[Mebendazole oral suspension in the treatment of enterobiasis, ascariasis and trichuriasis in children. Therapeutic yield of a single dose in enterobiasis (author's transl)].
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The paper outlines the results of studies dealt with the detection of risk factors and groups for enterobiasis, the efficiency of the treatment of children suffering from the disease with medamine, biologicals, and Normase. It is shown that risk factors may include an abnormal course of antenatality, minor developmental malformations (diastema, dystrophy, abnormalities of the eye, hand, foot, etc.), as well as early artificial feeding of babies (before they reach 3 months of life). Enterobiasis is found to have a negative influence on the physical, nervous, and mental development and suppression of non-specific immunity in children, which is suggested by the reduction in salivary lysozyme activity, which is lower than the normal level and on blood alpha-interferon production. There is strong evidence for the considerable immunosuppressive effects of enterobiasis on the formation of a postvaccinal immunity against measles. When given in a single course dose, medamine shows a 100% efficiency in the treatment of enterobiasis. Moreover, bificol, bifidumbacterin, and Normase may be useful to enhance the treatment efficiency and children's recovery from enterobiasis.
There were 2,471 school children suffering from enterobiasis in six primary schools of Tainan city. The infected children in five primary schools, Po-Ai, Yung-Hua, Fu-Hsiao, Pao-Jeng and Hsin-Nan, were treated with one single dosage of 100 mg mebendazole. In Shih-Men primary school, the sixth, the students were given placebos as a control group. Negative conversion rates of infected children were examined after three weeks of chemotherapy and school children in the six primary schools were surveyed for enterobiasis two months after chemotherapy to obtain infection rates. The method of examination was two consecutive-day adhesive cellophane perianal swabs. With the purpose of evaluating the efficiency of treatment, positive reduction rates were used and calculated according to the infection rates of school children gained before and after chemotherapy. Those rates in Pao-Jeng, Fu-Hsiao, Yung-Hua, Po-Ai and Hsin-Nan were 62.1%, 47.8%, 41.8%, 37.1% and 3.3%, respectively, and in Shih-Men 3.9%. Judging the data obtained from each grade or each class of schools showed that the efficacy of chemotherapy in reducing the rate of infection was variable. Hence, one single dose of mebendazole and education on personal hygiene were not sufficient to reduce the prevalence of enterobiasis in primary schools. This was because the cycle of E. vermicularis was relatively short, cutting out the routes of transmission was very difficult, and the factors involved were very complex. Overall, though the positive reduction rate presented in Hsin-Nan primary school showed nearly no success in reducing the infection, the other four schools showed valuable rates. Whether continue a treatment, of about three-months in duration, can inhibit the prevalence of enterobiasis among children in primary schools or not will need further study.
The invasion with enterobiasis in individual groups and antienterobiasis measures performed in Lithuania over the 1980-1989 period have been analysed. An overall average 10-year infectivity of children with Oxyuris vermicularis was 9.4%. The infectivity averaged 17.2% in organized groups of preschool children and 8.1% in nonorganized groups of preschool children. According to the data of 1984-1989 the infectivity in the pupils of the first-fourth forms averaged 18.4%. The infectivity of adults with enterobiasis was considerably lower than in children (1.6-2.3% on the average). Sanitary helminthological surveys have been conducted to assess the degree of contamination of articles in children preschool institutions with invaded matter. An overall index of contamination of the articles under study with Oxyuris vermicularis oocysts was 1.1%. So far enterobiasis control in the Republic has been focussed on the isolation and treatment of the invaded persons, as well as on the sanitary helminthological control over the environment. However, the above measures proved insufficient in combatting the epidemic process. It has been shown that the morbidity might be considerably lowered, provided rules of personal hygiene are strictly and constantly observed, the most essential of them being washing of children in the evening and in the morning. The struggle against enterobiasis may be effective in case all the antiepidemic measures are strictly observed with participation of parents and the personnel of the children institutions.
A total of 276 patients with taeniasis alone and taeniasis associated with enterobiasis or lambliasis were involved in the study. The most prevalent features in patients of all the three groups were combinations of the painful, dyspeptic and astheno-vegetative syndromes, the least so--an isolated astheno-vegetative syndrome. Combinations of these syndromes more frequently occur in taeniasis concomitant with enterobiasis (61% vs. 51% in taeniasis alone). Associations of taeniasis with enterobiasis or lambliasis are more frequently diagnosed in children. Combinations of the three syndromes were revealed in the patients with taeniasis coursing against the background of chronic gastritis, duodenal ulcer, cholepathies: in 79% vs. 33.3% in an uncomplicated course. Fenasal therapy for 3 days in a daily dose of 3 g proved fairly effective: 85.7 +/- 6.3% of adults and 82.6 +/- 6.4% of children recovered.
