A modern view of the problem of helminthiasis in children and effective ways to solve it

Gastroenterologist

Vinogradov

Dmitry Alekseevich

6 years experience

Gastroenterologist

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Ascariasis is damage to the small intestine of the body by helminthic infestations. The causative agent is roundworms - roundworms (hence the name), which parasitize the human intestinal tissue.

Intestinal nematodosis (another name for the disease) occurs everywhere in people of different ages and genders, regardless of climatic conditions.

Main symptoms of the disease

Symptoms of ascariasis depend largely on the extent of damage to the small intestine, as well as the age of the patient and the stage of development of the disease.

The primary phase can occur without clinical manifestations, especially during the period of larval migration. A person may experience one or more characteristic symptoms:

• an allergic reaction is manifested by numerous rashes on the limbs or torso. They itch intensely, causing serious discomfort;
• infectious syndrome is expressed by elevated body temperature, excessive sweating, loss of strength;
• a liver factor may be observed - ascariasis is manifested by an increase in the size of the spleen and liver and causes pain under the ribs on the right side.

In most cases, the patient suffers from a wet or dry cough and severe shortness of breath, and experiences pain in the chest area. All this can lead to pleurisy.

If ascariasis in children or adults is advanced, a sharp decrease in appetite, diarrhea, nausea, vomiting, bloating, pain in the intestinal area, cramps, and weight loss may occur.

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Main causes of infection

The main cause of ascariasis is infection with helminth eggs, which occurs as a result of their entry into a person’s mouth after personal contact with an infected person, as well as with unwashed vegetables, fruits, berries, and household items.

Once inside the human body, the larvae hatch from the eggs and penetrate the circulatory system, spreading to the capillaries of the lungs. From there they reach the bronchi, trachea and pharyngeal area. There they are mixed with saliva, swallowed by a person and again enter the small intestine, growing there into full-fledged adults.

What is ascariasis?

The human roundworm is a large dioecious parasite. The male is noticeably smaller than the female, its length is 15-25 cm, the female can reach 26-40 cm, an adult female can lay up to 240 thousand eggs per day. This type of helminth can parasitize the intestines for a year. Ascariasis is common in all climatic zones of the globe, with the exception of permafrost areas, highlands and deserts. According to the WHO Expert Committee, more than 1 billion people in the world suffer from ascariasis every year, most of them are children of preschool and school age. The highest incidence rate is observed in regions with a hot climate: Asia, the North Caucasus, Transcaucasia, Sakhalin and Tomsk regions, Primorsky Krai.

Preventive measures

Prevention of ascariasis is based on timely detection of the disease and adequate treatment under medical supervision.

Of particular importance in this process is compliance with all hygiene rules: it is necessary not only to keep your hands and the hands of children clean, but also to instill in them proper hygiene habits.

Regular hand washing after a walk, visiting the toilet, before eating, as well as proper sanitary treatment of food that comes on the table can significantly protect the body from infection with roundworms.

Diagnostic features

If you notice one or more symptoms of this disease in yourself or your child, you should seek help from an infectious disease specialist (in the case of a child, a pediatrician or pediatric infectious disease specialist).

Diagnosis of ascariasis involves a general blood test: the presence of the disease will be indicated by an increase in ESR and eosinophils, a slight increase in the number of leukocytes and a decrease in hemoglobin.

In addition, an X-ray of the lungs may be prescribed, which, in the presence of helminths, reveals foci of infiltration.

The presence of roundworms can be confirmed by microscopic examination of sputum.

It is important to seek help from a center with a truly competent specialist and high-quality equipment, since helminths tend to demonstrate themselves not in all tests. Only an experienced doctor is able to see their presence in the patient’s body.

Treatment

Drug therapy based on the use of anthelmintics is prescribed. They are selected depending on what stage the disease is currently at. In some cases, a single dose for ascariasis may not be enough, and the drug will need to be taken 3 times with a pause between doses prescribed by the doctor.

If allergic manifestations are present, the doctor will additionally prescribe antihistamines. If a patient has stool upset, bloating and abdominal pain, and other intestinal disorders, then enzymes and probiotics are also selected for him.

