Ascariasis in children is a parasitic disease that results from the infection of roundworms - roundworms in children. In children, ascariasis is manifested by symptoms such as weakness, fever, local allergic reactions, cough, abdominal and asthenovegetative syndromes, digestive problems, as well as weight loss. Diagnosis of ascariasis in children includes clinical and epidemiological results, general blood tests, serological tests, respiratory tests to detect gelment eggs. Children are prescribed anthelmintic drugs to treat ascariasis.
Ascariasis is one of the most common parasitic diseases among worm infections (helminthiasis). The disease is caused by Ascaris lumbricoides, which belongs to the family of roundworms. The main infected organisms are young children.
In children, the causative agent of ascariasis - human ascarids are arcuate, whitish-pink in color and much larger in size (in female ascarids - up to 40 cm in length, and in males - up to 25 cm). In soldiers, the child can parasitize various organs in the body. However, the parasite spends most of its life in the small intestine. Ascaridosis in children belongs to the group of anthroponotic geohelminthiasis: the only biological host of the helminth is a human, and the maturation of eggs takes place in the soil.
Causes and pathogenesis of ascariasis in children
Soldier's eggs fall to the ground by a sick human body. Mature ascarids do not have the ability to survive in the external environment, and their eggs can be stored in the soil for several years. Infection of children with ascarids occurs through the fecal-oral route, i.e., the child becomes infected when the soldier swallows his eggs.
The most common time of the disease is the spring-summer season, when children rarely follow the rules of sanitation and hygiene, have a lot of contact with soil and grass (during walks, children play on the sandy field) during), and in the summer months, children consume a lot of fruits and vegetables, greens, and can drink unboiled water.
A soldier’s life cycle involves several periods. In a mature soldier, the larvae hatch from their eggs, which pass through the intestinal mucosa into the portal vein and, along with blood flow, spread to the liver, gallbladder, right ventricle, lungs, and bronchi. When a child coughs, the larvae pass into the oral cavity with sputum and the larvae swallow it again through saliva, the larvae enter the intestine again and at this time they have the ability to reproduce sexually.
In Ascaris, it takes 2,5-3 months for an egg to reach the child's body, which is called the early migration stage of the disease. In the late intestinal stage, ascarids are mature and have the ability to reproduce sexually. In a day, a female soldier can lay up to 250.000 immature eggs, which are excreted from the patient's body through feces.
The lifespan of mature ascarids does not exceed 12 months - then they die. A new generation of larvae cannot develop in the same organism, and ascaridosis disappears completely within 1 year, even if left untreated, unless the child is re-infected during this time (autoreinvasion).
Symptoms of ascariasis in children
In children, ascariasis can be latent if infected in small amounts. Sometimes the symptoms of ascariasis are pronounced, intoxication and allergic symptoms appear within 1 week after the child is infected (in the early migration stage).
The child may experience general weakness, fever (may rise to 38 C), pain in the back of the chest, allergic rashes and itchy skin, dry or mucous sputum cough, and sometimes signs of pleurisy. Enlargement of the liver, spleen and lymph nodes of the child also occurs during the disease (hepatosplenomegaly).
In the intestinal stage of ascariasis - there are problems with digestion, a decrease in the acidic environment of the stomach and a decrease in enzyme activity, difficulty in digesting food, difficulty in absorption of nutrients.
The child has persistent abdominal pain (abdominal syndrome), decreased appetite, sometimes nausea under the influence of food, increased salivation, inability to tolerate certain foods, flatulence (abdominal rest) , suffers from diarrhea, weight loss, frequent colds.
Nervous system problems (asthenovegetative symptoms) characteristic of ascariasis in children - rapid fatigue, memory loss, irritability, sleep disturbances, vestibular deficiencies, hyperkinesis and epileptic seizures can also occur.
Complications of ascariasis in children
In children, ascariasis is considered dangerous with subsequent complications. Ascarida larvae can cause mechanical changes in various organs and vascular walls, focal or low-volume hemorrhages, inflammatory infiltrates, perforation of the liver, intestines, lung tissue, and micronecrosis.
Larvae and mature forms of roundworms have a strong toxic and allergic effect on the body, the products of life activities. In children, ascariasis causes general sensitivity of the organism and the appearance of obvious local allergic reactions, in severe cases, eczema and asthmatic suffocation may also occur.
Ascaridosis in children can lead to the development of dysbacteriosis, decreased immune system, increased risk of various infections. In the field of pediatrics, cases of ascariasis may be an indication against prophylactic vaccinations. Because in such cases the effectiveness of vaccines decreases.
As a result of multiple infections and the development of roundworms, mechanical or obstructive bowel obstruction, bile duct obstruction, and worm-like tumor obstruction occur in children.
As a result, may develop mechanical jaundice, symptoms of acute appendicitis, cholangitis, cholecystitis, pancreatitis. In children with endemic foci of ascariasis, it can be complicated in the form of severe pneumonia (zotiljam) and can be fatal.
Diagnosis of ascariasis
Early stages of ascariasis in children are based on clinical and epidemiological data and additional symptoms: leukocytosis and eosinophilia on general blood analysis, detection of parasitic larvae on microscopic examination of sputum, the appearance of eosinophilic infiltrate shadows on lung radiographs.
Methods of serological testing in the diagnosis of ascariasis (reaction to live larvae in ascarids, antibody antibody hemagglutination reaction to ascarids, etc.) are not currently widespread.
A definitive diagnosis of ascariasis in children can be made up to 3 months after the child is infected, when the larvae are mature, capable of sexual reproduction, and have entered the intestinal stage. In this case, laboratory tests of feces are performed to detect parasitic eggs.
In some cases, mature forms of roundworm can also be seen by X-ray examination of the bowel and chest area. In addition, endoscopic examinations and surgical interventions also provide accurate information in the diagnosis of ascariasis (performed in pediatric gastroenterology departments).
Treatment of ascariasis in children
In children diagnosed with ascariasis, anthelmintic drug treatment is performed. The type of drug and its dose are prescribed by a pediatrician or pediatric infectious disease specialist. This takes into account the severity and stage of the disease.
In the early migratory stage of ascariasis, desensitizing and anthelmintic agents are used (thiabendazole or mebendazole drugs, which have a broad spectrum of action against nematodes). Broncholytic and corticosteroid drugs are prescribed to relieve lung problems.
In the intestinal stage of ascariasis in children according to the doctor's instructions: levamisole - a single dose; pyrantel - to take once; piperizine, mebendazole - is prescribed to children older than 2 years, especially when infected with large amounts of parasites.
When treated with these tools, the effectiveness of treatment - 80–100%. The child is re-examined 1 month after the treatment. When prescribing these procedures, the doctor-gelmentologist chooses based on the individual condition of the child.
Consequences and prevention of ascariasis in children
When ascariasis is uncomplicated in children, it is completely treated with anthelmintic drugs and the child has no complications. If the disease is complicated, the resulting changes will focus on the severity.
In the primary prevention of ascariasis in children, the child must follow the rules of personal hygiene, in the secondary prevention - general sanitary and hygienic measures (protection of soil and water bodies from fecal contamination, detection and treatment of children infected with ascariasis, warning the population) ).
