Volume 02 Issue 09-2022
17
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
02
I
SSUE
09
Pages:
17-21
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
OCLC
–
1121105677
METADATA
IF
–
5.654
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
The work is based on the assessment of age-related features of clinical manifestations of giardiasis. We observed 124
patients aged 3 to 18 years, including 104 children with giardiasis and 20 children of the same age without giardiasis,
who made up the comparison group.
The clinical picture of giardiasis in children is characterized by a combination of pain, dyspeptic and astheno-neurotic
syndromes. With age, there is a decrease in the frequency of pain in the navel area and an increase in pain in the
epigastric region, left and right hypochondria, as well as a tendency to increase the frequency and intensity of pain,
without a clear connection with food intake. Dyspeptic disorders such as heartburn, belching, nausea are more
common in older children, while cases of vomiting become less frequent with age. Diarrhea is one of the leading
symptoms regardless of age. A characteristic clinical symptom of giardiasis is pigmentation of the navel and the white
line of the abdomen, the symptom has 100% sensitivity and 78% specificity.
KEYWORDS
Giardiasis, clinic, dyspeptic disorder, helicobacter infection.
INTRODUCTION
Uzbekistan is one of the countries with a hot climate
for which helminthic and protozoal diseases are
endemic [1,2]. To date, the number of infected is about
200 thousand people, 70% are children under 14 years
Research Article
AGE-RELATED FEATURES OF CLINICAL MANIFESTATIONS OF
GIARDIASIS
Submission Date:
September 10, 2022,
Accepted Date:
September 20, 2022,
Published Date:
September 30, 2022
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume02Issue09-05
Mukhtarova Sh.A.
Bukhara State Medical Institute, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 02 Issue 09-2022
18
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
02
I
SSUE
09
Pages:
17-21
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
OCLC
–
1121105677
METADATA
IF
–
5.654
Publisher:
Oscar Publishing Services
Servi
of age. The most widespread on the territory of
Uzbekistan from protozoal invasion belongs to
giardiasis,
and
from
helminthic
invasion
to
hymenolepidosis [3,4]. The problem of giardiasis is one
of the most urgent in childhood. According to WHO
(2002), its prevalence in the child population is 355
cases per 100,000 children. In different regions, this
figure may fluctuate up or down depending on social
and living conditions, housing conditions [5,6,7,8,9,
10], the possibility of diagnosing giardiasis, as well as
the alertness of doctors about this parasitic invasion.
The relevance of giardiasis in children is largely due to
the fact that its clinical manifestations are often
masked by various variants of gastroenterological
pathology [11,12,13,14,15,16], including functional
disorders of the gastrointestinal tract (gastrointestinal
tract), syndromes of excessive growth of intestinal
microflora in the small intestine, malabsorption,
multivitamin deficiency, as well as the development of
allergic diseases - recurrent urticaria, atopic dermatitis,
gastrointestinal form of food allergy, which without
adequate therapy acquire a recurrent course
[17,18,19,20,21,22]. At the same time, the lack of
verification of the diagnosis does not allow for
adequate therapy.
The purpose of the work
. To study age-related
features of clinical manifestations of giardiasis.
MATERIALS AND METHODS
The study was conducted on the basis of the Bukhara
Regional Infectious Diseases Hospital. We observed
124 patients aged 3 to 18 years, including 104 children
with giardiasis and 20 children of the same age without
giardiasis, who made up the comparison group.
Children with giardiasis, depending on the combination
with HP infection, were divided into 2 groups: group 1 -
42 people with giardiasis invasion without HP infection.
Group 2 - 62 people with giardiasis invasion in
combination with HP infection. 20 people in the
comparison group, without giardiasis, but with HP-
associated gastroduodenal pathology, made up group
3. The groups were formed in such a way in order to
clarify the clinical, endoscopic and morphological
differences of gastroduodenal pathology caused by HP
infection and giardiasis, as well as especially combined
invasion.
Clinical and anamnestic examination was carried out
according to a questionnaire developed by us, which
took into account complaints, anamnesis of the
disease, and objective examination data. All children
underwent the following studies: clinical blood and
urine tests, coprogram, stool culture for intestinal
group, stool culture for dysbiosis, stool analysis for
worm eggs and giardia cysts.