At the end of the main treatment, over the next 3 months the patient is registered at the dispensary with periodic blood and stool tests.

A modern view of the problem of helminthiasis in children and effective ways to solve it

According to the World Health Organization, of the 50 million people who die annually in the world, more than 16 million are caused by infectious and parasitic diseases. In the structure of infectious diseases, intestinal helminthiases are in third place. The World Bank estimates that the economic cost of intestinal helminthiases ranks fourth among all diseases and injuries. Given the importance of the control of parasitic diseases for many countries, the 54th World Health Assembly in 2001 approved a strategy for the control of soil helminthiasis until 2010 [5].

In the Russian Federation, more than 10 million people are examined annually for helminth infections, most of them are children. In 2002, 813 thousand infected were identified, of which 681 thousand (83.8%) were children under the age of 14 [4]. More than 15 types of helminths are found in children, of which the most common are enterobiasis, ascariasis, opisthorchiasis, diphyllobothriasis, trichocephalosis, and hymenolepiasis. In recent years, toxocariasis has been increasingly recorded, which is associated with the widespread introduction into practice of a diagnostic test system for its detection.

In the structure of helminthiasis, the leading place is occupied by enterobiasis (91%) and ascariasis (8%). Among all infected children, 92.3% of cases of enterobiasis, 71.1% of ascariasis, 61.5% of trichuriasis and 66.2% of toxocariasis occur.

The incidence of enterobiasis and ascariasis in children in rural areas is significantly higher than in cities, which is apparently due to different sanitary and hygienic conditions in child care institutions in the city and village, as well as the degree of contamination of the environment with helminth eggs (Fig. 5).

Ascariasis is one of the most common helminthiasis, in the formation of foci of which soil contamination with ascaris eggs is of primary importance. In 2002, 74,196 cases of ascariasis were identified, including 52,801 in children under 14 years of age; compared to 2001, the incidence increased by 3.5% and amounted to 217.7 per 100 thousand children.

The incidence of trichuriasis, with a clear downward trend over the last decade, in 2002 increased by 2.8% and amounted to 7.4 per 100 thousand children. Trichocephalosis is registered mainly in the Southern Federal District (Republic of Dagestan, Chechen Republic).

Enterobiasis still ranks first in terms of prevalence among other helminthiases. In 2002, 614,955 cases of the disease were registered among children, which amounted to 2535.5 per 100 thousand patients.

The maximum number of people infected with enterobiasis in 2002 was identified in the Siberian, Northwestern, Ural, Far Eastern, and Volga federal districts.

A feature of most helminthiasis is the chronic course of the disease, associated with the long-term presence of the pathogen in the body and repeated repeated infections. Helminth infections in children, as a rule, are accompanied by a variety of nonspecific clinical manifestations: weakness, fatigue, irritability, sleep disturbances, dyspeptic symptoms, slower growth and weight gain, and decreased immune status. The most important component of the pathology of helminth infections is the sensitizing effect of metabolic products and excretion of helminths, leading to the development of allergic reactions in the form of atopic dermatitis, asthmatic bronchitis, rhinitis, blepharitis, etc.

A selective analysis of the results of clinical examination of 520 children, carried out in the Sverdlovsk region of Perm in 2002, showed that ascariasis was detected in 1.35%, and enterobiasis in 5.8% of those examined. At the same time, on average, the number of health problems per child in children with enterobiasis in the group of preschoolers was 2.5, and in schoolchildren - 2.9. More often than others, diseases of the genitourinary system (in girls), allergic dermatitis, anemia, vegetative dystonia syndrome, neuropathic conditions and diseases of the gastrointestinal tract were noted. Of the diseases diagnosed in children with ascariasis, the most common were vegetative dystonia syndrome, functional diseases of the gastrointestinal tract, pneumonia, and allergic dermatitis. Among children with ascariasis, the incidence rate per child averaged 2.0. In the control group, which included children without parasitic diseases (37 people), the average number of health problems was significantly lower than among those infected with ascariasis and enterobiasis, and amounted to 0.2. Thus, the presence of ascariasis and enterobiasis leads to a deterioration in the general health of children. At the same time, children with various underlying diseases that lead to weakening of the body are more often infected with them.

