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This pathology can be encountered all over the world, however, according to the frequency of detected cases, the territories of the tropical and subtropical climate prevail, this is explained by the peculiarities of the life cycle of the helminth. The pathogen is especially dangerous for children aged 3-14 years, since hygiene measures are not always performed by them to the fullest.
- What is hymenolepiasis?
- How is hymenolepiasis diagnosed?
- Where and why to get tested for hymenolepiasis?
- When and who needs to be examined?
- Folk remedies
What is hymenolepiasis?
Hymenolepiasis is a disease associated with the penetration and parasitism in the human body or small rodents (rats, mice) of helminths, represented by dwarf or rat tapeworm, respectively, and is characterized by a predominant lesion of the small intestine.
The dwarf tapeworm belongs to the class of tapeworms and is a parasite (tapeworm) up to 4 cm in size.This cysticercoid has a body, represented by 150-300 segments, some of them contain eggs, these areas are separated from the individual and undergo further growth and reproduction in organism. The parasite also contains a head, which has suction cups and hooks for attaching to the intestinal mucosa.
The source of the invasion (intermediate and final host) is a person infected with hymenolepiasis. The infection has a fecal-oral transmission mechanism (through dirty hands, vegetables and fruits, household items). Clinical manifestations are observed 2-3 weeks after infection. During this time, the tapeworm goes through two phases of development in the body:
- tissue (release of the larva from the egg and introduction into the villi);
- intestinal (the formation of a cysticercoid and its penetration, thanks to the hooks, into the intestinal wall);
Hymenolepiasis is characterized by autoinvasion, in which the dwarf tapeworm reaches maturity in the intestine (intraintestinal form) without releasing eggs into the external environment (extraintestinal form).
The disease can be asymptomatic (subclinical) or with the development of the following syndromes:
- Astheno-neurotic. Symptoms such as headache, increased fatigue, dizziness, weakness, and irritability are typical.
- Painful. Manifested by paroxysmal abdominal pains.
- Allergic. Against the background of hematogenous spread of the pathogen, urticarial rash, skin itching, vasomotor rhinitis, asthmatic bronchitis may occur.
- Dyspeptic. It is characterized by diarrhea (mucus, blood in the stool), nausea, vomiting, heartburn, bloating, loss of appetite, weight loss.
If autoinvasion has occurred, then the manifestations of hymenolepiasis will be as follows:
- frequent urge to vomit;
- severe abdominal pain;
- reduced level of intellectual activity (attention, memory)
- sleep disturbance manifested by insomnia;
- increased body temperature;
- decrease in hemoglobin.
Children infected with this helminthiasis have a more severe course of the disease, represented by:
- Weight loss;
- Enlarged liver;
- Exhaustion manifested by constant thirst;
- Decreased cognitive function.
How is hymenolepiasis diagnosed?
In order to make a preliminary diagnosis of hymenolepiasis, it is necessary to be based on:
- clinical data. In addition to the main symptoms of helminthiasis, it is especially important to pay attention to allergic reactions of unclear etiology. In this case, patients may complain of rashes, asthmatic bronchitis, itching of the skin, arising without any external influence.
- data of physical diagnostic methods. Determination of pain along the affected intestine with pressure, dry skin, enlarged liver, rashes and their nature.
- the results of a blood test (an increase in eosinophils and ESR, a decrease in hemoglobin).
- epidemiological history. In the absence of identified hymenolepiasis among the patient's environment, it is difficult to assume the disease. This is due to the fact that patients deny non-compliance with hygiene rules.
The final diagnosis can be made only on the basis of laboratory research:
- Microscopic examination of feces. The collection of material is carried out three times, every two to three weeks. It is important to collect feces for hymenolepiasis in the morning of the study day. A native smear is used for massive infection (a large number of eggs are released).
- Flotation. Weak invasion (feces contains few helminth eggs) is an indication for this technique. It is carried out after provocation with drugs.
Where and why to get tested for hymenolepiasis?
You can take an analysis for hymenolepiasis and enterobiasis (as a rule, they are tested together) in polyclinics and specialized laboratories. Results can be obtained the next day. After that, the district pediatrician or therapist issues a certificate of health, presented at the place of demand and valid for 6-12 months.
Research is being conducted for the following reasons:
- with a preventive purpose (early detection and medical examination);
- to confirm the diagnosis;
- to avoid the spread of pathology and its transmission in collectives;
- for differential diagnosis with other types of helminthic invasions;
- for differential diagnosis with diseases of internal organs (oncology, bacterial or viral infections, inflammatory lesions of the gastrointestinal tract, poisoning).
When and who needs to be examined?
The doctor determines the indications for diagnostics of feces for eggs, and gives the appropriate direction. The specialist is based on specific complaints, epidemiological anamnesis, objective data and the results of a general blood test. However, there is a group of people (decreed contingent) who must be screened for hymenolepiasis every 6 months in order to prevent and prevent the spread of infection.
The decreed contingent includes persons working:
- in large teams and in direct contact with people (kindergartens, schools, hotels, medical institutions, hairdressers, etc.);
- in the food industry (distribution points, factories, canteens, canteens, etc.);
- in water supply networks;
- The drug of choice in the treatment of hymenolepiasis is Praziquantel (Biltricid). It is used once inside at the rate of 25 mg / kg.
- The reserve group includes Niclosamide (Fenasal). The treatment regimen with this remedy is not simple and has a cyclical approach (3 stages of 7 days with an interval of 5 days. 1st day - 2 grams, the remaining days - 0.5 grams, while on the first day of each stage, 3 hours after administration means, a laxative is given). But it is not sold in Russia.
- pumpkin seeds (in the form of an infusion, mixed with garlic or raw), you need to use 200 gr. in the morning on an empty stomach for 3 days;
- wormwood broth. You should drink ¼ glass 3 times a day on an empty stomach;
- infusion of tansy. 1 sip before meals.
- Sanitary educational activities among children and workers (training in hygiene standards).
- Carrying out regular wet cleaning in the foci of infection, the premises of children's groups, catering facilities.
- Medical examinations with research for helminthiasis among children entering kindergartens or schools, newly hired workers in these institutions and part of the population related to the food industry.
- Timely diagnosis and treatment of hymenolepiasis in patients.