Modern methods of diagnosis and treatment of giardiasis in children.
NV Khudyakov, the highest category doctor, associate professor of pediatrics hospital SSMU, Tomsk
Giardiasis is widespread among the population of the Tomsk region. According to statistics, Children's Hospital ¹ 1, Tomsk, for the year 5129 the laboratory conducted research on the eggs of worms, and in 404 cases (7.9%) in feces were found Giardia cysts. During the autumn period in Gnip "Virion" asked 273 children, and by ELISA in 54.5% of them had a positive result. On morbidity helminths in second place after the SARS and influenza. Giardia infestation in the adult population reaches 10-12% in children, especially those aged 2-5 years - up to 30% or more, with the age of infection is gradually reduced to 16 years reaches 10%. The structure of infested 98,5% are children (NV Merzlova et al., 1998). Lyamblioznaya invasion detected more frequently in the summer-autumn period. Infection occurs when a person penetrates lamblia cysts alimentary infections. Source of infestation is the only man. The cysts are fairly stable. Transfer factors - Contaminated cysts kitchen utensils, hands, vegetables, fruits, drinking water. The cysts can be transmitted by flies and cockroaches.
Lifespan lamblia in the human body in the absence of reinvazii ranges from 3 to 40 days, averaging about 4 weeks. Since giardiasis - an illness of "dirty hands" (oral infection occurs through contact with a child with objects contaminated by carriers of the parasite, or when consuming contaminated food or water), it is often found in other family members and groups of children, visited by these patients. We observed 178 children, seek help from the Children's Hospital ¹ 1. Giardiasis is diagnosed more often in girls (57.4%) and less often among boys (42.6%). Among them was 20% of preschoolers, primary school children - 63%, and high school students - 27%. One-third of patients with giardiasis of children found to have a high index of infectious and chronic foci of infection. One-fifth of patients suffered in the past hepatitis B and the same number of children - dysentery, half of the surveyed were carious teeth.
The clinical picture of giardiasis is very diverse, but most often diagnosed by symptoms that make up the pain, dyspeptic, intoxication syndrome and the effects of vegetative-vascular dystonia. In most cases the disease pattern was presented symptom of cholecystitis and duodenitis. In 42% of children with giardiasis, revealed intestinal dysfunction, associated with the violation of his motor functions, and often with the development of secondary fermentopathy. Many of the children during the exacerbation of symptoms evident, polyhypovitaminosis, dysbiosis, vascular dystonia. In 7% of children were observed functional changes in the pancreas. Analysis of feces with only the three-fold, at intervals of 1-2 days. This method Giardia were detected in 74.4% of children. The greatest information about the status of bile ducts gave results of fractional duodenal intubation and pursued after him microscopy of bile, and study its composition. Microscopy allowed us to discover portions of Giardia in 80% of the surveyed children, signs of inflammation - in 64%, diskineticheskih disorder biliary tract - in 79%, 75% of whom had dyskinesia gipermotornogo character. It is known that Giardia infection may spontaneously disappear after 6 weeks, but often persists for years. In this case, the excretion of cysts occur in 10 to 20-day pause, which explains the fact that Giardia cysts in feces are often not even when the diagnosis giardiasis. Diagnostic methods of the invasion were supplemented by microbiological and morphological studies. Has become a widely used enzyme immunoassay system "Giardia-AT-strip", the main component of which is treated surface proteins - the major immunodominant proteins of Giardia.
The most recent method, the possibility of enriching the patient to assume the presence of giardiasis, is a computer test on the device "Oberon."
Treatment of the disease should be carried out comprehensively. Protivolyamblioznymi drugs of choice may be tiberal, tinisan, Trichopol or furazolidone.
In recent years, the opportunity to treat giardiasis biologically active food supplements domestic production.
The Russian company ARTLIFE created and successfully used drugs and TOKSFIGHTER, HOLEGON. Good results were obtained in clinical trials artemisinin.
Side effects of these drugs are not observed.
The important thing is that in addition to antiparasitic action, they give expression to choleretic and anti-inflammatory effects, and also have the right to full recovery enterosorbtsionnoe action.
Thus, the treatment and prevention of giardiasis, biologically active additives can refuse to have a toxic effect of chemotherapy.
