Worms

Worm Disease 

Worm infection is one of the most common diseases spread and infect more than 2 billion people around the world. In general, worms rarely cause serious illness, but it can lead to chronic health problems, which is a very important economic factor. Infection can occur simultaneously by several types of worms at once. It is estimated that more than 60% of children in Indonesia suffer from a worm infection. 

Transmission 

Worm infections generally occur through: 

Mouth

Sores on the skin

Eggs or larvae that exist everywhere on the ground (worm eggs out of the human stomach with feces, if the waste is discharged into the environment then it would make more luas.Contohnya spread if spread in the river, then the worm eggs will contaminate "the river water , food, wind "). Diagnosis: Microscopic examination of eggs or larvae in the feces, urine, blood and tissue. This determination is important because the drugs work mostly depends on the type of worm parasites. 

Symptoms of Worms 

Itching of the anus or feet, diarrhea, constipation, abdominal pain and small bowel obstruction and pancreatic ducts.

Distended abdomen, kelalahan very, decreased appetite, seizures, nausea and vomiting.

Weight loss, pallor and anemia or anemia

Symptoms or complaints may be caused by the toxic effects of substances exchange products worms, intestinal obstruction and bile duct (obstruction) or withdrawal of essential nutrients for the body. Often the symptoms are not so obvious and the only form of gastrointestinal disorders, such as nausea, vomiting, heartburn, diarrhea, convulsions and loss of appetite periodically with (anorexia). 

Prevention 

Common actions that need to be done is to obey hygiene rules firmly and consistently, especially in children. For example precautions taken: 

Wash hands with soap before and after waking up, after defecation and before eating and cut fingernails and do not bite your nails.

Wear footwear.

Not to snack at any place, let alone snacks open

Wash vegetables and fruits before eating the first running water or dip it a few seconds in boiling water, and the meat should be cooked until matah right before eaten.

Clothing and room: give the kids in tight pants to avoid contact between the finger and the rectum, the bedrooms are regularly cleaned.

At the same time, children who suffer from intestinal worms must be treated immediately. However, despite all of the children are taking medication worms, worms do not mean the problem will be completed on the spot

Do not eat anything that has been dropped on the ground without washing thoroughly first.

Thus oral infection most often occurs, can be avoided. In eradicating worm infections common hygiene measures need to be taken which includes housing improvement, social and economic environment. 

Types of worms 

Worms are parasites that humans can be divided into 2 groups, namely: 

Plathelminthes (flatworms). Characteristics: flat shape and does not have a body cavity.

Tapeworms (Cestoda): Taenia, echinococcus, Hymenolepsis, etc.. Echinococcus has a fixed host (dog)

Flatworms (Trematodes): Schistosoma, Fasciola, etc.. Schistosoma infected by its active form (cercariae). Fasciola (liver fluke) specifically found in sheep and pose include an enlarged liver, rarely infect humans. 

Nematode (Roundworm): Oxyuris (Kermi worms), Ascaris (roundworm), Ancylostoma (hookworm), Strongyloides and Trichuris (whipworm). Infection can occur through egg, larva or worm itself, through the mouth or through the skin.

As for the types of worms that infect humans are: 

Pinworms, pinworms spread is more common in cold regions. The female pinworm measuring 8-13 mm x 0:44 mm with a long tail and pointy looking male pinworms measuring 2-5 mm with a circular tail. Berrkisar worm life cycle between 2 weeks to 2 months. Pinworm transmission and transmission is affected by dust from hand to mouth. Diseases caused by pinworms known Enterobiasis. That places the inflammation around the rectum and the vagina girls inflammation. The introduction is through examination of the skin around the anus.

Bracelet worms, roundworms, similar to worms tanahpanjang 10-30 cm, small intestine dironggo life. This worm landed on the dog, the eggs can be removed with the feces of infected children when playing in the dust and be ingested by humans through food terkontamonasi. The eggs will hatch in the intestine, and then develop into larvae penetrate the intestinal wall and into the lungs. After adult roundworms will inhabit the human gut and invade the food there so that causes people to suffer malnutrition because food intake is absorbed by roundworms. Moreover cause intestinal blockage and inflammation of the appendix or pancreatic lobe. The introduction is through a fecal examination, where the worms and eggs with a real egg obvious. 

Whip worms, whip-like shape, 3-5 cm long. Infection occurs through the egg in water and food. Spreading occurs when swallowing whipworm eggs. In children whipworm can be found throughout the colon and rektum.Gejala per4mukaan that may occur in this disease is anemia. As a result, the children flocked cause inflammation of acute appendicitis or peritonitis. There are no worms in stool, only eggs that can be recognized by the microscope. 

