Analysis for enterobiasis. How to take a child to a kindergarten, school, pool

Enterobiasis is a disease caused by pinworms. These are worms, white or light gray in color. Female pinworms reach a length of 10 mm, and males - no more than 6 mm. Enterobiasis is one of the most common diseases, so children often have to be checked through a simple and painless analysis. It is necessary to hand over the material immediately after sleep due to the peculiarities of the pathogen's vital activity.

When is a scraping test for enterobiasis prescribed?

As a rule, children receive a referral for the delivery of material to determine the presence or absence of enterobiasis. Detection of helminthic infestation will not allow the child to attend children's groups, in particular a kindergarten, and also deprive the child of the opportunity to swim in a public pool and go to school. Such severity in relation to enterobiasis is due to the broadest spread of infection.

According to data from open medical sources, including those posted on the website of the World Health Organization, up to 1 billion people are simultaneously carriers of enterobiasis all over the world. This confirms the urgency of the problem and clearly demonstrates the ability of infection to be transmitted from person to person.

One female pinworm can lay up to 13,000 eggs per day. Their microscopic size and countless number allow them to easily spread over surfaces, objects, substances and re-enter the mouth of an already infected person, infecting him again, despite the effective treatment.

An analysis for enterobiasis should be passed to a child every time he has been absent from the team for a long time, for example, after the summer holidays. In the middle of the year, preventive studies can be carried out to identify the presence of pinworms in pupils.

If at least one child tests positive, the entire group room, including curtains and toys, must be sanitized. Large-sized toys, which cannot be washed, are steamed or taken outside on a frosty day.

Before visiting the pool, it is also necessary to pass such an analysis. If a person infected with enterobiasis enters the water, pinworm eggs from the folds on the skin will fall into the water and instantly spread throughout the entire thickness. While swimming, the rest of the pool visitors will easily become infected through the nose or mouth when eggs, along with water droplets, accidentally enter the upper esophagus. Therefore, it is impossible to obtain a permit to visit the pool without a certificate of the absence of enterobiasis.

By September 1, each school requires the submission of the results of the analysis, the limitation period of which is no more than 10 calendar days. This measure is also aimed at reducing the spread of enterobiasis in schoolchildren. Children often forget to wash their hands, put pens in their mouths, and go to the dining room to eat after holding onto the stair rail. All this contributes to infection, so a child with a positive test will not be allowed to attend classes until he has fully recovered.

What is the best time to take the test?

To understand the best time to submit material for research, you need to know the life cycle of pinworms - the causative agents of enterobiasis. Pinworms enter the human body in the form of eggs through dirty hands. Most of the eggs are under the nails. Even a slightly grown edge of the nail can hide hundreds of future pinworms.

Once in the esophagus, the egg waits for the moment when it will be delivered by the digestive system to the lower parts of the small intestine. There, in a favorable environment for life, the egg matures and turns into an adult. Sexually mature pinworms feed on the contents of the intestine, attaching to its wall. Males don't go anywhere. After fertilizing the female, they remain in the upper part of the large intestine.

The female, with a clutch of eggs attached to the body, descends to the very bottom of the rectum, is fixed on its wall and waits for a convenient moment to exit. A person ceases to be active at night. When he sleeps, the sphincter of the anus relaxes, allowing the female pinworm to come out.

Here, in the folds around the anal ring, she lays more than ten thousand eggs and pours isovaleric acid on the clutch, which causes severe itching in the anus. In a dream, a person, having scratched a place treated with a pinworm, brings thousands of eggs under his nails. Further, during the day, they spread over all surfaces that an infected person is taken to.

In order for the analysis for enterobiasis to give a reliable result, it is important to take the material in the morning, immediately after waking up, even before the toilet of the external genital organs is carried out. Otherwise, the masonry will be washed off the folds with soap, and the result will be false negative.

