Parasitosis debidas a helmintos intestinales: una actualización sobre su abordaje y tratamiento farmacológico en Costa Rica
Autores
Alberto Solano-Barquero, Dennis León-Alán
Resumen
En Costa Rica, se tiene la percepción de que las helmintiasis intestinales son muy poco prevalentes en todo el territorio nacional. Esfuerzos de diagnósticos más precisos en comunidades vulnerables a las parasitosis intestinales en Costa Rica, revelan que estas siguen siendo muy prevalentes. Se acepta que el tener parasitosis intestinales en los niños contribuye significativamente a la anemia, malnutrición, bajo peso, un desarrollo físico y cognitivo más lentos o deficientes. Diversos factores están relacionados con un abordaje no óptimo de las helmintiasis en nuestro país, y parte de estos factores tienen que ver con las técnicas diagnósticas utilizadas, el tipo y cantidad de información que manejan los profesionales de salud de atención primaria con respecto a detalles del ciclo de vida de los parásitos y el uso incorrecto de los fármacos antiparasitarios. En esta revisión, se ha recopilado la información actualizada disponible sobre el manejo de las helmintiasis intestinales más importantes en Costa Rica; además, se incluye el tratamiento farmacológico de estas.
Palabras clave
Parásitos intestinales, diagnóstico, Ascaris lumbricoides, helmintos intestinales diagnóstico, abordaje, terapéutico, tratamiento, fármacos, farmacoterapia, antiparasitarios , uncinarias, Trichocephalus trichiurus, Strongyloides stercoralis, Taenia solium, Hymenolepis nana, Hymenolepis diminuta,Abstract
In Costa Rica, there is a general perception that intestinal parasites are of minor concern because of its low incidence and prevalence in the whole territory. More accurate parasitological diagnosis in vulnerable communities of Costa Rica, which have several of risk factors, reveal that prevalence of parasites continue to be high. It is accepted that having intestinal parasites contributes significantly to anemia, malnutrition, low weight and suboptimal physical and cognitive development. There is a myriad of factors that explain why in Costa Rica the helminthiases are poorly analyzed and treated. Among those factors we can cite insufficient diagnostic work, gaps in medical training in relation to parasitic diseases, misuse of antiparasitic drugs. In this review we have compiled updated information on how to make a better approach and treatment of intestinal parasitic diseases caused by helminths.
Key words
Intestinal parasites, diagnostics, intestinal helminths, hookworms, diagnosis, therapeutic approach, treatment, drugs, pharmacotherapy, antiparasitic Ascaris lumbricoides, Trichocephalus trichiurus, hookworms, Strongyloides stercoralis, Taenia solium, Hymenolepis nana, Hymenolepis diminuta,Texto completo
Referencias
1. Pullan R, SmithJ, Jasrasaria R, y Brooker S. (2014). Global numbers of infection and
disease burden of soil transmitted helminth infections in 2010. Parasites & Vectors. 7, 37.
2. Parija SC, Chidambaram M, y Mandal J. (2017). Epidemiology and clinical features of soil-transmitted helminths. Tropical Parasitology.7, 81.
3. Lazarte, C. E., Soto, A., Alvarez, L., Bergenståhl, B., Medrano, N., y Granfeldt, Y. (2015).Nutritional status of children with intestinal parasites from a tropical area of Bolivia, emphasis on zinc and iron status. Food and Nutrition Sciences.6, 399.
4. Guerrant, RL, Oriá RB, Moore SR, Oriá MO, y Lima AA. (2008). Malnutritionas an enteric infectious disease with long-term effects on child development. Nutrition reviews.66, 487-505.
5. Owada K, Nielsen M, Lau CL, Clements AC, Yacob L ySoares Magalhaês RJ.(2017). Measuring the effect of soil transmitted helminth infections on cognitive function in children: systematic review and critical appraisal of evidence. Advances in Parasitology. 98, 1-37.
