Enterobiasis in children
Enterobiasis in children is a parasitic invasion of the intestines, which is provoked by pinworms belonging to the roundworm species. The disease in childhood has quite vivid symptoms and is manifested by severe perianal itching, abdominal cramps, poor appetite, allergic reactions, delayed physical development and other signs.
Enterobiasis is the most common parasitic infestation that is diagnosed in childhood. It accounts for 91% of all reported cases of parasitic diseases. Statistics indicate that enterobiasis is present in 20% of preschoolers and in 50-90% of schoolchildren. This helminthic invasion is common throughout the world. It should not be taken lightly, since it has been scientifically proven that enterobiasis leads to the formation of a large number of somatic diseases in children and contributes to the exacerbation of chronic pathologies.
Content:
- The causes of enterobiasis in children
- Symptoms of enterobiasis in children
- Diagnosis of enterobiasis in children
- Treatment of enterobiasis in children
The causes of enterobiasis in children
Enterobiasis in children is provoked by pinworms. These are small roundworms that have one host - a person. Male pinworms are small, their body size does not exceed 3 mm in length. Females are larger, they can reach a length of 10 mm. The worms are white in color and have an elongated body with a pointed end.
Adults are attached to the small and large intestines of the child, for this they have special vesicles located on the head. Fertilization requires worms of both sexes. When the eggs mature inside the female's body, she moves into the lower parts of the large intestine, overcomes the sphincter resistance and crawls out. In the perianal folds, the female lays eggs in heaps and then dies.
During the movement of the worm in the perianal region, the patient experiences itching. He begins to comb the anus, as a result of which the eggs attach to his hands, fall under the nails and spread to the surrounding household items, to clothes, to the skin, etc.
If the eggs enter the mouth, they travel down the esophagus into the stomach and intestines, where digestive enzymes break down their shell. A larva emerges from the egg, which reaches puberty in the intestine and the helminth development cycle repeats again.
Each individual can exist in the body of a child for up to 2 months, after which the worm dies from natural old age. In the intestine, up to several thousand helminths can simultaneously parasitize.
After the eggs are laid in the perianal region, it takes 4 to 6 hours for them to become invasive. When a child swallows such eggs, he becomes infected with enterobiasis. Outside the human body, eggs retain their viability for up to 25 days.
Thus, the mechanism of transmission of enterobiasis is fecal-oral, and this mechanism is implemented by food and household. Children with enterobiasis pose a danger not only to themselves, but also to the people around them, as they are sources of the spread of the disease.
The following factors contribute to the transmission of infection:
- The child's habit of licking and sucking his fingers, putting various objects in his mouth. This often happens when the baby is passionate about something.
- The habit of biting your nails.
- Low formation of hygiene skills. It is important from childhood to teach a child to wash their hands after going to the toilet, after visiting public places, before every meal.
- Often, infection occurs during the change of deciduous teeth to molars. The teeth begin to loosen, and so the child puts his hands in his mouth to touch them.
- Use of personal hygiene items that do not belong to the child. This is especially true for kindergartens.
- Poor sanitary conditions in which the child lives, the presence of insects in the house. It has been established that eggs, which cause enterobiasis in children, can be carried on their paws by cockroaches and flies. In addition, they can be in the dust for almost a month without losing their viability.
Infection can occur in clubs, in children's clubs, in swimming pools and other organized institutions.
Symptoms of enterobiasis in children
The symptoms of enterobiasis in children are directly related to how massive the helminthic invasion is and how long it lasts. The age of the child and the individual characteristics of his body are of no small importance.
In general, the clinical picture of enterobiasis in children is as follows:
- Severe anal itching. It intensifies in the evening and picks up its maximum at night. Itching is a consequence of the migration of worms, when the female helminth descends into the rectum and crawls out through the sphincter in order to lay eggs. Itching haunts the child for no more than three days, after which he subsides. However, a month later, the unpleasant symptoms return as the next offspring of the worms begin to migrate.
- The more worms parasitize in the intestines of the child, the stronger the anal itching will be. In such cases, he can haunt the child on an ongoing basis, and will not subside even during the day.
- The child's sleep is disturbed, he becomes more restless. Female helminths are able to irritate not only the perianal region, but also the external genitalia. This leads to early masturbation of the child, to bedwetting.
- The perianal region is hyperemic, there is local irritation, traces of scratching are visible. With prolonged invasion, the child develops eczema or dermatitis.
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Bruxism, namely grinding teeth at night, is another indirect sign of enterobiasis. Although scientists still have not found scientific confirmation of bruxism with helminths, in most cases, checking a child grinding his teeth in a dream for a parasitic invasion reveals its presence.
- The overwhelming majority of children with enterobiasis indicate recurrent abdominal pain. They are localized in the iliac region or in the region of the appendix. The pains can be mild and intense enough, such that competent differentiation of enterobiasis from a disease requiring surgical intervention is necessary. In addition, parasites are indeed capable of provoking acute appendicitis in a child if they penetrate the appendix.
