Helminth disease– helminthiasis caused by helminths – parasitic worms are round and flat, rarely have rings and spines.Helminths are characterized by a chronic process and systemic effects on the body with the development of abdominal syndromes, allergies, anemia and chronic intoxication;damage to the lungs, liver, biliary tract, brain and visual organs.In diagnosing helminth infections, people use laboratory methods (helminoscopy, helminthoscopy, serology) and instruments (X-ray, endoscopy, ultrasound, etc.).Treatment of helminth infections depends on the type of parasite and includes specific therapy (helminthicides) and pathogenic therapy.
General information
Helminth infection is a helminth infection caused by many types of lower parasitic worms - helminths.Helminth disease has a chronic course, accompanied by body exhaustion and reduced natural defenses.In the structure of helminths, the leading positions belong to helminths, roundworms, hookworms, whipworms and toxocariasis.
According to official statistics, the rate of helminth infection in our country's population is 1-2%, but in some areas this rate reaches 10% or more.The problem of increasing incidence of helminthiasis is relevant not only for infectious diseases, but also for pediatrics, therapy, surgery, gastroenterology, dermatology, allergy, urology and other practical medical fields.
Cause of helminth disease
To date, more than 250 human helminthic pathogens are known;The most common of them are about 50 species.Helminths that parasitize the human body are mainly roundworms (class Nematoda) and flatworms (class flukes - Trematoda and tapeworms - Cestoidea);Less commonly, human infections occur with annelid worms (Annelida) and acanthocephala (Acanthocephala).Representatives of roundworms include pinworms, roundworms, trichinella, whipworms;tapeworms - beef, pork and dwarf tapeworms, echinococci, broad tapeworms;flukes - cat and liver flukes.
The life cycle of helminths includes egg, larval and adult stages.Depending on the development characteristics of parasitic worms and the route of infection, helminths are divided into biological helminths, terrestrial helminths and infectious (contact) helminths.
- Earth wormsMost are roundworms (nematodes).The development stages of helminth eggs and larvae take place in the soil under certain temperature and humidity conditions.Helminth infections occur due to lack of personal hygiene, drinking water, fruits and vegetables infected with parasites or contact with soil contaminated with feces.Geohelminthiase includes helminth diseases such as roundworm, hookworm, bristleworm, strongyloidiasis.
- Come numberbiological wormsbelongs to trematodes (trematodes) and tapeworms (cestodes), as well as some types of nematodes.To reach the invasive stage, they need to change one or two intermediate hosts, which can be fish, crustaceans, molluscs and insects.Biological helminthic pathogens enter the human body by eating meat or fish that have not been adequately heat-treated or drinking raw water.Representatives of biological helminths are diphtheria, clonorchiasis, opisthorchiasis, taenheimosis, teniarinchiasis, trichinosis, trypanosomiasis, echinococcosis.
- Kinfectious worm diseasebelongs to invasions that are transmitted from person to person through personal contact, through shared personal hygiene items, dishes, underwear or through self-infection.These are enterobosis, hymenospermia, strongyloidiasis, and cystic disease.
Classify
Helminth infections are classified depending on the biological characteristics of the helminths, their mode of existence in the external environment, the route of infection and the living environment in the human body.Taking into account the biological characteristics of the pathogen, the following are distinguished:
- nematode(Ascariasis, intestinal worm disease, bristleworm disease, hookworm disease, uterine worm disease, etc.)
- cestodiase(cysticercosis, cysticercosis, hymenoponiasis, teniarinchosis, echinococcosis)
- flukes(opisthorchiasis, clonorchiasis, schistosomiasis, trypanosomiasis).
Based on the mode of existence of parasitic worms in the environment, people distinguish local helminths, biological helminths and contact helminths.Helminth infections can occur through food, drinking water or through the skin.Depending on the location of the pathogen in the human body, helminth infections are divided into:
- intestinal tract.The human intestinal tract is parasitized by pathogens like ascariasis, intestinal worm disease, hookworm disease, bristleworm disease, strongyloidiasis, trichostrongyloidosis, diphtheria, tapeworm disease, taeniarynchosis, hymenoptera disease, etc.
- Outside the intestines.Extraintestinal helminths can live in the liver, gallbladder, blood vessels and subcutaneous tissue.Extraintestinal parasites include filariasis, dracunculosis, opisthorchiasis, schistosomiasis, trypanosomiasis, clonorchiasis, paragonimiasis, trichinosis, cysticercosis, etc.
In addition, according to the principle of localization, helminths in the lumbar region (including intestines) and tissues (skin and internal organs) are distinguished.