Let us dwell in more detail on the importance of the most common helminthiasis in the development of pathology in children - ascariasis and enterobiasis [1, 3].

Ascariasis. The development of the causative agent of ascariasis (Fig. 2, 3) in the human body occurs with the migration of larvae emerging from the eggs along the bloodstream through the lungs; the larvae are then swallowed with sputum and develop into adults in the intestine. The lifespan of roundworm in the human body is several months. Ascariasis has a significant impact on the quality of nutrition and immunological mechanisms in children. Ascaris allergen is the most powerful of allergens of parasitic origin. It can cause reactions in the lungs, skin, conjunctiva, and gastrointestinal tract. Allergic reactions can be so severe that they often pose a threat to the child’s life.

The immunosuppressive effect of roundworms is due to the lack of effect of vaccination and revaccination against measles, diphtheria, tetanus, and polioviruses in children.

The leading mechanisms of pathogenesis of the migratory stage of ascariasis are the traumatic effect of larvae and sensitization by parasitic antigens. In this case, 2 main types of lesions occur in different organs and tissues.

• The traumatic effect of migrating larvae in organs and tissues along the migration route. At the beginning of migration, the larvae are still small (no more than 0.5 mm long) and cause limited hemorrhages in the wall of the small intestine and in the liver. By the end of migration, the larvae reach 2 mm in size and, penetrating into the alveoli and bronchioles, and then into the bronchi, cause more significant hemorrhages.
• Eosinophilic inflammation of the tissues in which the larvae develop. The tissue phase of ascariasis occurs during the migration of ascaris larvae to the liver and lungs. The metabolites released in this process cause serious immunological changes and inflammatory reactions. In the migration phase, ascariasis can cause hepatomegaly and asthmatic syndrome. In this case, the clinical picture resembles respiratory allergosis.

In the intestinal phase of ascariasis, important pathogenetic factors are the ability of roundworms, reaching a length of 20–40 cm, to spiral forward movements and the desire to penetrate small openings (Vater's nipple, drainage tubes, etc.). The presence of invasion leads to hypertrophy of the muscular layers of the intestinal wall, a decrease in the depth of the crypts, changes in the chemical composition of the intestinal contents, and disruption of the motor-secretory function of the stomach and intestines. Roundworms secrete inhibitors of trypsin and chemotrypsin, as a result of which the absorption of nutrients, proteins, and fats worsens. With ascariasis, functional deficiency of pyridoxine develops, the level of retinol and ascorbic acid decreases, and lactase tolerance decreases. Ascariasis is usually accompanied by intestinal dysbiosis.

Often symptoms of the intestinal phase of ascariasis are nausea, vomiting, diarrhea, fatigue, dizziness, poor sleep, and abdominal pain. An increased level of eosinophils in the peripheral bloodstream is characteristic of the migratory phase of ascariasis.

Complications of the intestinal phase of ascariasis: intestinal obstruction caused by a ball of adult roundworms; peritonitis due to perforation of the intestinal wall or penetration of roundworms into the abdominal cavity through a surgical suture; obstructive jaundice during migration of helminths into the common bile duct; blockage of the pancreatic ducts; asphyxia due to the migration of roundworms into the upper respiratory tract.

Enterobiasis. The development of the enterobiasis pathogen (Fig. 1) in the human body occurs within the gastrointestinal tract. The larvae emerge from the eggs (Fig. 4) and, on average, develop into adults within 2 weeks, which parasitize the lower parts of the small intestine and the upper parts of the large intestine. The lifespan of pinworms can reach 100 days, and the state of infestation in children due to repeated infections can last much longer.

Inflammatory reactions during enterobiasis develop under the influence of larvae, which produce hyaluronidase, proteolytic enzymes, lectin-like substances that promote the activation of the complement system, the release of prostaglandins by the cells of the host tissues surrounding the helminth [1, 2, 3].

