Table of contents:
- What is ascariasis - description
- Diagnosis of ascariasis
- Overview of the main anthelmintic drugs for children
With the arrival of warm days, children begin active walks and games in the fresh air. And this means that there is a possibility of infection with helminthiases. During this period, parents have to be constantly on the lookout to protect their beloved child from infection. However, this is not at all easy to do. Many helminths are transmitted through soil, which means they can be found in sand, earth and dust. Helminth eggs get there with rainwater, are carried by people on shoes, when transporting sand and soil. In this sense, the most dangerous are geohelminths, in which part of the life cycle occurs in the ground. The most common representatives of geohelminths are roundworms, worms that cause ascariasis.
- What is ascariasis - description
- Development reasons
- Clinical manifestations
- Diagnosis of ascariasis
- Treatment of ascariasis
- Overview of the main anthelmintic drugs for children
- Prevention of ascariasis
What is ascariasis - description
Ascariasis is a parasitic infection caused by ascaris. Roundworms are large worms from the nematode class (roundworms) that are white, pink or yellow in color. Their length can be 40 or more centimeters. These worms are localized, as a rule, in the small intestine, but the migration of larvae can occur throughout the body. Ascaris females are very fertile, they are able to lay about 250 thousand eggs per day.
The eggs enter the soil along with the feces of an infected person. They are capable of staying in the soil for a long time (within 2 years), waiting for a potential host. If there are no conditions suitable for development, then roundworms retain their viability for a long time in an encapsulated state (the capsule is very strong, has five layers). Ascaris eggs are destroyed only when boiled, under the influence of direct sunlight, alcohol or other disinfectants.
When ingested, the eggs enter the small intestine, where the larvae are released from them within a few hours. Then the migratory form of ascariasis begins. Since the larvae enter the bloodstream through the intestinal wall, and from there they enter the heart, liver, gallbladder and lungs with blood flow. A new stage of development of larvae occurs in the lungs, they remain there for up to 14 days. Then the larvae migrate to the oral cavity and, together with saliva, are swallowed again. Once in the gastrointestinal tract, the larvae are localized in their permanent habitat - the small intestine. Here they become adults, reproduce and lay eggs. Further, the eggs of ascaris, together with the feces, go outside, and their life cycle repeats again. The entire development process in the human body lasts 2–3 months.Roundworms parasitize in the body for about a year, then die or leave with feces.
Experts believe that healing from ascariasis with non-massive invasions takes place on its own. In addition, the disease leaves behind a strong immunity. But this does not mean at all that you should not carry out anthelmintic therapy and let the disease take its course. After all, being in a child's growing body, roundworms do him great harm. First of all, it is an allergization of the body and mechanical damage, which provoke worms migrating through the body. They are able to rupture capillaries in the small intestine, lungs, liver, resulting in extensive hemorrhages.
Infection with parasitosis occurs for several reasons, but most often the reason is quite trivial - it is non-observance of basic rules of personal hygiene. Potential victims of ascariasis are young children of preschool or primary school age. Infection can occur at any time, as Ascaris eggs are spread through dirty hands and food.
So, the main ways of infection in a child:
- dirty hands;
- eating unwashed vegetables, berries and herbs;
- contact with grass, soil and sand;
- drinking dirty water;
- door handles of various establishments;
- public transport;
- pet hair.
The peak of all infectious diseases occurs in late summer and early autumn. Parasitic infections are no exception, since during the warm season, the largest number of eggs with already matured larvae accumulates in the soil.
Signs of ascariasis in children depend on the degree and intensity of helminthic invasion. As a rule, this disease has two stages of development:
- migration stage (early acute);
- intestinal stage (late chronic).
With small helminthic invasions, ascariasis may proceed in an erased form, or its symptoms may be completely absent.
At the initial stage of the disease, symptoms of intoxication and allergies appear. During migration through the body, the larvae secrete their waste products, which cause severe allergization of the body. With the penetration of larvae into the liver and lungs, symptoms from the gastrointestinal tract are observed:
- loss of appetite;
- stomach ache;
- upset stool;
- enlargement of the liver and spleen;
- stagnation of bile;
- allergic skin rash;
- deterioration in general health.
When they migrate to the lungs, symptoms from the respiratory system develop:
- coughing up phlegm;
- heavy sweating;
- swelling of the eyelids and face;
- wheezing in the lungs;
- rash and itching on the skin;
- leukocytosis and eosinophilia in the blood;
- swollen lymph nodes;
- temperature increase;
- muscle pain.
With complicated helminthiasis, pneumonia and pleurisy, granular hepatitis and myocarditis may develop. Against this background, the body's defenses are weakened and its general allergization continues.
These are the symptoms of the first migratory stage of ascariasis.