Material for research

It is not difficult for a child to take an analysis for enterobiasis. The material is taken painlessly using adhesive tape or a special small spatula. Sticky tape is glued to the anal sphincter for a second and the material is immediately transferred to laboratory glass. An alternative method is scraping with a special spatula, which is carried out along the folds of the anus. The collected particles must also be transferred to glass.

In order to be able to assert with 100% certainty that a person is not infected with pinworms, the analysis is carried out in several stages:

• hand over material strictly in the morning;
• before submitting the material, you must not wash and empty the intestines;
• the frequency of delivery of the material - 1 time in 2 days;
• frequency - 7 times.

But since, according to this scheme, analyzes are handed over in rare cases, one has to believe a single study. Re-delivery, as a rule, is appointed only when there are complaints of the examinee himself about itching in the groin.

Preparing the child for analysis

An analysis for enterobiasis can be taken to a child without any special training. The study does not require prior diet, physical activity, or no breakfast. When handing over the material in the conditions of the treatment room of the city polyclinic, it is enough to arrive on time with a referral for analysis.

Children of any age can enter the office in the presence of their parent. Preschoolers need an adult for both physical assistance and moral support. Primary school students must be tested before each school year, but in the event of a severe epidemiological situation, additional research may be carried out within the school.

Each parent must warn the child that, without his official consent, they do not have the right to force him to take an enterobiasis test at school.

If the material is handed over to a commercial laboratory, and not to a state clinic, it is better to collect it yourself. This will improve the reliability of the results. Features of collecting material at home are shown in Table 1.

Table 1. Rules for collecting material at home.

Container type	Sterile tube and swab probe	Container with a spatula impregnated with water-based glue
What material is collected	Swab in glycerin.	Putty knife
How to collect material	Scrap the folds around the anus.	Press the glue-coated end of the spatula against the folds of the perianal area.
How to store collected biomaterial	Place the swab probe into the tube and close the lid tightly.	Lower the spatula into the container and securely close the lid.
Permissible storage time and conditions	Keep the test tube in a refrigerator at a temperature from +2 to + 8 ℃. Do not freeze! Deliver to the collection point before 18:00 of the current day.

You need to collect material immediately after waking up, without getting out of bed. While lying on your side, you need to bend your knees and press them to your stomach. This is the most convenient way to access the perianal area. You can get a special container or test tube at the collection point of the paid laboratory where you plan to donate the material. Some organizations provide containers for free, others sell them, but the cost of the container is later deducted from the total amount of the laboratory test.

Analysis method

In the course of conducting thousands of studies, medical statistics showed that three methods were the most informative:

• the Graham method - the main tool of which is sticky tape;
• the Rabinovich method, in which glass spatula sticks are used;
• method using cotton swabs with glycerin.

Regardless of how the biomaterial was obtained, it is applied to a special glass. It is enough for a laboratory assistant to bring it under a microscope and examine the active area at moderate magnification.

Graham's method is recognized as the most convenient when it comes to mass examination.

The preparation of instruments and the procedure are carried out in several stages:

1. Measure 8-10 cm of sticky tape (narrow stationery tape) and secure it to the slide.
2. Before taking the material, peel off the piece of tape from the glass and, holding it by both ends, press it tightly against the folds around the anus with the sticky side. The technician should not touch the perianal area with his hands.
3. The adhesive tape is carefully removed from the skin and evenly adhered to the glass slide so as to minimize the number of bubbles on the plane.
4. Excess tape fragments that go beyond the edge of the glass are cut off.

The child will not have to take the analysis for enterobiasis again if the microscopy is not hindered by a poorly glued strip on the glass slide. The laboratory technician will microscop the samples with the objective lens 8 or 10 times and the eyepiece 7-10 times. In addition to enterobiasis, Graham's technique allows you to identify two other diseases: teniasis and teniarinhoses.

