From Big Medical Encyclopedia

DEWORMING (Latin the de-prefix extraction, destruction + helminth[s]) — the complex of therapeutic and preventive measures directed to release of people, animal from helminths and to the prevention of pollution at the same time of the environment by invasive elements (eggs and larvae of helminths). For persons of some professions (employees of the food enterprises, cattle breeders and some other) D. is obligatory since patients with helminthoses can constitute in these conditions especially big danger as sources of an invasion. The term «deworming» is entered by K. I. Scriabin (1925). Then it put forward a problem devastation (see) helminths.

Of the population is carried out on an outpatient basis or in day gelmintol. hospitals under the direction of parazitol, departments city a dignity. - epidemiol, stations or a dignity. - epidemiol. departments of regional BCs. At the same time each patient who saw a doctor and each inpatient with any disease is inspected on availability of helminths and at identification of the last D.

Effektivnost D. is exposed depends on that, how fully it captured all patients. In this regard displays of a disease go for treatment without fail all infested irrespective of degree a wedge. Of the population is combined with wide a dignity. - a gleam, work and holding the actions directed to the prevention of new infections.

Mass D. of the population is of especially great importance in fight with ankilostomidozam (see), ascaridosis (see), hymenolepiasis (see), diphyllobotriases (see), opistorkhozam (see), enterobiosis (see) and teniarinkhozy. It is planned taking into account species composition of causative agents of helminthoses, availability of these or those anthelmintics, features of local conditions and life of the population. First of all treatment will see off among the most struck segments of the population, napr, children at an ascaridosis, an enterobiosis and a hymenolepiasis among them, fishermen and their families at diphyllobotriases.

The planned D. which is carried out to the USSR led to falloff of a prevalence of the population the majority of helminthoses. So, e.g., incidence teniarinkhozy in 1960 — 1970 is reduced by 20 times. The large role in decrease in prevalence of helminthoses is played by increase in welfare of the population, growth of its cultural level, improvement of living conditions and an action for improvement of the cities and villages.

At the choice of anthelmintics it is necessary to consider the state of health of each patient. In some cases to D. or along with it it is necessary to carry out treatment of other diseases which are available for patients or to direct them to the corresponding specialists. At some helminthoses it is required, in addition to specific, and pathogenetic treatment (e.g., anemias at diphyllobotriases and ankilostomidoza, damages of a liver at opistorkhoza, etc.). Purpose of anthelmintic drugs can be contraindicated to certain patients. Number of drugs (fern, etc.) has the increased solubility in alcohol and fats; therefore the products containing these substances shall be excluded from a diet in day of treatment and within 1 — 2 days after it.

For increase in efficiency of therapy release of intestines from the remains of food and slime is quite often reasonable. For this purpose appoint for one - two days to and during treatment easily assimilable food, and on the eve of treatment give laxative. At treatment long starvation since it weakens the patient is not recommended and increases his sensitivity to toxic effect of drugs.

Usually sick treat in process of identification of helminths, but in certain cases carry out mass D. when at patients still the immature worms which are not allocating invasive eggs and, therefore, harmless in epidemiol, the relation prevail. It is so-called preimaginalny D.; it is applied at an ascaridosis.

Control of efficiency of treatment is carried out at various helminthoses differently. At D. using laxative make washing of excrements for detection of the departed parasites and especially a scolex of tape-worms. In most cases helminths depart after treatment within several days; there is an allocation of eggs even longer. In this regard control of efficiency of treatment by a research of excrements on eggs and larvae of helminths is carried out in 2 — 3 weeks after D. (see. Helmintologic methods of a research ). In case of a negative take the research through some term is repeated. At treatment by phenasal of diphyllobotriases control is carried out in a month, at treatment of a teniarinkhoz in 3 — 4 months, at therapy of an opisthorchosis in 6 months after treatment.

Therapy of fabric helminthoses (filariases, shistosomoz) has the features. Many drugs enter subcutaneously, intramusculary or intravenously. At mass death of tissue parasites, and in some cases and the helminths parasitizing in the bilious courses of a liver and other bodies the phenomena of intoxication and an allergy can be observed. In order to avoid it recommend to extend a course of treatment, reducing daily doses of drugs.

A component of D. are preventive actions. The parasites who are allocated during treatment and excrements neutralize not extinguished or lime chloride. Toilet bowls and vessels process abrupt boiled water. In not channeled bathrooms the toilet seat and a floor process lime chloride.

Because at therapy patients with helminthoses allocate eggs and parasites for several days, it is necessary to provide ambulatories with lime chloride and to carry out explanatory work about importance of neutralization of excrements. Special danger of infection of people is constituted by dispersion of eggs and joints of pork and dwarfish tapeworms in this connection at therapy of a teniosis and hymenolepiasis rules of public and personal hygiene shall be followed especially carefully.

Along with individual hygiene carry out public a dignity. - preventive actions. In rural areas will organize cleaning of the territory of estates of garbage and fecal pollution, repair of bathrooms and so forth. Widely conduct a dignity. - a gleam, the work directed to an exception of a possibility of new infection with helminthoses of people and domestic animals. In fight against geohelminthoses (an ascaridosis, a trichuriasis, etc.) the leading value has neutralization of the excrements used for fertilizer of gardens and kitchen gardens, careful cleaning and washing of vegetables, fruit and other products. In fight against biohelminthoses (teniarinkhoz, a teniosis, a trichinosis diphyllobotriases, opistorkhoza, etc.) the main role belongs to full vt. - a dignity. to examination of meat and fish, consumption of enough thermally processed or salted meat and fish products. For prevention of infection of people echinococcosis (see) and nek-ry other larvaceous tsestodozam (see) vt. the service carries out planned D. guard and domestic dogs, extermination of stray dogs.

See also Helminthoses .

Bibliography: A. I moles. Bases of experimental therapy of helminthoses, M., 1973; L of e y to and N and E. S. The most important helminthoses of the person, page 162, M., 1967; Methodical materials on improvement of the population from helminthoses, under the editorship of V. P. Podjyapolskaya, page 199, M., 1969; Scriabin K. I. and Shultsr. AA. Helminthoses of the person, the p. 2, page 590, M. — L., 1931.

A. I. Krotov.