At the intestinal stage, when the larvae again enter the intestines and begin to actively grow and multiply there, then symptoms characteristic of diseases of the gastrointestinal tract appear. It can be observed:
- decreased acidity of gastric juice;
- insufficient production of gastric juice;
- decrease in enzyme activity;
- deterioration in food digestion;
- obstructive jaundice;
- intestinal colic;
- weight loss;
- inflammation of the mucous membrane of the stomach and intestines.
Due to the suppression of the beneficial intestinal microflora, the immunity of the whole organism begins to suffer, which is getting worse and worse with its protective function. Therefore, the child constantly has secondary diseases in the form of viral and infectious diseases. Children's infectious diseases are complicated and last for a very long time.
Also, the child has complications from the nervous system:
- nervousness and moodiness;
- fast fatiguability;
- delay in physical development;
- hysterical or convulsive seizures;
- violation of concentration of attention;
- decreased memory;
- restless sleep.
An active and cheerful child suddenly becomes moody, irritable and restless.
In the process of migration of larvae, ulceration, perforation of the intestinal walls and micronecrosis are often observed. With massive and neglected invasions, serious complications are observed, which can sometimes threaten the life of a child:
- appendicitis (when ascaris penetrates there);
- inflammation of other organs and systems (kidneys, brain, heart);
- intestinal obstruction;
- ulceration of the small intestine;
- perforation (violation of the integrity) of the walls of the small intestine.
Diagnosis of ascariasis
Only a specialist diagnoses the disease. It includes several stages:
- collection of anamnesis;
- observation of symptoms;
- feces studies for helminth eggs;
- clinical blood test;
- microscopic smear of sputum (larvae may be in it);
- X-ray of the lungs (the picture shows eosinophilic infiltrates in the lungs);
- serological blood test (show an increase in antibodies).
In some cases, roundworms can be accidentally discovered during surgeries and endoscopy, which are performed in pediatric surgery.
Treatment of ascariasis
Treatment of ascariasis includes a complex of therapeutic and prophylactic measures, which is carried out in several stages according to a certain scheme. Treatment regimen for ascariasis in children:
- Preparatory stage. First of all, it is necessary to save the child from intoxication caused by the products of the vital activity of helminths. For some time, the child is given sorbents.
- Treatment with antihistamines. With the help of antihistamines, symptoms of allergy, intoxication and inflammation are stopped.
- Treatment with anthelmintic drugs. Preparations of a wide and narrow spectrum of action reliably destroy ascaris.
- Anthelmintic therapy. After antihelminthic therapy, it is necessary to remove the dead helminths from the body. In this case, the child is given laxatives along with sorbents. Also at this stage, the child is prescribed hepatoprotectors (drugs that protect the liver).
- Diet. Diet is necessary at all stages of antihelminthic therapy. During the period of treatment, the child's diet should be dominated by fermented milk and protein products, fresh vegetables, herbs and fruits. Refined and other carbohydrates (sugar, buns, bread and pasta) are excluded.
- Cleansing enemas. Cleansing enemas are used to cleanse the colon. The first enema is done one day after taking the antihelmite agent. Further, depending on how many days the treatment lasts.
Overview of the main anthelmintic drugs for children
Ascariasis responds well to treatment and, subject to the rules of personal hygiene, you can quickly and easily get rid of this helminthic invasion. However, parents should remember that children cannot be treated on their own. Only a specialist prescribes the correct dose and treatment regimen, depending on the age, weight, intensity of helminthic invasion and the current state of health of the child. In addition, antihelminthic therapy is prescribed individually for each child. In addition, at an early stage, some drugs are prescribed, and at a later stage, completely different anthelmintic drugs.
Drugs for the treatment of the early stage of ascariasis:
Also during this period, antihistamines, bronchodilators are prescribed; corticosteroids. With helminthic invasion in infants, Albendazole is prescribed, and Piperazine is prescribed for children older. At the intestinal stage, Levamisole Mebendazole (Dekaris) or Kombantrin (Pirantel) are prescribed. These drugs are consumed no more than 3 days. Naphtamon is a low-toxic drug. Medamin for children with ascariasis provides for a single dose, and Mintezol is taken against the eggs and larvae of ascaris. All anthelmintic drugs have a bitter taste, so they can be slightly diluted with honey.
Prevention of ascariasis
Prevention of this helminthiasis can be both primary and secondary. The most important prevention of infection with ascariasis is to observe the rules of personal hygiene. Therefore, parents must first of all teach the child the rules of personal hygiene:
- washing hands after using the toilet and before eating;
- washing hands after contact with animals;
- a ban on food during outdoor games;
- a ban on eating unwashed fruits and vegetables;
- prevention of contamination of sandpits and playgrounds with animal feces;
- drinking only pure water.
Secondary prevention of ascariasis consists of:
- in the regular conduct of sanitary and epidemiological measures;
- timely identification of infected children in preschool and school groups;
- timely treatment of patients with ascariasis;
- disinfection of public places;
- neutralization of sewage;
- deworming of domestic dogs and cats;
- disinfectant treatment of tap water.