiasis is, how to make a scraping and give a referral for examination. Tests for enterobiasis can be taken in a commercial laboratory or in a regular one at a state clinic.
What groups should be examined for enterobiasis
Not only persons with suspected enterobiasis are subject to research, but all children attending preschool institutions, schoolchildren of grades 1-4 and personnel of children's institutions should be examined once a year.
Food group workers and all persons equated to them, persons receiving a certificate for visiting the pool, as well as applicants. In addition, all children admitted to hospital of any profile and sanatorium-resort treatment are also subject to additional examination for enterobiasis.
If in children's groups, during the examination, more than 15% of cases of infection were found, then no further search is carried out, and all babies are subject to compulsory treatment.
Preparation for the procedure
Examination of scraping for enterobiasis does not require special preparation from the patient.
But to get objective results, you should strictly follow the following rules:
- Samples must be collected in the morning before the time the person has completed the usual personal hygiene procedures.
- It is optimal to send the source material to the laboratory immediately after collection. Before the start of the study, the scraping is stored at certain temperature indicators - from 4 to 8 ° C.
- Pinworms, like other worms, go through certain stages in their development. Therefore, egg-laying does not occur every night. Determining the time when to take a scraping is easy - just observe the patient. If his sleep is restless, involuntary scratching of the anus zone was observed, then you can take a scraping on the eggs of the worm.
- Before starting the procedure, children must undergo moral training.
Hygiene procedures before taking the analysis are allowed only the day before. The use of disinfectants is strictly prohibited, as they will destroy the eggs of the worms, ready to leave their host, and make the analysis unreliable.
A trip to the clinic or self-sampling of material should be postponed if a person has performed an act of defecation - this also reduces the reliability of the research result.
The practice of infectious disease specialists shows that employees of laboratories of medical institutions are engaged in the collection of material for scraping. Today, the technique of taking scrapings for enterobiasis is carried out in two ways.
- a cotton swab and a glass jar are being prepared;
- the stick is moistened with purified water or glycerin and held along the folds near the anus;
- the sample stick is placed in a jar or container and tightly closed
This technique is also known as perianal scraping.
- special adhesive tape or ordinary scotch tape is used, as well as sterile laboratory glass;
- the tape is glued to the anal area, capturing the skin. Important - be sure to avoid getting air under the tape. To do this, you should spread the buttocks as far as possible and only after that manipulate;
- the tape is carefully peeled off and glued to the glass.
The analysis obtained in this way should be delivered to the laboratory as soon as possible.
Therefore, before carrying out scraping for enterobiasis by this method, it is important to find out where to donate a sample taken at home.
It should be noted that the collection of an analysis for enterobiasis at home is allowed in a number of cases:
- if you need to conduct research in a person with a disability;
- children of the first year of life.
In this case, preparation for scraping for enterobiasis is no different from the actions in the case of passing the analysis in a laboratory.
Decoding of the obtained results
The ideal scraping results are that there are no traces of any parasites, regardless of type. However, it should be remembered that pinworms are characterized by a frequent change of generations and the laying of eggs with some frequency.
Therefore, in order to get a valid, correct result, it is important to be examined at least three times in 1-2 days. It is also important to know how and how they take a scraping for enterobiasis.
In the case of pinworm infestation, positive results may look like this:
- low degree of infection, i.e. In humans, single samples of parasite eggs were found in the test material. It is marked in the "+" result sheet;
- medium - several pinworm eggs were found. "++" is marked;
- high degree - a large number of eggs are detected. Marked as "+++".
If the results obtained are repeated three times, the therapy of the condition is necessarily prescribed. With a timely visit to a doctor, the treatment has a positive outcome.
You should know that with a single sampling of material for enterobiasis, a false-negative result is obtained. It is not uncommon for the human immune system to suppress the vital activity of parasites. The invasion can be judged solely by local characteristics.
But even in this case, the doctor prescribes treatment. When choosing the prescribed drugs, he focuses exclusively on the results of the examination and questioning of the patient.
Analysis preparation time
For the examination of material taken as a result of scraping, the laboratory, as usual, takes no more than one working day.
Under the condition of the minimum load of laboratory technicians, the analysis is prepared within a few hours. Accordingly, a certificate can be issued on the day of delivery of scraping for enterobiasis, but most often this happens the next day.
The most common mistakes in the analysis
For correct and accurate diagnosis, it is very important not to make mistakes when sampling biological material.
The result is influenced by the slow delivery of the test sample to the laboratory, determination of helminthiasis during the period of taking medications, such as antibacterial drugs, antidiarrheals or laxatives, antacids. You should refuse to accept them at the time of taking the tests or, if this is not possible, notify the laboratory.