Decoding the analysis for enterobiasis

While examining the slide, the technician looks for specific pinworm eggs. The size of each depends on the degree of maturity. Some can be 50x40 microns, while others can be almost one and a half times larger and reach 70 microns in length and 50 in width.

Pinworm eggs are asymmetrical, oval in shape. One side of the egg is oval, while the other is flattened. The structure of the shell is smooth, multi-layered and thin. An embryo can hide inside, the stage of development of which depends on the duration of stay on the skin. Sometimes already mature larvae can be seen.

On the decryption sheet, the laboratory indicates the name of the pathogen, the presence of which must be confirmed or refuted by analysis. In this case, it is "Eggs of Enterobius vermicularis". Microscopy is indicated as the type of examination.

If the laboratory assistant saw the desired masonry on the glass, the decryption will indicate “found”. Admission to children's and other public institutions can only be obtained if there is a result labeled "not found" - this is the second possible variant of the research result. There are no intermediate values.

What can affect the result of the analysis?

The analysis can give a false negative result in several cases:

• The patient had a bowel movement before taking a swab / collecting material. The feces, passing through the anus, touch its straightened folds, as a result of which most of the eggs may end up in the sewer. In addition, after the act of defecation, the use of dry or wet wipes, as well as running water, can completely clean the surface of the skin from pinworm larvae.
• Hygiene procedures before visiting the clinic or self-collection of material.
• Using the cream at night around the anus. This type of care ensures that all the eggs that the female pinworm will lay on the underwear and bedding, and not stick to the skin.
• Active scratching of the anus - traces of pinworms will be collected to a greater extent under the nails and spread over the bed and objects, and there will be no eggs left on the perianal region for research.
• Material improperly assembled - the adhesive tape was loosely adhered to the skin.

Due to the fact that the result is determined by the laboratory assistant, the human factor is not excluded. In the case of reagents, when several substances enter into a chemical reaction, there are fewer errors. therefore, tests for hormones and blood levels of various impurities, as a rule, are rare false negative.

Additional examination in case of deviation from the norm

Analysis for enterobiasis can be carried out in a complex. In this case, a scraping is taken - a method that gives a maximum of information, and along with it an analysis of feces for worm eggs and a blood test for antibodies to pinworms is prescribed. If the child went to the toilet on the eve of the delivery of the material, the container with feces should be stored in the refrigerator.

An additional method for examining feces for worm eggs is considered only as a secondary source of information, since clutching is extremely rare in feces. Only by coincidence, both the female pinworm and her eggs end up in excrement - when she did not have time to gain a foothold on the intestinal wall and was carried out along with the feces.

It is possible to find sexually mature pinworms in the patient's stool even in the case when the infection has occurred a long time ago and the population of pinworms has become so large that females do not find free space at the exit from the rectum to gain a foothold, and find themselves outside together with feces.

Additionally, there is another diagnostic method when you need to donate blood. But this research method is considered expensive, which is why it is not widespread. In rare cases, medical institutions resort to it when it is necessary to identify the presence and number of antibodies to pinworms. However, this diagnostic method does not provide information about the infection of a person at a given time.

Even the most reliable - scraping - does not always show a truly negative value. Antibodies to pinworms in the blood indicate only that the human body has dealt with this type of worm, and immunity recognized it. As a defense reaction, antibodies have been produced that remain forever in the circulatory system.

Do not ignore the direction for analysis, which allows you to identify enterobiasis. The delivery of the biomaterial is absolutely painless, which means that it does not harm the child even as a preventive measure. The absence of obvious symptoms in the form of itching of the anus is not yet an indicator of the absence of helminthic invasion, since pinworms can live in the human body for a long time without giving themselves out.

On the contrary, nocturnal grinding of teeth is not an indicator of the development of enterobiasis. This is an exclusively psychological feature of a person, often indicating emotional overstrain during the day.

Author: Rudich Anastasia

Video about the analysis for enterobiasis

Scraping for enterobiasis: