Features of toxocariasis course in children
AbstractBackground. Lack of awareness of physicians, especially pediatricians, about the features of clinical picture and the limitations of laboratory diagnosis of toxocariasis leads to late diagnosis. Most often, toxocariasis is registered under various diagnoses: allergy, chronic pneumonia, dermatitis, etc. The purpose was to study the incidence and peculiarities of the clinical course of toxocariasis in children. Materials and methods. During 2010–2017, 180 children aged 2 to 16 years with a diagnosis of toxocariasis were examined. The comparison group consisted of 50 children with seronegativity for toxocariasis in enzyme-linked immunosorbent assay. A comprehensive survey was conducted using the RIDASCREEN® Toxocara IgG (R-Biopharm, Germany). Statistical processing of the obtained results was performed using Student’s criterion by means of Microsoft Statistica Software, StatSoft, version 6.0. Results. In the structure of parasitosis over the past 7 years, enterobiasis (98 %) is dominated, ascariasis (1.5 %) and toxocariasis (0.4 %) are found rarely, the prevalence of other helminthiasis is 0.1 %. In 125 (69.4 %) children suffering from toxocariasis, geophagia and/or the presence of a dog were registered. Analysis on the gender dependence of patients with toxocariasis revealed prevalence of boys — 80 (64 %). Most often, toxocara were found in the age group of 5 to 7 years. The main clinical manifestations of toxocariasis in children were dyspeptic, asthenoneurotic, skin-allergic and respiratory syndromes. All patients with toxocariasis had antibodies, hypochromic anemia, leukocytosis, eosinophilia. Almost half of children with toxocariasis had changes in the hepatobiliary system (elevated alkaline phosphatase, dysproteinemia, hyperenzymemia) with high titres of toxocara antibodies, hepatomegaly, heterogeneity of the liver tissue echostructure, three-phase type of blood flow in duplex scanning and functional disorders of the biliary tract. Conclusions. A relatively high incidence of toxocara invasion among children was detected, as well as key risk factors for infection (geophagia and/or contact with a dog), polymorphism of a clinical manifestation of the disease.
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