THE RESULTS OF THE STUDY AND THEIR DISCUSSION
The analysis of clinical and anamnestic features in
children of the studied groups showed that the clinical
symptoms of giardiasis in children are characterized by
a combination of abdominal pain and dyspeptic
symptoms. Most often, the pain is localized in the navel
area (53.1%) and can be combined with pain in the right
(15.6%) and left (15.6) hypochondria. Pain is infrequent,
moderate in intensity (78.1%), sometimes mild (6.25%),
more often unrelated to eating (62.5%), or occurring
immediately after eating (21.8%). Unlike giardiasis, for
children with HP-associated diseases, recurrent
epigastric pain is more characteristic (65%), usually
daily (50%), more intense (25%), which are associated
with food intake (100%) and are more often noted an
hour after eating (80%) or immediately after eating
(20%). Patients with mixed giardiasis and HP infection
are characterized by a combination of the features of
the pain syndrome described above. The most
characteristic dyspeptic disorders in children with
Volume 02 Issue 09-2022
19
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
02
I
SSUE
09
Pages:
17-21
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
OCLC
–
1121105677
METADATA
IF
–
5.654
Publisher:
Oscar Publishing Services
Servi
giardiasis were diarrhea, it was observed in 71.5% of
children, 69% had flatulence, 24% had periodic
vomiting. With HP infection, symptoms caused by
dysmotor disorders of the upper gastrointestinal tract
were more common: nausea (65%), belching (40%) and
heartburn (25%), without violation of the frequency
and nature of stool. With combined invasion, any of the
above
symptoms
were
noted
in
different
combinations. With age, with giardiasis, there is a
decrease in the frequency of pain in the navel area,
which is probably due to the fact that older children
can more accurately localize pain, and there is also an
increase in pain in the epigastric region, left and right
hypochondria. In addition, with age, there is a
tendency to increase the frequency and intensity of
pain, without a clear connection with food intake.
pancreatic type - it was found only in patients with
giardiasis: in 2.3% in group 1 and in 8.1% of patients with
combined invasion.
Data analysis showed that allergic reactions to food
antigens occur in children with giardiasis in 82% overall,
which is significantly more common than in HS
(p<0.05). Allergic reactions to citrus fruits, milk, fish,
and eggs were more common. Allergies to fish and red
fruits were significantly more common (p<0.05) than in
the comparison group.
Allergic reactions to medications in children with
giardiasis tended to increase with age. Eosinophilia
occurred in a third of patients with giardiasis (17%), it
was somewhat more common with a combination of
giardiasis and helicobacter infections (22.5%) and was
not observed in any patient from the comparison
group (p<0.05). Eosinophilia was more common in
middle age groups: in group 2, 5 (24%) patients, in
group 3, 10 (29%). In adolescents aged 15-18 years,
eosinophilia occurred in 4 (14%) cases, in children aged
3-6 years - in 2 (10%).
During an objective examination of patients with
giardiasis, we noticed a high frequency of
pigmentation symptoms around the navel and along
the white line of the abdomen. This symptom had 100%
specificity and 78% sensitivity.
The astheno-neurotic syndrome, manifestations of
vegetative-visceral
dysfunctions
and
allergic
manifestations found in patients with giardiasis in all
cases were combined with pain and dyspeptic
abdominal syndromes, which did not allow us to
identify individual clinical forms of giardiasis. The high
frequency of these extra-digestive syndromes
indicates an undoubted connection of their
development with this parasitic invasion and
complements its clinical picture.
Conclusion. The clinical picture of giardiasis in children
is characterized by a combination of pain, dyspeptic
and astheno-neurotic syndromes. With age, there is a
decrease in the frequency of pain in the navel area and
an increase in pain in the epigastric region, left and
right hypochondria, as well as a tendency to increase
the frequency and intensity of pain, without a clear
connection with food intake. Dyspeptic disorders such
as heartburn, belching, nausea are more common in
older children, while cases of vomiting become less
frequent with age. Diarrhea is one of the leading
symptoms regardless of age. A characteristic clinical
symptom of giardiasis is pigmentation of the navel and
the white line of the abdomen, the symptom has 100%
sensitivity and 78% specificity.
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Volume 02 Issue 09-2022
20
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
02
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SSUE
09
Pages:
17-21
SJIF
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MPACT
FACTOR
(2021:
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694
)
(2022:
5.
893
)
OCLC
–
1121105677
METADATA
IF
–
5.654
Publisher:
Oscar Publishing Services
Servi
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