With enterobiasis, the processes of absorption and digestion of food products are disrupted. In 30–40% of infected people, the acidity of gastric juice decreases, up to anacidosis and inhibition of pepsin-forming function. In most children, the intestinal microbiocenosis changes. Impaired absorption and digestion of nutrients in the intestines lead to weight loss and delay the growth and development of the child.

An additional factor in the pathogenesis of enterobiasis is the mechanical effect of pinworms in the intestines, leading to pinpoint hemorrhages, erosions, and penetration of bacterial flora, in particular pathogens of intestinal infections.

A striking symptom of enterobiasis is perianal itching, which occurs when the female moves during oviposition (Fig. 6). Severe itching occurs, as a rule, during sleep, more often at night, from 23.00 to 1.00 am. It is at this time that helminths can, remaining unnoticed, lay eggs that will mature to the invasive, contagious stage by the morning. Despite its apparent harmlessness, perianal itching is difficult for children to tolerate and can persist for quite a long time after enterobiasis is cured as a result of the formation of a persistent focus of excitation in the cerebral cortex. Complications that arise as a result of perianal itching are skin damage when scratching, perianal pruritis, eczema, weeping dermatitis. The etiological agent of the inflammatory process is most often streptococci.

Abdominal pain is a common symptom of enterobiasis. Pain of a transient nature is observed in the majority of infected people. Sometimes acute abdominal pain may be the reason to seek surgical help. In such cases, it is often not possible to detect a specific pathology; only the accumulation of gases is detected.

In recent years, the number of cases of the formation of perianal granulomas or abscesses in children, inside which female pinworms or helminth eggs were found, has increased. In this regard, it is advisable to screen all children with these conditions for enterobiasis.

In many cases, enterobiasis occurs over a long period of time and is repeated many times. As a result, the intestinal biocenosis is disrupted and the antagonistic properties of the intestinal microflora in relation to pathogens of acute intestinal infections are reduced. In the majority of infected children, the number of E. coli decreases and the proportion of lactonegative intestinal flora increases. The activity of enterokinase and alkaline phosphatase in feces increases. Since the intestinal microflora is one of the factors that supports the activity of intestinal enzymes, disturbances in the processes of digestion and absorption of nutrients that develop as a result of enterobiasis lead to loss of body weight and retard the growth and development of the child. Pinworms have a mechanical effect on the intestinal mucosa, which leads to pinpoint hemorrhages, erosions, and penetration of bacterial flora, in particular pathogens of intestinal infections. The antagonistic properties of the flora in relation to the causative agents of typhoid fever and other intestinal infections are reduced [1, 3].

If pinworms migrate into the abdominal cavity, urinary and genital tracts, inflammatory and allergic reactions outside the intestine may develop.

One of the common complications of enterobiasis is vulvovaginitis due to the penetration of pinworms into the genital tract and the addition of bacterial infections. If vulvovaginitis develops in a girl, a parasitological examination for enterobiasis should be prescribed and, if the result is positive, this invasion should be treated with simultaneous bacteriological examination and, if necessary, antibacterial therapy.

Against the background of enterobiasis, children often develop urinary tract infections, especially girls, since enterobiasis is a factor predisposing to the development of this complication.

Parasitism by pinworms in children leads to suppression of nonspecific immunity, manifested by a decrease in the level of interferon a in the blood serum. A decrease in the nonspecific resistance of the child’s body leads to an increase in the incidence of viral and bacterial infections.

The presence of enterobiasis leads to a decrease in the effectiveness of preventive vaccinations. The immune layer against diphtheria was initially lower among children infected with pinworms. Protective immunity does not develop during primary vaccination against this dangerous infection, and during revaccination in many cases there is no immune response. It is difficult to develop immunity when vaccinated against measles and tetanus, so to increase the effectiveness of vaccinations, you first need to make sure that the child’s body is free from helminthiasis pathogens.

In children with allergic diseases, enterobiasis develops much more often. Due to the relatively high probability of detecting enterobiasis in children with allergic diseases, patients in this group should be recommended to be examined for enterobiasis and deworming if infestation is detected.

