Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Build Healthy India Movement, NGO, Chandigarh, India.
Indian J Pediatr. 2018 Nov;85(11):1017-1024. doi: 10.1007/s12098-017-2505-z. Epub 2017 Nov 11.
Worm infections continue to be among the most common diseases affecting children from low and middle income countries. Major worm infections of public health importance include Ascariasis, Trichuriasis, Hookworm, and Enterobiasis, which are transmitted through contaminated soil. In India, combined prevalence rates of worm infestation as per pooled data of 127 surveys is over 20%. Although most helminthic infections are mild and are often asymptomatic, but moderate to heavy worm infestations are generally associated with growth faltering, nutritional compromise, anemia and suboptimal academic performance among children from endemic regions. Migration of larval or adult worms also underpins pulmonary and gastrointestinal morbidity in affected children. Some of the distinctive life cycle and clinical features of various worms are discussed in the review. The gold standard diagnostic technique for evaluation of worm infestation includes stool microscopy for direct egg detection and species identification. Most of the community based surveys for detecting soil transmitted helminths (STH) use Kato-Katz technique. The drug armamentarium against worm infestation has evolved tremendously in last three to four decades with the availability of more efficacious and broad spectrum anthelminthics. The key strategies of a multi-component integrated management of worm infestation include individualized treatment, community management (mass drug administration) as well as preventive measures. Finally, barriers to diagnosis, treatment and prevention of worm infestations need to be identified and aggressively managed at individual, family and societal levels so that WHO's 75% coverage target can be achieved to eliminate soil transmitted helminthiasis in children by 2020.
蠕虫感染仍然是中低收入国家儿童最常见的疾病之一。主要的公共卫生重要蠕虫感染包括蛔虫病、鞭虫病、钩虫病和蛲虫病，这些疾病通过受污染的土壤传播。在印度，根据 127 项调查的汇总数据，蠕虫感染的综合流行率超过 20%。虽然大多数寄生虫感染是轻微的，通常没有症状，但中度到重度的蠕虫感染通常与生长迟缓、营养不足、贫血和流行地区儿童的学习成绩不佳有关。幼虫或成虫的迁移也会导致受影响儿童的肺部和胃肠道疾病。本文综述了各种蠕虫的独特生命周期和临床特征。评估蠕虫感染的金标准诊断技术包括粪便显微镜检查直接检测虫卵和鉴定种类。大多数针对土壤传播性蠕虫（STH）的社区调查都使用加藤厚涂片技术。在过去三四十年中，驱虫药物的武器库发生了巨大的变化，出现了更有效和广谱的驱虫药物。蠕虫感染多组分综合管理的关键策略包括个体化治疗、社区管理（大规模药物治疗）以及预防措施。最后，需要在个人、家庭和社会层面上确定诊断、治疗和预防蠕虫感染的障碍，并积极加以管理，以便实现世界卫生组织到 2020 年将儿童中的土壤传播性蠕虫病感染率降低 75%的目标。