6. Ministerio de Salud de Costa Rica, INCIENSA. CCSS, INEC, ICD. (2012). Encuesta
Nacional de Nutrición 2008-2009. Fascículo 5: Parásitos Intestinales“. San José, Ministerio de Salud.
7. Abrahams-Sandí E, Solano M, y Rodríguez B. (2005). Prevalencia de parásitosintestinales en escolares de Limón Centro. Costa Rica. Revista Costarricense De Ciencias Médicas.26, 33-38.
8. Cerdas C, Araya E, y Coto S. (2003). Parásitos intestinales en la escuela 15 de agosto,
Tirrases de Curridabat, Costa Rica, mayo-junio de 2002. Revista Costarricense De Ciencias Médicas.24, 127-133.
9. Vercruysse J, Albonico M, Behnke JM, Kotze AC, Prichard RK, McCarthy JS y Levecke B. (2011). Is anthelmintic resistance a concern for the control of human soil-transmitted helminths? International Journal for Parasitology: Drugs and Drug Resistance.1, 14-27.
10. INEC. (2013). X Censo Nacional de Población y VI de Vivienda: Territorios Indígenas. Censo 2011.
11. Castro-Castillo A y Guerrero-Bermúdez OM. (2004). Técnicas de diagnóstico parasitológico. EUCR, Costa Rica.
12. Liu C, Lu L, Zhang L, Bai Y, Medina A, Rozelle S, Smith DS, Changhai Z y Zang W. (2017). More Poop, More Precision: Improving Epidemiologic Surveillance of Soil-Transmitted Helminths with Multiple Fecal Sampling using the Kato–Katz Technique. The American Journal of Tropical Medicine and Hygiene.97, 870-875.
13. Nikolay B, Brooker SJ, y Pullan RL. (2014). Sensitivity of diagnostic tests for human soil-transmitted helminth infections: a meta-analysis in the absence of a true gold standard. International journal for parasitology.44, 765-774.
14. Núñez-Fernández FÁ, Gonzalez ES y Villalvilla CMF. (1991). Comparison of several coproparasitological techniques for diagnosis of soil-transmitted helminthiasis. Revista do Instituto de Medicina Tropical de São Paulo.33, 403-406.
15. Brunton L y Chabner B. (2011). Goodman y Gilman's The pharmacological basis of therapeutics. New York: McGraw-Hill Medical.
16. Robertson DB, Maibach HI, Katzung B y Trevor A. (2015). Basic and Clinical
Pharmacology. Nueva York: Mc Graw-Hill.
17. Mehta PN. (2013). Drugs for intestinal helminths. Pediatric Infectious Disease.5, 22-25.
18. Kappagoda S, Singh U y Blackburn BG. (2011). Antiparasitic therapy. Mayo Clinic
Proceedings. 86, 561-583.
19. Jourdan P, Lamberton P, Fenwick A y Addiss D. (2017). Soil-transmitted helminth infections. The Lancet. doi: 10.1016/S0140-6736(17)31930-X.
20. Andrade AM, Perez Y, Lopez C, Serrano-Collazos S, Medina-Andrade A, Ortiz-Ramírez G y Medina-Andrade L. (2015). Intestinal obstruction in a3-year-old girl by Ascaris lumbricoides infestation: case report andreview of the literature.Medicine.94, e655.
21. Khuroo MS, Rather AA, Khuroo NS y Khuroo MS. (2016). Hepatobiliary and pancreatic ascariasis. World journal of gastroenterology.22, 7507
22. Agrawal A, Aggarwal B, Maletha M y Gupta S. (2017). Duodenal perforation with Ascaris lumbricoides in a child: A case report. Indian Journal of Child Health.4, 447-448.
23. Sangkhathat S, Patrapinyokul S, Wudhisuthimethawee P, Chedphaopan J y Mitamun W. (2003). Massive gastrointestinal bleeding in infants with ascariasis. Journal of pediatric surgery.38, 1696-1698.