Symptoms of helminths
The clinical picture of helminthiasis is diverse and includes a general reaction of the immune system in response to parasitic invasion and organ-specific damage.During helminth infection, an acute or early stage (from 2-3 weeks to 2 months) and a chronic stage (up to several years) are distinguished.The main pathological effects of helminths on the human body include toxic allergic reactions, mechanical damage to organs and tissues, nutritional and vitamin deficiencies and reduced immunity.
Acute phase
In the acute stage of helminthiasis, the main manifestations are due to the toxic allergic effects of parasitic worms on the body.Patients have fever, skin rash, muscle pain and lymphadenopathy.Abdominal syndrome (indigestion, abdominal pain), pulmonary syndrome (dry cough, bronchospasm, difficulty breathing), liver syndrome (enlarged liver and spleen), asthenic syndrome (lethargy, fatigue, sleep disorders, irritability) often develop.
Chronic phase
In the chronic stage of helminth disease, specific organ damage predominates, mainly due to mechanical trauma at the site of helminth parasites.Thus, the determining factor in the development of intestinal helminth disease is indigestion and abdominal pain.Violation of the intestinal absorption process is accompanied by polyhypovitaminosis and a gradual decrease in body weight.Iron deficiency anemia is a frequent companion of intestinal helminths.With large helminth infections, rectal prolapse, hemorrhagic colitis and intestinal obstruction may occur.
In the chronic stage of helminthiasis, which occurs with primary damage to the hepatobiliary system, obstructive jaundice, hepatitis, cholecystitis, cholangitis and pancreatitis may occur.In cases where pinworms migrate in enteric disease, persistent vaginitis, endometritis and salpingitis may develop.
The chronic stage of strongyloidiasis occurs with the formation of ulcers in the stomach and duodenum.With trichinosis, the cardiovascular system (myocarditis, heart failure), respiratory organs (bronchitis, bronchopneumonia) and central nervous system (meningitis, encephalomyelitis) can be affected.Because filariae invade lymphatic vessels, filariasis often develops lymphadenitis, lymphedema of the limbs accompanied by swelling of the mammary glands and genitals.With echonococcosis, cysts of the liver and lungs occur, and when they fester, complications in the form of purulent peritonitis or pleurisy may occur.
Against the background of helminthiasis in children and adults, the effectiveness of preventive and re-vaccination is reduced, due to which the necessary level of protective immunity is not achieved.In the presence of concurrent diseases, helminths change and aggravate their course.The outcome of helminthiasis can be recovery (with natural death or expulsion of the helminth) or residual phenomena, often with disabling consequences.
Diagnose
Based on clinical and epidemiological data, helminthiasis is mainly diagnosed in the chronic stage.To identify the causative agent of helminth disease, special laboratory methods are used: microhelminthoscopy (scraping to find helminths), helminthoscopy (examining stool for helminth eggs), helminthoscopy, serology (ELISA, RIF, RSK, RNGA), histological testing.Test materials to detect eggs, larvae or adult helminth fragments can be stool, vomit, duodenal fluid, sputum, urine, blood, skin biopsy, etc.
For intestinal helminths, skin allergy testing to helminth antigens can be informative.To determine and evaluate the severity of organ-specific lesions, instrumental diagnostic methods are widely used: ultrasound of the liver, pancreas, FGDS, endoscopy, endoscopic biopsy, X-ray and CT of internal organs, liver scintigraphy.
Treatment of helminths
A comprehensive approach to treating helminth infections includes therapy that treats the cause and the syndrome.Specific treatment includes the prescription of antihelminthic drugs, taking into account the type of helminth and the stage of invasion.The effectiveness of deworming is evaluated based on the results of repeated parasite examinations.For the treatment of helminthiasis with etiotropic drugs, the following groups of drugs are used:
- anti-pinworm medicine
- anticestodia
- against flukes
- broad-spectrum medicine.
For intestinal helminths, antibacterial drugs, intestinal absorbents, enzymes, probiotics, etc.added to the main treatment.Symptomatic treatment of helminthiasis may include prescribing antihistamines, intravenous infusions, vitamins, cardiac glycosides, NSAIDs, and glucocorticoids.For tapeworm disease, the main treatment method for patients is surgery (liver cyst/abscess surgery, liver cyst removal).
prevent
The prevention of helminthiasis is carried out through hygiene education of the population, protection of the environment from fecal pollution and instilling in children the rules of personal hygiene.To prevent the spread of biological helminths, deworming of livestock, veterinary and sanitary control of the sale of meat products as well as careful heat treatment of meat and fish play an important role.In the prevention of contact helminthiasis, the most important thing is to break the mechanism of transmission of pathogens in organized groups, mainly children.Seasonal household helminth prophylaxis (e.g. albendazole) and regular parasite testing in children and at-risk groups should be carried out.