[Current approaches to the treatment of helminthiasis in children].
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Flubendazole 5%, a parafluor analog of benzimidazole derivative, mebendazole, was found efficient in eliminating Trichuris trichiura infection of baboons when administered orally at a dose rate of 27 to 50 mg of the active ingredient per kg body weight twice daily for five days. The drug was found safe, without toxic effects and its palatability was excellent.
A group of 30 improved Valashka sheep, grazed in submontane pastures 3 and 6 km far from the emission source of mercury-dominated heavy metals (L1 and L2) and in pasture situated out of mercury emission fall-out (K), were investigated for the prevalence and mean intensity of pasture helminth infection. Hg concentration in the grass stand was determined by the distance of emission source. The amount of mercury was increasing in the direction from control locality to locality 1, lying 3 km from the emission source. With the mean concentration of 4.298 mg Hg/kg in grass stand, 0.346 mg Hg/kg in the liver, 0.591 mg Hg/kg in the kidneys and 0.030 mg Hg/kg in the muscles (Tab. I) a high prevalence of pasture helminths was recorded in sheep. This prevalence was increasing in the direction from control locality to the nearest emission source (Tab. II). The only exception was Moniezia spp. and Strongyloides papillosus, with values at locality 2 being lower than those at control locality. Trichostrongylus spp. and Cooperia spp. were equally prevalent at all the localities studied. Mean infection intensity (Tab. III) showed an increasing tendency from control locality towards locality 1. Only Dicrocoelium dentriticum and Strongyloides papillosus were an exception, with the highest mean infection intensity recorded at locality 2 (5.3 and 3.3 specimens, respectively). The highest mean intensity at control locality was recorded for Cooperia spp. infection (4.5 specimens). Mean infection intensity at locality 2 (6 km from emission source) and control locality showed proximate values in Moniezia spp. (1.3-1.2 specimens), Nematodirus spp. (2.6-2.4 specimens) and Cooperia spp. (4.0-4.5 specimens).(ABSTRACT TRUNCATED AT 250 WORDS)
Papua New Guinean schoolchildren in the highlands were randomly assigned to treatment groups in order to verify the effectiveness of mebendazole (Nordia) and compare it with mebendazole (Janssen) in both extended and single-dose therapy in a double-blind controlled study. Only the Janssen product given twice daily for three days was of value in 'curing' hookworm. Single-dose treatment with the same product was highly effective in treating roundworm but not hookworm or whipworm. Observations suggest that drug particle size may be an important determinant of efficacy against hookworm. Based on this study, the use of the Janssen formulation of mebendazole would be preferable.
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As part of a wide ranging project concerning education and health, aiming both to update and develop new materials and methods for 1st Grade schools, the present study investigated the state of knowledge and prevalence of helminthic diseases in school populations. Interviews and parasitological exams undertaken in four schools (two experimental and two controls) on the outskirts of Belo Horizonte showed: a. that both teachers and pupils have little information concerning helminthic diseases as well as incorrect notions and ignorance of the mechanisms of transmission; b. high prevalence in the school: 69.0% and 76.0% (Bairro Gorduras) and 46.0% and 24.0% (Vale do Jatobá and Barreiro de Cima) in the first year of study (1988). Comparing the four schools, there is a direct relationship between the living conditions of the pupils and the indices of prevalence. Considering the fact that such helminthic diseases are known to have been present for a long time, it is a striking how removed the school is from the problems and realities of its pupils.
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Very few uncertain and not trustworthy reports about the frequency of intestinal helminthiases found in humans have been made in México. However, with the few trustful studies carried out from 1981 to 1992, it is possible in México to verify that ascariasis, trichuriasis, hookworm infection and hymenolepiasis are present with significant percentages of infected people 11.2%, 1.7%, 0.15% and 1.8%, respectively. With the information obtained from the researches analyzed in this article, one can conclude that human infections by intestinal helminths in México, at the present time are almost as frequent as in past decades. Without any doubt, this occurs because still remain the factors that contribute to the persistence and spreading of the intestinal helminths, such as fecalism, poor hygienic and alimentary habits within deficient environmental sanitary conditions.