24. Goyal A, Vishwakarma SK y KumarR. (1998). Abnormal migration of Ascaris into
the middle ear. Indian journal of pediatrics.65, 147-148.
25. Faraj JH. (1993). Upper airway obstruction by Ascaris worm. Canadian Journal of
Anesthesia/Journal canadien d'anesthésie.40, 471-471.
26. Gan RWC, Gohil R, Belfield K, Davies P y Daniel M. (2014). Acute airway obstruction by Ascaris lumbricoides in a 14-month-old boy. International journal of pediatric otorhinolaryngology, 78, 1795-1798.
27. World Health Organization. (2006). Preventive Chemotheraphy in Human
Helminthiasis:coordinated use of antehelminthic drugs in control interventions. a manual
for healthprofessionals and programme managers.Geneva, Switzerland: World Health
Organization.
28. Truscott JE, Turner HC y Anderson RM. (2015). What impact will theachievement of
the current World Health Organisation targets for anthelmintic treatment
coverage in children have on the intensity of soil transmitted helminth infections?.
Parasites&vectors. 8, 551.
29. Anderson RM, Turner HC, Truscott JE, Hollingsworth TD y Brooker SJ.(2015).
Should the goal for the treatment of soil transmitted helminth (STH) infections be
changed from morbidity control in children to community-wide transmission elimination?.
PLoS neglected tropical diseases.9, e0003897.
30.Steinmann P, Utzinger J, Du ZW, Jiang JY, Chen JX, Hattendorf J, Zhou Hy Zhou
XN. (2011). Efficacy of single-dose and triple-dose albendazole and mebendazole against
soil-transmitted helminths and Taenia spp.: a randomized controlled trial. PloS one.6,
e25003.
31. Keiser J y Utzinger J. (2008). Efficacy of current drugs against soil-transmitted
helminth infections: systematic review and meta-analysis. JAMA. 299, 1937-1948
32. Moser W, Schindler C y Keiser J. (2017). Efficacy of recommended drugs against
soil transmitted helminths: systematic review and network meta-analysis. BMJ.358, j4307.
33. Beach MJ, Streit TG, Addiss DG, Prospere R, RobertsJM y Lammie PJ. (1999).
Assessment of combined ivermectin and albendazole for treatment of intestinal
helminth and Wuchereria bancrofti infections in Haitian schoolchildren. The American
journal of tropical medicine and hygiene.60, 479-486.
34. Knopp S, Mohammed KA, Speich B, Hattendorf J, Khamis IS, Khamis ANy Utzinger
J. (2010). Albendazole and mebendazole administered alone or in combination
with ivermectin against Trichuris trichiura: a randomized controlled trial. Clinical
infectiousdiseases.51, 1420-1428.
35. Speich B, Ali SM, Bogoch I, Alles R, Huwyler J, Albonico M, Hattendorf J, Utzinger J y Keiser J. (2015). Efficacy and safety of albendazole plus ivermectin, albendazole plus mebendazole, albendazole plus oxantel pamoate, and mebendazole alone against Trichuris trichiura and concomitant soil-transmitted helminth infections: a four-arm, randomised controlled trial. The Lancet Infectious Diseases. 15, 277-284.
36. Moser W, Ali SM, Ame SM, Speich B, Puchkov M, Huwyler J, Albonico M,
HattendorfJ y Keiser J.(2016). Efficacy and safety of oxantel pamoate in school-aged
children infectedwithTrichuris trichiura on Pemba Island, Tanzania: a parallel,
randomised, controlled, doseranging study. The Lancet Infectious Diseases.16, 53-60.
37. Li QY, Zhao DH, Qu HY y Zhou CN. (2014). Life-threatening complications
of ascariasis in trauma patients: a review of the literature. World journal of emergency
medicine. 5, 165-170.
38. Nayak B, Dash RR y Mallik BN. (2014). Round worm in common bile duct, a rare
pathology: Review of 15 cases. Journal of Health Specialties.2, 174.