Mine worm, this worm length between 6-12 mm. Has 4 teeth were similar, 90% of these infections are caused by N. Americanus. Hookworm eggs out along with feces, within 1 1.5 days the eggs will hatch into larvae called rhabditiform larvae. Three days later the larvae turn into filariform larvae that can penetrate the skin lareva feet and into the human body. In the human body, following the moves of hookworm bloodstream, heart, lungs, throat, and swallowed kemudiaan into the intestine. In the intestine, the larvae become adult worms are ready to suck the blood of so dangerous because it can cause anemia in humans. The symptoms are itching in the legs and cough with increasing temperature. 

Thread worms, worm infection worms live in the soil, infection occurs through the larvae penetrate the foot. The symptoms are intense itching in the anal area and inflammation of the skin. The introduction of the infection can be identified and thread worm larvae feces that do not contain eggs. The introduction can be recognized from larvanyha in the stool, which does not contain eggs. 

Ribbon worm, this worm length 60 cm in T. Solium and 2 m in T. Saginata found in beef liver. Consequently dangerous penetrate the intestinal wall, blood circulation and to other organs such as the brain, liver and lung. Transmission occurs by eating meat that has not been cooked long enough and still contain worm eggs. After hatching, the larvae grow into worms in the gut cavity. The introduction can be recognized from the eggs and ruasnya (3 cm long, 1 cm wide) are present in the feces. 

Breeding Worms 

Community widespread worms in the stomach easily. As an illustration, an adult female roundworm can produce 200,000 eggs per day. If there are five in the belly of the tail, they can produce a million eggs a day. Only egg size in units of microns (1 micron is one thousandth of a millimeter). So small, the eggs can only be seen with a microscope. 

Type Worm Disease 

Ascariasis: Mebendazole, pyrantel, Albendazole, piperazine. Ascaris lumbricoides (roundworm) 10-15 cm in length and usually reside in the small intestine. Transmission occurs through food by infected eggs and larvae that develop in the small intestine. The larvae penetrate the intestinal wall, through the heart and then to the lungs. After reaching the throat, then swallowed and breeding larvae into adult worms in the small intestine. Treatment: Mebendazole, Albendazole and pyrantel is the drug of first choice. Kur often have to be repeated with a second chair, because not all worms or eggs can be destroyed. 

Oxyuriasis: Mebendazole, pyrantel, Albendazole, piperazine. Enterobius vermicularis (formerly called oxyuris) or worms that are common in Kermi coecum, cause itching around the anus and severe convulsions in children. Sometimes these infections cause inflammation of the lobe acute appendicitis (appendicitis). Transmission in young children is often the case with the auto-reinfection, ie, through the eggs attached to the fingers while scratching the anal area, which felt very itchy and thus allowing secondary infections. The cause is the female worms are 8-13 mm in length, which is in between the hours of 8-9 nights out of the anus to lay eggs on the skin around the anus. Kermi worm infection is an infection of worms that is the only transmission takes place from person to person, so that all family members should be treated simultaneously as well, although they do not show any symptoms. The cause is the new female worms lay their eggs between 3-6 weeks after infeksi.Terapi: Mebendazole, Albendazole and pyrantel no lethal eggs so after 2 weeks of worms that hatched should be turned off by the second chair. Piperazine is the second choice drug. 

Taeniasis: Praziquantel, niclosamide. The most common tapeworm Taenia solium there is, T. Saginata there is lots of pork / beef, fish also. Transmission occurs by eating meat that is not cooked long enough and still contain larvae. Taenia difficult to eradicate, because the fist (scolenya) a relatively small embedded into the intestinal mucous membrane to terkenan no cure. Worms parts (segments) that come into contact with drugs and had been turned off, removed from the scolex which then makes new segments (regeneration). Segments and their eggs can be recognized in the stool, but scolexnya usually digested by the nodes usus.Terapi: the first choice drug Praziquantel and niclosamide. 

Ancylostomiasis: Mebendazole, Albendazole. There are 2 types of worms that Necator americanis Mine are mainly found in the United States and Ancylostoma duodenale are found in tropical / subtropical and length of approximately 10 mm. Transmission occurs by the larvae enter the broken skin on the feet and cause local reactions. Having entered the vein, the larvae to the lungs and bronchi ultimately to the gastrointestinal tract. Hookworm is also associate themselves with the intestinal mucosa and suck blood host to serious anemia. Treatment is directed at two objectives, namely improve blood picture (nutritious foods and iron compounds) and eradicate the worm. Mebendazole and pyrantel worm medicine is the first choice as well as to eradicate roundworm infection when mixed. 