Assessment of the enterobiasis preventive measures in the children's institutions of Leningrad Province demonstrated that wide treatment-and-prophylactic measures didn't reduce enterobiasis. Low efficiency (0.5% of positive results) was found in the sanitary helminthological examination of utensils, which had been performed at the pediatric institutions. The authors found it inexpedient to make planned mass screening of children attending or just entering the preschool institutions. A set of sanitary-and-hygienic and sanitary education measures producing a sustained and reliable effect in enterobiasis control without therapy is proposed to be used.
Children numbering 6,197 were tested for taeniasis. Those children were examined from May, 1981 to July, 1989. Sixty one primary schools, in eight mountainous districts provided the test group of children. The method used in these tests was the Scotch tape perianal swab. The overall infection rate of taeniasis was 1%. A total of 6,667 children were also examined for enterobiasis and the infection rate was 10%. There was no significant difference in the rate of taeniasis and enterobiasis by sex. The infection of taeniasis was highest in Tatung District (3%), Ilan County. However, there was no significant difference among the rates by district. The prevalence of enterobiasis was highest in Jenai District (17%), Nantou County and lowest in Lanyu District (2%), Taitung County. Taeniasis was not found among non-aboriginal school children, while 3% of aboriginal school children were infected with Taenia. However, the infection rate of Enterobius vermicularis among non-aborigines (39%) was much higher than that among aboriginal children (5%). These findings indicate that aboriginal children still eat raw meat and viscera of wild animals and acquire Taenia infection.
The correlation between enterobiasis and urinary tract infection was studied in girls aged 6-14 years. Enterobius ova were demonstrated in anorectal scrapings, carried out three times in each case. Of the 84 patients suffering from urinary tract infection, 55 were Enterobius positive, as compared to 60 among 100 control girls. The difference was not significant. Enterobiasis was not found to be more frequent even when urinary tract infection reappeared within 6 months. There was no significant difference among patients with monosymptomatic bacteriuria and pyuria either. Enterobiasis thus seems to play no pathogenic role in urinary tract infections of girls.
Enterobiasis is the most common helminth in the USSR. Despite of its clinical manifestations in children, some parents do not see a doctor. 105 parents were interrogated by questionnaires. 71% of them called the reason why they had taken no medical advice and the rest evaded the question. The parents' questionnaire is an important measure for preventing and controlling enterobiasis with regard to better health education methods used in the work with parents and tutors from pediatric institutions.
Risk factors for enterobiasis were qualitatively and quantitatively assessed by a questionnaire given to 277 health schoolchildren and 277 schoolchildren who suffered from enterobiasis. A prognostic table was developed for primary screening of risk groups. Preventive measures are recommended in the paper.
Using social and economic criteria, the efficacy of health improving measures against enterobiasis in the organized groups of pre-school children has been assessed. The introduction of mass treatment of children with vermox into a complex of antienterobiasis measures has a considerable health improving effect, without rendering the procedure more expensive. A considerable difference between the economic damage inflicted by enterobiasis and the economic efficacy of antienterobiasis complex, including mass children treatment, forms the basis for the wide use of anthelmintics in the control of this type of helminthiasis.
Children with enterobiasis in nursery schools and kindergartens were treated with medamine according to a one-day scheme. A satisfactory tolerance to and high efficacy of medamine have been demonstrated during treatment of enterobiasis according to the above scheme.
The efficacy of hygienic measures and drug therapy of patients with enterobiasis has been compared in different organized groups of children in various regions of Lithuania. Nondrug measures and drug therapy were of similar efficacy. Vermox administration twice a year decreased the incidence of enterobiasis in children 1.9-fold, while nondrug measures decreased it 1.5-6.1-fold.
The prevalence of enterobiasis was investigated among 2,195 children in kindergarten and grade one of 12 Macao Catholic schools by a single modified Scotch tape swab. The overall infection rate was 31.5%; it ranged from 15.2% to 63.3% among schools and was higher in grade one. The prevalence was independent of sex but increased with age to a peak at 7 years; it was higher among children of lower social class and those born in Mainland China. The infection was more prevalent in the poor and congested parts of the city. The educational level of parents was a critical factor in the eradication of enterobiasis. The prevalence rate was not associated with the employment status of mother, family size, and sibling size.
We report on a patient with chronic urticaria associated with enterobiasis vermicularis (oxyuriasis). The current distribution of Enterobius vermicularis and its importance concerning chronic urticaria of endogenous origin is evaluated and discussed.
A complex plan of enterobiasis control measures for a sharp and stable decrease of the prevalence level at nursery schools in new buildings is presented. This complex plan allows one to reduce the extent of investigations 3-4-fold. A trial of the complex plan proposed on territories with foci of different types should be expedient with its subsequent introduction into the practice.
Evidence is provided for the value and priority of sanitary and hygienic measures and hygienic education of the population in the prevention of enterobiasis. It is emphasized that preventive work can be successful only when the parents, tutors of preschool institutions and teachers of schools are obligatorily attracted to it.
Presents data on enterobiasis prevalence, medicosocial significance, and epidemiologic features in the former USSR and CIS. Analyzes the causes of ineffective control of this disease. Emphasizes the necessity of simultaneous solution of medical and nonmedical (social) problems. Distinguishes the priority trends in the disease prevention.