39. Becerril MA. (2014). Parasitología médica. McGraw Hill Mexico.
40. Dei M, Di Maggio F, Di Paolo G y Bruni, V. (2010). Vulvovaginitis in childhood. Best Practice y Research Clinical Obstetrics y Gynaecology.24, 129-137.
41. Tjaden BL y Schropp KP. (2014). Pediatric Intussusception Associated with Enterobius vermicularis. The Journal of pediatrics. 165, 1272-1272.
42. Serpytis M y Seinin D. (2012). Fatal case of ectopic enterobiasis: Enterobius vermicularisin the kidneys. Scandinavian journal of urology and nephrology. 46, 70-72.
43. Lamps LW. (2015). Hepatic Granulomas: A Review With Emphasis on Infectious Causes. Archives of Pathology and Laboratory Medicine.139, 867-875.
44. Beltrán M, Hara T y Tello R. (2005). Evaluación de los métodos de Graham y pin tape en el diagnóstico de Enterobius vermicularis. Revista Peruana de Medicina Experimental y Salud Pública.22, 76-78.
45. Georgiev VS.(2001). Chemotherapy of enterobiasis (oxyuriasis). Expert opinion on
Pharmacotherapy.2, 267-275.
46. Olsen A, Van Lieshout L, Marti H, Polderman T, Polman K, Steinmann P, Stothard R,
Thybo S, Verweij JJ yMagnussen, P. (2009). Strongyloidiasis–the most neglected of the
neglected tropicaldiseases?. Transactions of the Royal Society of Tropical Medicine and
Hygiene.103,967-972.
47. Geri G, Rabbat A, Mayaux J, Zafrani L, Chalumeau-Lemoine L, Guidet B, Azoulay Ey
Pène F. (2015). Strongyloides stercoralis hyperinfection syndrome: a case series and a
review of the literature. Infection.43, 691-698.
48. Izquierdo I, Briones J, Lluch R, Arqueros C y Martino R. (2013). FatalStrongyloides
hyperinfection complicating a gram-negative sepsis after allogeneic stem cell
transplantation: a case report and review of the literature. Case reports in
hematology.2013,1-5.
49. Montini F, Grenouillet F, Capellier G y Piton G. (2015). Strongyloidiasis: an
unusual cause of septic shock with pneumonia and enteropathy in western countries. BMJ
Case reports.doi:10.1136/bcr-2014-209028.
50. Igual-Adell R, Oltra-Alcaraz C, Soler-Company E, Sánchez-Sánchez P, Matogo-Oyana J y Rodríguez-Calabuig D. (2004). Efficacy and safety of ivermectin and thiabendazole in the treatment of strongyloidiasis. Expert opinion on pharmacotherapy.5, 2615-2619.
51. Fink DW y Porras AG. (1989). Pharmacokinetics of ivermectin in animals and
humans. In Ivermectin and abamectin (pp. 113-130). Springer New York.
52. Suputtamongkol Y, Premasathian N, Bhumimuang K, Waywa D, Nilganuwong S,
Karuphong E y Silpasakorn S. (2011). Efficacy and safety of single and double doses
of ivermectin versus 7-day high dose albendazole for chronic strongyloidiasis. PLoS
neglected tropical diseases.5, e1044.
53. Henriquez-Camacho C, Gotuzzo E, Echevarria J, White JrAC, Terashima A, Samalvides F, Pérez-Molina JA y Plana MN. (2016). Ivermectin versus albendazole or thiabendazole for Strongyloides stercoralis infection. Cochrane Database Systematic Reviews. doi:10.1002/14651858.CD007745.pub3
54. Yung EE, Lee CM, Boys J, Grabo DJ, Buxbaum JL y Chandrasoma PT.
(2014). Strongyloidiasis hyperinfection in a patient with a history of systemic lupus
erythematosus. The American journal of tropical medicine and hygiene.91, 806-809.
55. Chai JY. (2013). Praziquantel treatment in trematode and cestode infections: an update. Infection y chemotherapy.45, 32-43.