Enterobiasis negatively affects the neuropsychic development of children. This invasion leads to a lag behind the corresponding age norms. Among those infected with enterobiasis, there is a high percentage of irritable children, with a disruption in the process of falling asleep, and with negative habits (biting nails, sucking fingers, etc.).

With enterobiasis in children, the level of copper, zinc and magnesium in the blood decreases significantly. Since the lack of these microelements can negatively affect the physical and mental development of children, their loss should be compensated by introducing certain foods into the child’s diet, prescribing medications (or nutritional supplements) until these indicators are normalized after enterobiasis is cured.

Main indications for examination for helminth infections:

• stomach ache;
• frequent nausea, vomiting;
• diseases of the gastrointestinal tract;
• fatigue, irritability, restless sleep, grinding teeth in sleep;
• allergic conditions;
• perianal itching (enterobiasis);
• vulvovaginitis (enterobiasis);
• urinary tract infections (enterobiasis);
• increased level of eosinophils in the blood;
• retardation in height, weight;
• untidiness.

The diagnosis of enterobiasis and ascariasis is made only upon receipt of positive results from a laboratory parasitological examination of the patient. If enterobiasis is suspected, a perianal scraping (imprint) is examined, and fecal samples are examined for ascariasis. On the laboratory referral form, you should indicate what kind of helminthiasis the doctor suspects in the child. The choice of the most effective research method by laboratory specialists will depend on this.

Treatment of ascariasis and enterobiasis

The search for remedies for the treatment of helminthiases, including enterobiasis and ascariasis, began many centuries ago. To expel pinworms, Ibn Sina recommended taking elecampane and celandine with sugar, washing them down with water. The medicine for expelling worms (“killing worms”), indicated in the Ebers Papyrus, contains, among other components, date seeds and the plant disart, sweet beer. The Salerno Health Code, which dates back to the early 16th century, recommends another remedy: mint [3].

The modern arsenal of drugs used to treat intestinal helminthiases includes a significant number of drugs of various chemical classes. They are used both in clinical practice for the treatment of identified patients or parasite carriers, and for the purpose of mass prevention.

The Russian pharmaceutical market currently offers several anthelmintic drugs that act on the causative agents of ascariasis and enterobiasis (Table 1).

The most effective drugs for the treatment of enterobiasis and ascariasis are derivatives of carbamate benzimidazole (mebendazole, medamine) and tetrahydropyrimidine (pyrantel). In addition to the ability to influence mature forms of helminths, they are distinguished by high ovicidal and larvicidal activity. Drugs of these pharmacotherapeutic groups disrupt oxidative processes, inhibit glucose transport in helminths, act on the muscles of intestinal nematodes by depolarizing their neuromuscular junctions and block the action of cholinesterase.

The effectiveness of medicines used to treat enterobiasis and ascariasis is very high, the method of administration is very simple and is designed primarily for children. It is very important that as a result of their intake, the process of releasing the pathogen into the environment is not activated. Thus, during treatment the person does not become more dangerous to others. However, pinworm eggs that have already entered the environment, in particular indoors, persist for a long time - more than 2 weeks. Therefore, it is recommended to repeat the treatment of enterobiasis after 2-3 weeks at the same dose in case hygienic measures were not effective enough. For the same reason, simultaneously with the treatment of infested people, everything possible must be done to clear the premises of pathogens.

For many years, pyrantel has been used throughout the world to treat ascariasis and enterobiasis, and has gained popularity among pediatricians and patients. According to recommendations developed in the USA (Medical Letter, 2002), pyrantel is considered a first-line drug for the treatment of enterobiasis in children and adults.

The anthelmintic effect of pyrantel pamoate is associated with a stimulating effect on the H-cholinergic receptors of the ganglion synapses of helminths, leading to spastic paralysis and their subsequent expulsion from the human body. Clinical trials of the effectiveness and tolerability of pyrantel showed its high medicinal activity against enterobiasis and ascariasis - 94-100%, as well as good tolerability [1, 3].

