Helminthiasis – parasitic diseases caused by worms – round and flat, rarely ringed and koljuchegolovye parasitic worms. For helminth infections characterized by a chronic course and systemic effects on the body with the development of the abdominal, allergic, anemic syndromes, and chronic toxicity; pulmonary, liver, biliary tract, brain, organ of vision.
In the diagnosis of helminthiasis applied laboratory (helminthotheca, gelmintological, serological) and instrumental (x-ray, endoscopy, ultrasound, etc.) methods. Treatment of helminthiasis depends on the type of parasite and includes the specific (de-worming) and pathogenetic therapy.
Helminthiasis – worm infestation caused by different species of lower parasitic worms – helminths. Helminth infection has a chronic course, accompanied by the exhaustion and decline of its natural defenses. In the structure of helminth infections leading places belong to the enterobiasis, ascariasis, hookworm, and toxocariasis trihozefaleza. According to official statistics, the invasion of the Russian population with helminth infection is 1-2%, but in some regions it reaches 10% or more. The rise in the incidence of helminthiasis is relevant not only for infectious diseases but also Pediatrics, medicine, surgery, gastroenterology, dermatology, Allergology, urology and other practical fields of medicine.
Causes of helminthiasis
Today there are more than 250 pathogens of helminth infections in humans; of them, the most common of about 50 types. Parasites in humans worms are mainly represented by roundworms (class Nematoda) and flatworms (class Trematoda – trematode and tapeworm – Cestoidea); rarely is the infection of human annelids (Annelida) and thorny-headed worms (Acanthocephala). The representatives of roundworms include pinworms, Ascaris, Trichinella, whipworm; tape – bovine, swine and dwarf cepni, tapeworm, broad tapeworm, flukes cat and liver Fluke.
Life cycle of helminths includes the egg stage, the larval and adult forms. Depending on the characteristics of the development of parasitic worms, and tract infection parasitic diseases are divided into Bioelements, geohelminths and contagious (contact) helminthiasis. Geohelminths are most roundworms (nematodes). Stage of development of eggs and larvae of geohelminths are in the soil under certain temperature and humidity conditions. Infection geohelminthoses occurs when the lack of personal hygiene, eating parasites contaminated water, fruits, vegetables or from contact with feces contaminated soil. Geohelminths include such parasitic diseases as ascariasis, ankilostomidoz, trihozefalez, strongyloidiasis.
Among Bioelements belong flukes (trematodes) and tapeworms (cestodes) and some species of nematodes. To reach the infective stage they need to change one or two intermediate hosts in which there may be fish, crustaceans, mollusks, insects. Bioelements pathogens penetrate into human body by eating not passed sufficient heat treatment of meat or fish, drink raw water. Representatives of Bioelements are difillobotrioz, clonorchiasis, opisthorchiasis, taeniasis, beef tapeworm infection, trichinosis, fascioliasis, echinococcosis. To belong to the contagious helminthiasis infestation transmitted from person to person through personal contact, through shared toilet, kitchenware, linen, or by samsarajade. This enterobiasis, gimenolepidoz, strongyloidiasis, cysticercosis.
Classification of helminths
The helminths are classified according to the biological characteristics of helminths, method of existence in the environment, routes of infection, habitat in the human body. Given the biological characteristics of pathogens isolated nematodes (ascariasis, enterobiasis, trihozefalez, ankilostomidoz, necatoroz, etc.); cestodosis (taeniasis, cysticercosis, gimenolepidoz, beef tapeworm infection, echinococcosis); the trematode (opisthorchiasis, clonorchiasis, schistosomiasis, fascioliasis). By way of the existence of parasitic worms in the environment are distinguished geohelminths, Bioelements and contact helminthiasis.
Infection with helminths may occur through food, water, percutaneous way. Depending on the localization of pathogens in the human body helminth infections are subdivided into intestinal and extraintestinal. Human intestinal parasites are the causative agents of ascariasis, enterobiasis, hookworm, trichuriasis, strongyloidiasis, trichostrongyloidosis, difillobotrioz, teniasis, beef tapeworm infection, etc. gimenolepidoz Extraintestinal helminths can live in the liver, gall bladder, blood vessels, subcutaneous tissue. To extraintestinal parasitosis are filaretos, dracunculiasis, opisthorchiasis, schistosomiasis, fascioliasis, clonorchiasis, paragonimoz, trichinosis, cysticercus etc. in addition, in accordance with the localization principle, there are translucent (including enteric) and tissue (cutaneous and visceral) helminthiasis.
Symptoms of helminthiasis
The clinical picture of helminthiasis is very colorful and consists of the General reaction of the immune system in response to invasion of parasites and organ-specific lesions. During helminth infections there is acute or early (from 2-3 weeks to 2 months) and chronic phase (several years). The main pathological effects of helminths on the human body include toxic and allergic reactions, mechanical damage organs and tissues, nutritional and vitamin deficiencies, reduced immune competence.
