K. T. Hlushko*, H. A. Pavlyshyn, K. V. Kozak

Department of Pediatrics No 2, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine;
*e-mail: glushko_kt@tdmu.edu.ua

Received: 29 January 2021; Accepted: 23 April 2021

Diseases of the digestive system such as gastroduodenal disorders (GDD) and hepatobiliary diseases (HBD) are fairly common among children. At the same time, intestinal parasites are widespread gastrointestinal tract infectious agents. We examined 108 children with GDD (n = 54) and HBD (n = 54) (mean age 11.8 ± 4.3 years) who were treated in a children’s hospital. The following were performed: blood test for specific Ig to Ascaris lumbricoides, Toxocara canis; feces analysis for helminth eggs, Giardia cysts; and pinworm test. The serum level of interleukin-4 (IL-4) was measured in 97 of 108 children. Overall parasitic co-infections were found in 60.2% of children: giardiasis in 30.6%, toxocariasis in 17.6%, ascariasis seropositivity in 13.9% and enterobiasis in 8.3% of cases. Parasitic infections (PIs) occurred in 72.2% of the HBD group and in 48.2% of the GDD group (P = 0.01). Among the PIs only ascariasis was found more often in the HBD group (22.2%) compared with the GDD group (5.6%) (P = 0.01). The mean age of children who were positive for PI (PI+) was 9.9 ± 4.6 years; while in the PI negative (PI–) group the mean age was 12.8 ± 3.3 years (P < 0.001). In GDD the IL-4 level in PI+ group was 9.3 ± 0.9 pg/ml in the versus 6.9 ± 1.8 pg/ml in the PI‒ group (P = 0.02). Children with HBD and PI had higher IL-4 levels (14.2 ± 18.8 pg/ml) compared to those without PI (7.5 ± 2.4 pg/ml) (P = 0.03). The differing impact on the course and immune response in children depending on co-infection with PIs indicates the need for additional testing for these infections.

Keywords: children., digestive diseases, interleukin-4, parasitic infections