Pyrantel for the treatment of enterobiasis is prescribed at a rate of 10 mg/kg per day once during or after meals. For the treatment of ascariasis, pyrantel is prescribed at a dose of 5 mg/kg once. The drug is well tolerated by children; in some cases, nausea, vomiting, diarrhea, abdominal pain may develop; very rarely, a transient increase in the activity of liver transaminases, headache, dizziness, and sleep disturbances may occur. Pyrantel is contraindicated in children with liver disease.

We have extensive experience in treating enterobiasis in children with the drug Pyrantel (tablets, suspension). Pyrantel is well known on the world market of anthelmintic drugs and is widely used for the treatment of enterobiasis in Russia by many generations of doctors. In our opinion, this drug has a number of advantages compared to other anthelmintic drugs. Firstly, the drug in the form of a suspension is easy to give to children, secondly, Pyrantel has a pleasant peach taste, as a result of which the child does not experience negative emotions during treatment, and, finally, thirdly, Pyrantel has a reasonable price and is widely sold in pharmacies. The bottle is equipped with a measuring spoon with a division scale of 2.5 and 5.0 ml, which makes it easy to dose the drug depending on the body weight of the infected child (or adult). Pyrantel suspension can be used in children from 6 months of age.

Along with pyrantel, mebendazole and medamine have a good anthelmintic effect against enterobiasis and ascariasis.

Mebendazole (Vermox) for the treatment of enterobiasis is prescribed to children 2–5 years old at the rate of 5 mg/kg per day, over 5 years old - 100 mg per day. For the treatment of ascariasis in children 2–5 years of age, the drug is prescribed at a dose of 5 mg/kg in 2 doses per day for 3 days; for children over 5 years of age, mebendazole is prescribed at a dose of 10 mg/kg per day in 2 doses for 3 days.

Mebendazole is not recommended for use in the first trimester of pregnancy. It must be remembered that the drug is contraindicated in children under 2 years of age. Side effects of mebendazole include abdominal pain and loose stools.

Medamine (2-medoxycarbanylamino-benzimidazole) is close in chemical structure and spectrum of anthelmintic action to mebendazole. For the treatment of enterobiasis, it is prescribed at a dose of 10 mg/kg per day in 2-3 doses (simultaneous administration is also possible) after eating a small amount of food; it is recommended to chew the tablets and wash them down with water. For the treatment of ascariasis, medamine is prescribed in the same doses for 3 days.

Side effects of medamine include nausea and weakness. In case of allergic manifestations, the drug is discontinued. Medamin is contraindicated in the first trimester of pregnancy.

To restore the microbiocenosis of the colon in patients with intestinal nematodes, including enterobiasis and ascariasis, and to increase the effectiveness of specific therapy, it is recommended to prescribe bificol, milk bifidum-bacterin. Food products and medicinal plants that can be used for the treatment and prevention of enterobiasis have long been known. Carrots and carrot juice have a good anthelmintic effect. You can also use the anthelmintic activity of walnuts, wild strawberries, pomegranate (especially pomegranate juice), garlic and lovage.

Among the medicinal plants, St. John's wort is used in the form of decoctions and infusions, tea, as well as elecampane (Inula helenicum). The effectiveness of herbal medicine for enterobiasis is low, but the introduction of foods with anthelmintic effects into the diet is a good measure for the prevention of enterobiasis and enhances the effect of medications prescribed by a doctor.

The criteria for the effectiveness of treatment of helminthiases are a negative result of a control parasitological study of fecal samples (for ascariasis) and a perianal scraping or print (for enterobiasis), as well as the disappearance of clinical symptoms of invasion.

Prevention of helminthiases

Features of the prevention of helminthiases depend on the characteristics of their epidemiology. With enterobiasis and ascariasis, the only source of infection is humans. Infection occurs when mature infective helminth eggs are ingested. However, the epidemiology of these helminthiases is otherwise very different. Pinworm eggs mature indoors and on the human body within a few hours and last on average up to 1 month on various household items. Ascaris eggs mature when dropped into the soil within several months and remain there for up to 10 years or more. Enterobiasis is transmitted indoors from one person to another mainly through dirty hands, bed and underwear, toys, dishes and other household items contaminated with pinworm eggs.