In the acute phase of helminth infections are the main manifestations are due to toxic-allergic effect of parasitic worms on the body. In patients with marked fever, skin rash, muscle pain, lymphadenopathy. Often develops abdominal syndrome (dyspepsia, abdominal pain), pulmonary syndrome (dry cough, bronchospasm, shortness of breath), hepatolienal syndrome (enlarged liver and spleen), asthenovegetative syndrome (apathy, fatigue, sleep disturbances, irritability).
In the chronic phase of helminthiasis is dominated by organ-specific lesions caused mainly mechanical traumatization of the place of parasitism of helminths. So, in determining the course of intestinal helminths are dyspepsia and abdominal pain. The malabsorption in the intestine is accompanied by the polyhypovitaminosis, progressive weight loss. Frequent companion of intestinal helminth infections is iron deficiency anemia. When a massive parasitic infestation may rectal prolapse, hemorrhagic colitis, intestinal obstruction.
In the chronic phase of helminthiasis proceeding with a primary lesion of the hepatobiliary system can occur jaundice, hepatitis, cholecystitis, cholangitis, pancreatitis. In the case of migration of pinworms enterobiasis when perhaps the development of persistent vaginitis, endometritis, salpingitis. Chronic stage strongyloidiasis proceeds with the formation of gastric ulcers and 12 duodenal ulcer. When trichinosis can affect the cardiovascular system (myocarditis, heart failure), respiratory organs (bronchitis, pneumonia), CNS (meningoencephalitis, encephalomyelitis). As a result of infestation by filarial lymphatic vessels during filariasis often develops lymphangitis, impedimenta with edema of the mammary glands and genital organs. When ehinokokkoze arise cysts of the liver and lungs, when the abscess which is possible complications such as septic peritonitis or pleurisy.
On the background of helminthiasis in children and adults reduced the impact of preventive vaccination and re-vaccination, resulting in not achieved the required protective level of immunity. In the presence of concomitant diseases helminthiasis alter and aggravate them. The outcome of helminth infections may be a recovery (in the natural death or the expulsion of worms) or the residual effects are often disabling effects.
Diagnostics of helminthiasis
Based on clinical and epidemiological data helminthiasis is mainly diagnosed already in the chronic stage. To identify the causative agent of helminthiasis used special laboratory techniques: microgametocytes (scraping on enterobiasis), helminthotheca (research of a feces on eggs of worms), gelmintological, serological (ELISA, RIF, RSK, Phragmites), histological coprology. Study material for detection of eggs, larvae or fragments of Mature specimens of helminths can serve as feces, vomit, duodenal contents, sputum, urine, blood, biopsies of the skin, etc.
In intestinal helminth infections can be informative skin-allergic tests with antigens of helminths. To identify and assess the severity of organ-specific lesions is widely used instrumental diagnostics: ultrasound of the liver, pancreas, EGD, colonoscopy, endoscopic biopsy, x-rays and CT scans of internal organs, scintigraphy of the liver.
Treatment and prevention of helminthiasis
A holistic approach to the treatment of helminthiasis consists of etiotropic and posindromnoy therapy. Specific treatment involves the appointment of anthelmintic drugs for the type of worms and stage of infection. For etiotropic therapy of helminthiasis the following groups of drugs: protivopolozhnye (albendazole, levamisole, Beenie hydroxynaphthoate, piperazine, Pyrantel, etc.), protivozastojnye (niclosamide, albendazole), protivorevmaticalkie (tetrachloroethylene, hexachloro, bithionol), and drugs broad-spectrum (mebendazole, albendazole). The effectiveness of deworming assessed the results of repeated parasitological examinations.
When intestinal helminths to the basic treatment added antimicrobial agents, chelators, enzymes, probiotics, etc. Symptomatic treatment of helminthiasis may include the appointment of antihistamines, intravenous infusions, vitamins, cardiac glycosides, NSAIDs, glucocorticoids. When echinococcosis primary treatment is surgery (surgery for the cyst/abscess of the liver echinococcectomy).
Prevention of geohelminthoses is carried out by the hygienic education of population, protection of the environment from faecal pollution, instilling in the children the rules of personal hygiene. In terms of preventing the spread of Bioelements plays an important role deworming of domestic animals, veterinary and sanitary control of meat products, the careful heat treatment of meat and fish. In the prevention of contact of helminth fundamental rupture mechanism of transmission of pathogens in an organized, mostly children, groups. It is advisable for seasonal drug for the prevention of helminthiasis in the families (e.g., albendazole), regular parasitological examination of children and risk groups