Unfair and poor-quality work of laboratory technicians (incorrectly prepared material or lack of persistence when examining the slide) often leads to failure in the analysis of feces. It is important to remember that microscopy of the material during the period when the female stops laying eggs (silent period) will also show a false negative result.
Why pinworms are rarely detected in feces
The generally accepted analysis of feces for helminth eggs to detect enterobiasis is not very informative, due to the morphobiological characteristics of pinworms, since they do not lay eggs in the intestinal lumen. That is why scatological methods of laboratory diagnostics rarely reveal helminths.
Standard microscopy of stool is usually used to detect the eggs of other parasitic worms (roundworm, opisthorchus, tapeworm, etc.).
Scraping of the perianal folds and microscopy is the most effective way to detect the eggs of Enterobius vermicularis pinworms. Of course, if adults were found in their underwear or the anus, during the laying of eggs, then the diagnosis of enterobiasis is beyond doubt.
What is the reason for such a diagnostic search
Laboratory research is based on the helminth development cycle.
All processes of maturation and fertilization of the parasite take place in the distal part of the small intestine, after which the females with ripe eggs descend into the rectum. Actively crawling out of the anus, they lay up to fifteen eggs in the perianal folds, on the skin and die.
The eggs laid are fully ripe after an average of five hours. The movement of females during laying causes irritation and severe itching. Children, by scratching the perianal region and perineum, contaminate their hands and re-swallow eggs, from which larvae emerge in the duodenum. The life span of pinworms is two to four weeks.
Is it possible to fence material at home
The Rabinovich method can also be used at home, be sure to comply with all the above rules for sampling. Instead of a sticky spatula, you can also use a cotton swab with glycerin, which will also need to be placed in a test tube that closes tightly. On the test tube, you must indicate the name, year of birth and address of the subject.
Adhesive tape technology is also good at home. To do this, you need to contact the laboratory to obtain not only the tape itself, but also two clean slides.
Observing the technique of correctly taking the material, apply the tape to one glass, and close it tightly with the second from above. As in the case of imprinting on a transparent spatula with a sticky layer (according to Rabinovich), the material must be delivered to the laboratory within two hours.
It is important for mothers to remember that the correct diagnosis and further treatment depend on their technique of taking the material, the time and temperature of storage.
Other methods for the diagnosis of enterobiasis infection
In addition to scraping from perianal folds and its various modifications, a number of other laboratory tests are used to diagnose enterobiasis. First, helminth invasion is often accompanied by reactive changes in the peripheral blood. In the KLA, an increase in the level of eosinophils is found (more often relative eosinophilia than absolute).
Do not forget that the content of these cellular elements of the blood also increases in case of allergic diseases. This option cannot be considered reliable, but persistent blood eosinophilia prompts the doctor to also think about helminthic invasion.
All of the above facts indicate that attempts to diagnose helminthiasis do not always give one hundred percent results. This is due to the possibility of diagnostic errors as a result of improper sampling, falsification of material for research, asymptomatic course of minor invasion of enterobiasis.
Because of this, pinworm invasion currently remains a low-diagnosed pathology. The study of new information-specific verifiers of parasitic infection available to the population remains relevant to this day.
Treatment and prevention of enterobiasis
If the presence of helminthic invasion has been confirmed, you need to act immediately. In this case, it is necessary to mentally prepare for long-term treatment, because cases of self-infection are possible. To expel worms from the body, special medications are used. They have a detrimental effect on the metabolic processes of worms and their viability. Already after the first time, a large number of parasites are excreted, and their number decreases with each drug intake.
After each intake of a course of drugs, it is necessary to take tests to understand whether the treatment helped. In the future, it is imperative to restore the disturbed intestinal microflora with special bacterial preparations. During the entire time of treatment, the house must be thoroughly cleaned using disinfectants.
The bed and underwear must be changed every day (it is imperative to wash it, boil it and iron it). Children need to be taught to follow the rules of personal hygiene and weaned from the habit of biting their nails or licking their fingers.
Prevention of enterobiasis consists in following a number of rules that will help avoid re-infection with worms. First of all, it is recommended to keep your hands clean and try to cut your nails short, as well as regularly and thoroughly clean under the nails.
You should try to wean a small child from the habit of taking other people's toys or things. It is better for babies to wear panties with loincloths for the night, so that the eggs of helminths, after being laid by the female, do not fall on the bed and do not spread around the apartment. Periodically, you need to clean and dust all carpets, sofas, pillows and mattresses. Only vegetables, fruits and herbs processed with boiling water can be eaten. If all these recommendations are followed, in combination with drug therapy, it will be possible to avoid re-infection with helminths and guaranteed to get rid of parasites.
Find out more:
- Scraping for enterobiasis: how to get tested for a child
- Enterobiasis scraping - how they take an analysis for enterobiasis in children
- Analysis for enterobiasis: how it is carried out and how to prepare for it