56. Debacq G, Moyano LM, García HH, Boumediene F, Marin B, Ngoungou EB y Preux, P. M. (2017). Systematic review and meta-analysis estimating association of cysticercosis and neurocysticercosis with epilepsy. PLoS Neglected Tropical Diseases.11, e0005153.
57. Del Brutto OH, Nash TE, White AC, Rajshekhar V, Wilkins PP, Singh G, Vásquez CM, Salgado P, Gilman RH y Garcia, HH. (2016). Revised diagnostic criteria for neurocysticercosis. Journal of the neurological sciences.372, 202-210.
58. Garcia HH, Nash TE y Del Brutto OH. (2014). Clinical symptoms, diagnosis, and treatment of neurocysticercosis. The Lancet Neurology.13, 1202-1215.
59. Taylor-Robinson DC, Maayan N, Soares-Weiser K, Donegan S y Garner P. (2012). Deworming drugs for soil-transmitted intestinal worms in children: effects on nutritional indicators, haemoglobin, and school performance. The Cochrane Database of Systematic Reviews.7, 1-157.
60. Keiser J y Utzinger J. (2010) The drugs we have and the drugswe need against major helminth infections. Advances in Parasitology. 73,197–230.
61. Campbell SJ, Nery SV, McCarthy JS, Gray DJ, Soares-Magalhaes RJ y Clements ACA. (2016). A critical appraisal of control strategies for soil-transmitted helminths. Trends in Parasitology.32, 97-107.
62. Walker M, Churcher TS y Basáñez MG. (2014). Models for measuring anthelmintic drug efficacy for parasitologists. Trends in parasitology.30, 528-537.
63. Luna Tortós C, Cedeño-Guerra HE y Correa-Prisant MT. (2007). Prácticas de manejo y uso de antiparasitarios internos en fincas lecheras artesanales de Costa Rica.Ciencias veterinarias.25, 359-380.
64. Maroto R, Jiménez AE, Romero JJ, Alvarez V, De Oliveira JB y Hernández J. (2011). First report of anthelmintic resistance in gastrointestinal nematodes of sheep from Costa Rica. Veterinary medicine international.2011, 1-4.
65. Salam RA, Haider BA, Humayun Q, y Bhutta ZA. (2015). Effect of administration of antihelminthics for soil-transmitted helminths during pregnancy. The Cochrane database of systematic reviews.doi: 10.1002/14651858.CD005547.pub3.
66. Mpairwe H, Tweyongyere R y Elliott A. (2014). Pregnancy and helminth infections. Parasite immunology.36, 328-337.
67. Imhoff‐Kunsch B y Briggs V. (2012). Antihelminthics in pregnancy and maternal, newborn and child health. Paediatric and perinatal epidemiology.26, 223-238.
68.Ndibazza J, Muhangi L, Akishule D, Kiggundu M, Ameke C, Oweka J, Kizindo R, Duong T, Kleinschmidt I, Muwanga A y Elliott AM. (2010). Effects of deworming during pregnancy on maternal and perinatal outcomes in Entebbe, Uganda: a randomized controlled trial. Clinical Infectious Diseases.50, 531-540.
69. Mpairwe H, Webb EL, Muhangi L, Ndibazza J, Akishule D, Nampijja M y Dunne DW. (2011). Anthelminthic treatment during pregnancy is associated with increased risk of infantile eczema: randomised‐controlled trial results. Pediatric Allergy and Immunology. 22, 305-312.
70. Sirivichayakul C, Pojjaroen-Anant C, Wisetsing P, Praevanit R, Chanthavanich P y Limkittikul K. (2003). The effectiveness of 3, 5 or 7 days of albendazole for the treatment of Trichuris trichiura infection. Annals of Tropical Medicine & Parasitology.97, 847-853.
71. Horton J. (2000). Albendazole: a review of anthelmintic efficacy and safety in humans. Parasitology.121, S113-S132.