- The child's appetite suffers, it worsens, as a result of which the patient begins to lose weight.
- Stool with enterobiasis is almost always unstable, constipation alternates with diarrhea. In parallel, there is bloating, flatulence, false urge to empty the intestines.
- Metabolic disorders, pathological activity of worms, their use of nutrients from food for their own needs - all this leads to a delay in the physical growth and development of the child, to the formation of vitamin deficiency and iron deficiency anemia.
- Allergic reactions are a characteristic companion of enterobiasis in children. They proceed as atopic dermatitis, conjunctivitis of an allergic nature. More serious manifestations of allergies are possible, including Quincke's edema and bronchial asthma. When getting rid of parasites, it is far from always possible to get rid of health problems caused by their waste products. It was found that allergic syndrome accompanies enterobiasis in children in 71.3% of cases.
- The normal intestinal microflora is disrupted, which eventually leads to the development of dysbiosis.
- It has been proven that intestinal infections in children with helminthic invasions are much more difficult and longer than their healthy peers. The longer mechanical irritation of the intestinal wall with worms is observed, the stronger the inflammation of the intestine, the more infiltrates, erosions, punctate hemorrhages, granulomas appear in it. As a result, such children are observed by a gastroenterologist for enteritis, gastritis, gastroduodenitis.
- Enterobiasis leads to suppression of immunity, the child begins to get sick often, viral infections take longer and more severe. It has been proven that parasites influence the formation of post-vaccination immunity. Immunological deficiency contributes to the fact that children are classified as frequently ill.
- Extensive manifestations from the nervous system. Children with parasitic infestations are more irritable and emotionally unstable. They are prone to headaches, get tired faster during class, which affects school performance. Cognitive processes deteriorate, there is a developmental disorder.
- Nausea, abdominal cramps, indigestion - all these symptoms are not associated with food intake and occur even with a rational and adequate diet.
Diagnosis of enterobiasis in children
Diagnosis of enterobiasis in children, as a rule, is not difficult. Attentive parents on their own can notice the child's itching annoying at night, and sometimes see pinworms on the skin around the anus, or in his feces.
The leading method for detecting parasitic infestation in children is scraping for enterobiasis. It is done with adhesive tape or a cotton swab. Scraping is taken in the morning from the child's perianal folds before washing and before changing underwear.
So that the efforts do not go unsuccessfully, it should be borne in mind that pinworm eggs are laid at regular intervals. Therefore, a single or double scraping for enterobiasis is not very informative. It must be performed 3-4 times with an interval of 2-3 days.
Indirect laboratory signs of enterobiasis can be such blood parameters as: eosinophilia, basophilia, anemia.
The doctor should suspect enterobiasis in a child by allergic, asthenic and abdominal symptoms, which are present on an ongoing basis. Therefore, it is so important to take into account the indirect signs of enterobiasis and be persistent in diagnosing the invasion.
Treatment of enterobiasis in children
Treatment of enterobiasis in children begins with the intake of specific anthelmintic drugs. Modern medicine has several drugs used to treat intestinal parasites of this type. They can be used both for the treatment of already identified patients, and for the prevention of enterobiasis among people at risk.
Before starting therapy, it should be noted that a prerequisite for the successful treatment of enterobiasis is the involvement of all family members and the team in which the child is constantly in this process. In addition, it is important to follow strict hygiene rules during therapy to avoid reinfection.
These conditions include:
- Daily wet cleaning of the premises. There is evidence that pinworm eggs can exist in dust particles that are at a height of 1.5 meters.
- Every morning it is necessary to carry out high-quality hygienic intimate hygiene. Underwear should be changed twice a day. It must not only be washed, but also ironed.
- It is important to keep your hands clean, especially before every meal.
- Child's nails should be cut short.
- All toys the child comes into contact with should be disinfected.
For the treatment of enterobiasis in children, the following drugs can be used:
- Mebendazole (Vermox). The child is offered 100 mg of the drug once.
- Pirantel is prescribed as a single dose of 10 mg / kg of body weight.
- Albendazole (Nemozole). The drug is taken as a single dose of 400 mg.
Mebendazole and Albendazole are approved for use in children over 2 years of age. All family members must undergo deworming.
In order to more effectively and quickly rid the intestines of parasites, it is possible to perform cleansing enemas in the evening. A water-soda solution is suitable for this purpose. Two weeks after the first deworming, the course should be repeated. To make sure that the treatment is effective, the child is tested for enterobiasis three more times.
Drug treatment in combination with the general rules for getting rid of enterobiasis gives a positive result in 95% of cases. However, it is important to eliminate all contact of the child with the source of the infestation.
The author of the article: Sokolova Praskovya Fedorovna | Pediatrician
Education: Diploma in the specialty "General Medicine" received at the Volgograd State Medical University. A specialist certificate was immediately received in 2014.
