Токсокароз у детей: эпидемиологические, клинические и лабораторные аспекты

Abstract

Aim: to optimize the diagnosis of toxocariasis based on the analysis of epidemiological, clinical and laboratory data in children with the infestation. Patients and Methods: the analysis of official statistical data for the period of 2014–2018, literature sources, a retrospective analysis of 57 medical records of patients (40 children and 17 adults) who received treatment and diagnostic in the clinic of the Rostov Research Institute of Microbiology and Parasitology of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing in 2015–2018 was conducted. Results: a decrease in the incidence of newly diagnosed infestation cases was revealed (registered in the clinic of the Rostov Research Institute of Microbiology and Parasitology of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing). It correlated with official statistics (r=0.9, p=0.05). Based on clinical and laboratory examination, the diagnosis was established in 26 patients (45.6%). Among patients with a verified diagnosis of toxocariasis, the proportion of children aged 1 years and 1 months to 10 years old, was 96%. An analysis of epidemiological data showed that 76% of children had close contact with the soil. The infestation occurred in the form of latent toxocariasis in 36% of patients. In more than half of the cases, the disease was clinically manifested by geophagy (56.0%). A permanent laboratory parameter was the eosinophilic leukemoid reaction in patients with toxocariasis. Peripheral blood eosinophilia ranged from 15.66.2±9.31% in latent toxocariasis to 25.5±15.0 % in visceral toxocariasis. The positive rate in ELISA with Toxocara antigen was higher than that in the group of patients with visceral toxocariasis. However, there was no correlation between the eosinophilia level and positive rate (r=0.1, p=0.05). Conclusion: in areas where the incidence of toxocariasis and environmental contamination with invasive helminth eggs are high, it is advisable to perform tests of the peripheral blood in children at least one time per year in the autumn for timely diagnosis of infestation. The use of ELISA with Toxocara antigen is reasonable in the cases of peripheral blood eosinophilia. KEYWORDS: toxocariasis, statistics, incidence, eosinophilia, enzyme-linked immunosorbent assay, Toxocara antigen. FOR CITATION: Andreeva A.O., Golovchenko N.V., Zhuravlev A.S. Toxocariasis in children: epidemiological, clinical and laboratory aspects. Russian Medical Inquiry. 2020;4(11):670–675. DOI: 10.32364/2587-6821-2020-4-11-670-675.