Strongyloidiasis: tiabendazol, Ivermectin, Albendazole. Strongyloides stercooralis (thread worms) found in the tropics and subtropics. Transmission through the thread-shaped larvae penetrate the skin. The larvae can be recognized in the stool, which does not contain eggs. Since the auto-reinfection occurs, the worms can survive for decades in the mucosa of the upper small intestine. In this place, the worms cause inflammation and damage. Typical symptoms are intense itching (urticaria) on the rear, which is temporary, also stomach upsets and respiratory irritation (cough) due to migration of worms. Treatment: Tiabendazol and Ivermectin is the drug of first choice for thread worms. Albendazole is also effective. 

Trichiuriasis: Mebendazole, pyrantel, Albendazol.Trichiuris trichiura (whipworm) in the state are generally hot and humid climates. Contained in coecum (appendectomy) and settles in the ileum and colon mucosa, with causing damage and inflammation. Eggs are excreted in feces and used for diagnosis. Eggs can be grown in the ground. Transmission occurs through infected food and water. Symptoms in young children can lead to acute appendicitis. Due to blood loss anemia may also occur. Treatment is done effectively with Mebendazole, pyrantel, and Albendazole. 

Filariasis: Dietilkarbamazin (DEC) and Hetrazan. Wucheria bancrofti (filarial worm) is a family of filarial nematodes, which cause tropical diseases elephantiasis (elephantiasis). Inflammation of the lymph vessels to the blockage followed by adult worms (8-10 cm in length). As a result, hypertrophy of these tissues, especially in the legs that can grow up to 30 cm diameter. Transmission to humans occurs through the mosquito Culex fatigans, which stung by night. Treatment: Dietilkarbamazin especially when administered at an early time, sometimes requiring surgery to repair a lymph drainage and remove excess tissue. 

Schistosomiasis: Praziquantel. Schistosoma haematobium (flatworms) are not segmented worms and schistosomiasis are the cause of the disease is transmitted by a type of carrier snail larvae. Once developed, the parasites penetrate human skin and enter the blood circulation. Transmission occurs by cercariae, typical forms are released into the water by which the host (snail) which then penetrate human skin or mucous membranes. Sexual cycle occurs in humans with the formation of eggs excreted in feces or urine. In the water, out of the eggs and larvae infect snails, which produced tens of thousands of cercariae. Treatment: Medication is the first choice for all types of schistosomiasis Praziquantel that attack humans. 

Helminthic 

Anthelmintics or worming (Greek = anti = opponent, helmins = worm) is a drug that can destroy worms in humans and animals. 

Many antelmintika have efficacy against 1 or 2 types of worms. Only a few drugs that have efficacy against more types of worms (broad spectrum), eg: Mebendazole. 

Various Kinds of Drugs Worms 

Mebendazole: tiabendazol, albendazole.

very effective against pinworms, bracelets, ribbon, whip and mine.

Widely used as monotherapy for the treatment of mass deworming, also in mixed infections 2 or more worms. Working as vermicid, larvacid and ovicid.

Mechanism of action: counteraction revenue and accelerate the use of glucose (glycogen) in the worm.

Dosage: Children and adults alike, the Oxyuriasis single dose of 100 mg at breakfast time. In the roundworm infection, mining, thread, ribbon and whip 2 dd 100 mg for 3 days, if necessary, be repeated after 3 weeks.

2. Piperazine: Upixon 

Oxyuris and highly effective against Ascaris.

Worms paralyzed and then removed from the body by the intestinal peristalsis, as well as efficacious laksan weak.

Widely used because it is effective and inexpensive, but in many western countries since 1984 is not used anymore because of side effects, especially neurotoxicity.

Dose: Ascaris: 75 mg / kg or a single dose of 3 g for 2 days. Oxyuris 65 mg / kg or a single dose of 2.5 g for 7 days. 

4. Levamisole 

Effective against Ascaris, hookworms.

Side effects are rare, which is an allergic reaction (rash), granulocytopenia and other blood disorders 

5. Niclosamide: Yomesan 

Highly effective against tapeworms human / animal

Mechanisms: increased sensitivity to the protease enzyme that worm worm easier to digest.

Almost no side effects, but these drugs are highly toxic, its use must be careful to increase resorption disorders (colitis and bowel injuries).