ANKILOSTOMIDOSIS

ANKILOSTOMIDOZY - helminthiases caused by ankilostomids; Distinguish ankylostomiasis (causative agent - hookworm) and non-carotid (causative agent - nectar). Both helminthias have a similar clinical picture.

Ankylostomidosis is widespread mainly among the population of the tropical and subtropical zones, in the countries of South and Central America, South Asia, and Africa. The foci of ankylostomiasis are also found in the south of Europe, as well as in some regions of Georgia and Azerbaijan.

Pathogens are two closely related species of roundworms (nematodes): ankylostoma (Ancylostoma duodenale) and a necator (Necator americanus), related to geogelminthes. Sewer hook dimensions: length of male 8-11 mm, females 10-14 mm; The size of a non-root: the length of a male is 5 - 9 mm, females 9-12 mm. Sexually mature ankylostomids live in the upper section of the human small intestine. Fertilized females lay 6,000-10,000 eggs a day, excreted with the feces of the patient. Of the eggs in the soil at 27 ° C (optimum temperature) and sufficient humidity after 1-2 days non-invasive larvae leave, which within 7-12 days acquire invasiveness and keep it from 7-8 weeks to 1.5 years. The development of larvae is possible at t 14 - 40 ° C. The larvae usually concentrate in the surface layer of the soil at a depth of up to 10 mm, and can also rise 20 - 22 mm along the wet stems of plants.

The hookworm larvae enter the human body primarily through the mouth and, developing in the intestine (without migration), reach 4-5 weeks of sexual maturity. Larvae nekatora usually actively penetrate into intact skin and, penetrating the capillaries, migrate through a large and small circle of blood circulation. Having reached the lungs, they pass through the bronchi, trachea and esophagus into the intestine, where in 8-10 weeks develop into adult parasites. It is possible to develop hookworm and in infection through the skin, and nekatora - for infection through the mouth. Adult hookworms parasitize in the intestine for 5 to 8 years, and an incubator for up to 15 years.

The source of infestation is only man. Dissipation of larvae in the environment is facilitated by contamination of the soil with faeces, erosion of cesspools by storm showers, as well as the use of untreated faeces for fertilizing vegetable gardens. The infection of a person occurs when it comes into contact with the soil in areas that are unsuitable for this helminthic region (walking barefoot, lying on the ground, performing agricultural and earth works), eating vegetables, fruits, greens contaminated with feces containing ankylostomide larvae, through dirty hands. In the subtropics, the soil in most centers in the winter is completely cleared of larvae, so infection of people occurs in a certain season, lasting about 6 months.

During the migration of larvae, sensitization of the human body occurs through the products of their metabolism and decay. The result is a rash on the skin, itching, bronchitis, bronchopneumonia, eosinophilia of blood up to 30 - 60%.

Adult parasites, attaching to the mucous membrane of the upper part of the small intestine, damage the mucous membrane and blood vessels. Clinically, this is manifested by symptoms such as weakness, headaches , dizziness , shortness of breath , abdominal pain. Develop hypochromic anemia, exhaustion right up to cachexia, children may delay physical and mental development.

The diagnosis is based on the detection of eggs in the contents of the duodenum, obtained by duodenal sounding and in feces, as well as on the results of serological reactions - hemagglutination, latex agglutination. In the blood there is a decrease in the amount of hemoglobin and the number of red blood cells to 1 000 000 - 800 000 in 1 μl of blood with a decrease in the color index to 0.3 - 0.5, an increase in ESR, eosinophilia.

Treatment (dehelminthization) is carried out by outpatient mebendazole, naphthimol, pyrantel. In case of anemia, preparations of reduced iron and other anti-anemia agents are prescribed. In severe cases, transfusion of erythrocyte mass is indicated.

Prevention consists of activities aimed at eliminating existing foci of ankylostomiasis and preventing the emergence of new foci. The elimination of foci is carried out by means of deworming the population, sanitary improvement of populated areas, environmental protection from faecal contamination, disinfection of contaminated soil areas. With the purpose of dehelminthization of the population, a koprolological study of all inhabitants of endemic ankylostomidosis populated areas is carried out once a year. All patients are treated with de-worming with naphthamone. For the destruction of larvae in small parts of the soil, for example around the outcrops of the outhouse latrines, the soil is treated with table salt at a rate of 0.5-1 kg per 1 m2 or it is poured with steep boiling water once every 10 days during the season of possible infection.

To prevent the emergence of new foci of ankylostomiasis in places with a humid warm climate, persons arriving from an ankylostomidosis-unfavorable terrain are subjected to a one-time coprological examination with subsequent treatment of the invasive ones. Persons who are to work in mines are preliminarily given a scrappy research; Identified patients are subject to mandatory treatment.

Those living in foci of ankylostomidosis must comply with the basic rules of individual prevention: wash hands before meals, perform various earth and agricultural work in shoes and mittens, thoroughly wash before consumption vegetables, berries, fruits and pour them with boiling water.