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CLINIC OF VIRAL HEPATITIS A IN COMBINATION WITH HEMIOLIPEDIASIS
AND ENTEROBIASIS Koziyev Н.Н.1, Kalandarov M.K.2
1Koziyev Hamidullo Hayitboy ugli - Master, SPECIALIZATION: INFECTIOUS DISEASES;
2Kalandarov Madamin Kalandarovich - Candidate of Medical Sciences, Senior Lecturer, DEPARTMENT OF INFECTIOUS DISEASES ANDIJAN STATE MEDICAL INSTITUTE, ANDIJAN, UZBEKISTAN
Abstract: it has long been established that intestinal parasitoses are the most common among children everywhere in the world. Despite the enormous efforts made to combat them, the achievements are far from the desired. At the same time, new aspects of the socio-economic significance of intestinal parasitoses are revealed, in particular, their impact on the physical and mental development of children, on the increase in various morbidity among them. A number of transnational phenomena contribute to the deterioration of the situation of intestinal helminthiasis in the world.
Keywords: hepatitis A, enterobiosis, hymenolepidosis, clinic.
КЛИНИКА ВИРУСНОГО ГЕПАТИТА А В СОЧЕТАНИИ С ГЕМИОЛИПЕДИОЗОМ И ЭНТЕРОБИОЗОМ Козиев Х.Х.,1 Каландаров М.К.2
1Козиев Хамидулло Хайитбой угли - магистр, специализация: инфекционные болезни;
2Каландаров Мадамин Каландарович - кандидат медицинских наук, старший преподаватель,
кафедра инфекционных болезней, Андижанский государственный медицинский институт, г. Андижан, Республика Узбекистан
Аннотация: давно установлено, что наиболее распространенными среди детей повсеместно в мире являются кишечные паразитозы. Несмотря на огромные усилия, прилагаемые для борьбы с ними, достижения далеки от желаемого. Одновременно с этим раскрываются новые стороны социально-экономической значимости кишечных паразитозов, в частности, их воздействие на физическое и психическое развитие детей, на повышение среди них различной заболеваемости. Ухудшению ситуации по кишечным гельминтозам в мире способствует ряд транснациональных явлений. Ключевые слова: гепатит А, энтеробиоз, гименолепидоз, клиника.
УДК 6181-072-019
Relevance. The problem of viral hepatitis, despite the major achievements in its study, in the modern period remains traditionally relevant for world and domestic health care. Every year, more than 50 million people in the world become infected with hepatitis B, which is among the top ten causes of death in the population, killing about 1.5 million people annually, and, along with HS, belongs to diseases with high chroniogenic and oncogenic potential [2, 9].
The attention of specialists is still attracted by viral hepatitis A. In the last decade, the epidemic process of HA in the world has acquired a fundamentally new characteristic, which was primarily expressed in a decrease in its intensity, a shift in the incidence to older age groups of children, adolescents and adults. The proportion of the immune population among adults has significantly decreased, so in the age group of 20-29 years, antibodies to the HA virus are found only in 26.3% of individuals [5, 7, 11]. Despite such transformations, GA is the leading one in the etiology of liver diseases in children.
Children are a high risk group for intestinal parasites. Often, invasions are superimposed on the infectious process caused by hepatitis viruses. Viral hepatitis in 11% of cases proceeded in combination with giardiasis and helminthiases [5, 9, 10].
Purpose of the study. Based on the analysis of epidemiological patterns and the study of clinical and laboratory features of viral hepatitis in combination with enterobiasis and geminolepiasis in patients, to develop proposals for optimizing epidemiological diagnosis and prevention of mixed (viral-parasitic) pathology.
Materials and research methods. Comparison of epidemiological anamnesis data in 85 children of the main group suffering from GA against the background of giardiasis, and in 90 children suffering from monohepatitis A (comparison group) showed that the epidemiological anamnesis in the main group was more intense and indicated the likelihood of combined infection with GA and enterobiasis and geminolepidosis .
Research results. In modern conditions of transformation of the epidemic process of viral hepatitis in Andijan, GA occupies a leading position, both in the etiological structure and in intensity. Children are still the risk group for GA, but organized children aged 7-14 years are more actively involved in the epidemic process.
The prevalence of enterobiasis and geminolepidosis as a concomitant disease in children did not depend on the etiology of CH and ranged from 17 per 100 cases of GA to 20 per 100 cases of HB and HS. The frequency of detection of enterobiasis and heminolepidosis in patients with AVH exceeded, on average, 10 times that in the population of practically healthy children in the Andijan region.
The frequency of concomitant enterobiasis and geminolepidosis in patients with GA was determined by the influence of biological and social factors. The combined incidence of enterobiasis and geminolepidosis and HA was the highest (p<0.05) in boys, children aged 11-14 years. A trend towards an increase in the rates of concomitant giardiasis with an increase in the age of children has been established: from 14 per 100 patients with GA (1-6 years old) to 18 per 100 patients (7-14 years old). Hepatitis A and its accompanying enterobiasis and geminolepidosis were characterized by synchronous fluctuations by months with peaks in September and January.
Children with GA in combination with giardiasis were more often registered in family foci of mixed infection, lived in unsatisfactory sanitary conditions or outside the city.
GA in combination with giardiasis is characterized by a peculiar clinical picture: a longer incubation and prodromal period, a greater frequency of intoxication and dyspeptic syndromes in the icteric period, a slowdown in the normalization of biochemical parameters in the recovery period, and an increase in the frequency of relapses in the convalescence period.
During the period of convalescence, it is necessary to observe patients by specialists and laboratory examination in order to prevent relapses and control antiparasitic treatment.
Conclusion. The study of trends and features of the epidemic and infectious processes of hepatitis A in combination with intestinal parasitic diseases in patients made it possible to determine the structure of concomitant invasions, trends in the formation of mixed pathology, risk groups, develop an algorithm for epidemiological diagnosis and optimize the tactics of treatment and preventive measures.
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