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In case of nonspecific, not constantly occurring abdominal symptoms the investigator should be aware of invermination, especially when immigrants or tourists returning from far regions complain about diarrheal tendency, stomach ache, nausea or hepatic and biliary symptoms. Intestinal helminthism is spread all over the world. Some of these diseases are limited to warm regions, but they are more and more often seen in our gastroenterological outpatient departments. Nematodes are found most frequently, with a predominance of Ascaris, Trichuris, and Enterobius. But Ancylostoma and Strongyloides are not seldom, too. Concerning Cestodes, Taenia and Vampirolepis are predominant. Trematodes = Fasciola, Echinostoma, Schistosoma are less frequent. Larva migrans, Acanthocephala and Dipylidium sometimes cause considerable diagnostive problems. Classification of macroscopic and microscopic findings is decisive for the therapeutic strategy. For nematodiasis Mebendazole (Vermox, Surfont), Pyrantelembonate (Helmex), Pyrviniumembonate (Molevac, Pyrcon) are effective. Albendazole (Eskazole) is approved for strongyloidiasis. For cestodiasis Niclosamid (Yomesan) and Praziquantel (Cesol) are suited. Higher doses of Praziquantel (Biltricide) are recommended for trematodiasis. During pregnancy and lactation period absorbable anthelmintics have to be avoided.
In a study of urban slum school children (276 boys and 231 girls), in Ujung Pandang, Indonesia, parasitological and anthropometric exams were cross-sectionally performed to assess prevalence and intensity of helminth infections and nutritional status. Prevalence of Ascaris, Trichuris and hookworm was 92%, 98%, and 1.4%, respectively. 91% children had both Ascaris and Trichuris infections. About half of the Ascaris- and Trichuris-infected children (46% and 58%, respectively) had moderate infections. Stunting was seen in 55% of the children, while wasting was observed in 10%. Boys had lower nutritional status than girls (p < 0.001), based on weight-for-age (WA) and height-for-age (HA) Z-scores. Age had an inverse relationship with WA and HA Z-scores (p < 0.0004). A relationship between helminth infections and nutritional status was observed between log Trichuris egg count and WA and HA Z-scores after controlling for age, sex, and log Ascaris egg count (p = 0.048 for HA Z-score, and p = 0.058 for WA Z-score). The relationship was also found when Trichuris infection was categorized into mild, moderate, and severe infections (p = 0.017 and p = 0.001 for HA and WA Z-scores, respectively). Scheffe's test for multiple mean comparisons showed that Trichuris-infected children with above 1,000 eggs per gram feces had significantly lower nutritional status than lower epg or non-infected children (p < 0.001 and p < 0.05 for HA and WA Z-scores respectively).
A cross sectional survey was carried out on intestinal parasites in a rural village located in a Sudan savannah area of Mali in September 1994. This survey was aimed to describe the prevalence of intestinal protozoa and helminths, and to evaluate the possible epidemiological impact of some sociobehavioural factors. A total of 209 stool specimens were examined with 3 methods: fresh stool examination, Kato thick smear technique and a formalin-ether concentration technique in a closed system. Cryptosporidium was also searched following the Ziehl-Neelsen staining and the immunofluorescence method using monoclonal antibody. Microsporidia were investigated by Trichrome staining technique. The concentration technique, as expected, was the more sensitive method: the protozoan cyst rate and the helminth egg rate were 70.3% and 11%, respectively. The low prevalence of intestinal nematodes, unexpected for this area, could be attributed to the improvement in sanitation (traditional WC present in 73.9% of the families), but also to the repeated treatments of the population against onchocercosis with ivermectin since 1992. We found no cases of isosporosis, cryptosporidiosis and microsporidiosis in our study population, neither significant association between socio-behavioural factors and parasitic infections.
The nematode Cyathostoma variegatum (a lungworm) was present in the distal trachea and proximal bronchi of an 8-mo-old emu that was euthanatized after fracturing the left tibiotarsus. Clinical signs of infection were not present prior to euthanasia and abnormalities were not noted on gross or histologic examination of the respiratory tract. The absence of respiratory signs in this and other emus underscores the need for routine fecal examinations to interrupt the inadvertent spread of this potentially life-threatening parasite. In addition to the lungworms, large helminth eggs were present in renal and reproductive tissue. Egg morphology was suggestive of species of Deletrocephalus or Paradeletrocephalus. The mechanism by which these eggs became lodged in this ectopic site is unknown.