A person becomes infected with ascariasis by ingesting soil particles containing invasive roundworm eggs (with unwashed vegetables, herbs, and fruits). The risk of infection (in the case of ascariasis) increases if a child has such a bad habit as geophagy (tasting or eating earth, sand, clay), which occurs quite often (in 3-10% of children under 7 years of age).

Prevention of enterobiasis and ascariasis is the most important task of medical and educational institutions and parents. It can be solved by simultaneously implementing a set of measures, the main components of which are the identification and treatment of infected people and sanitary and hygienic measures. Prevention of ascariasis, enterobiasis and other helminth infections in the Russian Federation is regulated by new sanitary standards and rules approved by the Ministry of Health of the Russian Federation in 2003.

For questions regarding literature, please contact the editor.

T. I. Avdyukhina, Candidate of Medical Sciences, Associate Professor T. N. Konstantinova, Candidate of Medical Sciences, Associate Professor M. N. Prokosheva RMAPO, Moscow Children's Clinical Hospital named after. P. I. Pichugina, Perm

Answers to common questions

Is it possible to drive away roundworms with herbs?

Many medications contain herbal ingredients. Herbs also have a certain effect, but we must not forget about the serious adverse reactions that their thoughtless use can lead to.

It is strictly not recommended to treat ascariasis yourself with herbs.

Can I get rid of roundworms myself without seeing a doctor?

No, this is strictly prohibited, as it is fraught with poisoning of the body and the occurrence of serious complications in the functioning of internal organs, in particular the organs of the pulmonary system and intestines.

How is ascariasis transmitted?

The disease can be transmitted by shaking hands, as well as by other types of bodily contact.

The most common infection is through contact with poorly washed fruits, vegetables, berries and herbs. You should also remember about hand hygiene after returning from the street and visiting the toilet.

What foods can serve as a source of disease?

Absolutely any, if they are not processed properly.

Why does a cough develop with ascariasis?

Cough appears due to the penetration of larvae through capillary vessels into the area of ​​the lungs and bronchi.

What is the prognosis after treatment for ascariasis?

The prognosis is generally favorable. After adequate treatment, complications can occur only in people with weak immunity and serious chronic diseases.

Suspensions for children

The use of anthelmintic suspensions is especially important for children from infancy to 3 years of age. It is much easier for a child who cannot chew to swallow a suspension than a tablet. Liquid medications usually have a pleasant taste and smell, without losing any effectiveness compared to conventional medications.

Typically, 10 ml of suspension contains the same amount of active ingredient as 1 tablet. The dosage calculation when using anthelmintic suspensions for children is carried out according to the formula: 10 mg per 1 kg of baby’s weight. You need to take the medicine once a day - in the evening before bed.

Since suspensions are one of the forms of release of anthelmintic drugs for children, they have the same effect as the tablets discussed above.

Pirantel

Prescribed from 6 months. The drug is taken once in the morning after breakfast.

Dosage:

• 6 months – 2 years – 125 mg (2.5 ml suspension);
• 2-6 years – 250 mg (5 ml suspension);
• 6-12 years – 500 mg (10 ml suspension).

To prevent re-infestation (self-infestation), the medicine in the same dosage can be taken once every 3 weeks.

The cost of the suspension is from 50 rubles. per bottle with a capacity of 20 ml. Helmintox (a complete analogue of Pyrantel) costs about 120 rubles.

Wormil

10 ml of suspension contain the same amount of active substance albendazole as 1 tablet, that is, 400 mg. Take 1 time per day. The dosage is calculated at 15 mg per 1 kg of body weight. The dose is set individually.

Usually it is:

• For children 1-2 years old – 5 ml (200 mg);
• Over 2 years – 10 ml (400 mg).

Cost from 50 rub.

Nemozol

The active ingredient albendazole is included in the Nemozol suspension at a concentration of 20 mg/ml. The suspension is taken orally during meals. To increase the bioavailability of albendazole, it should be taken with a fatty meal. The duration of the course is 3 days.

Take once a day in the following dosage:

• Children 1-2 years old – 10 ml (1 dessert spoon);
• Over 2 years – 20 ml.

Cost about 200 rubles.