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O‘ZBEKISTON RESPUBLIKASIDA ASKARIDOZ KASALLIGINING RETROSPEKTIV
EPIDEMIOLOGIK TAHLILI HAMDA PROFILAKTIK CHORA – TADBIRLARNI
TAKOMILLASHTIRISH
Sh.M. Rasulo , A.Y. Toshpo‘la o
Toshken ibbiyo akademiyasi Te miz iliali
Anno a siya:Ushbu maqolada O‘zbekis on Respublikasida 2011 – 2021 yilla dagi aska idoz
kasalligining e ospek i epidemiologik ahlili,ya’ni Respublika bo‘yicha, ma’mu iy hududla
bo‘yicha hamda kasallikning yoshla a jinsla bo‘yicha ahlili na ijala ibayon qilingan. Bundan
ashqa i maqolada aska idoz kasalligining p o ilak ikasini akomillash i ish bo‘yicha akli la ishlab
chiqilgan.
Kali so‘zla : epidemiologiya, aska idoz, geogelmin , gelmin , in aziya, e ospek i epidemiologik
ahlil, p o ilak ika.
РЕТРОСПЕКТИВНЫЙ ЭПИДЕМИОЛОГИЧЕСКИЙ АНАЛИЗ ЗАБОЛЕВАЕМОСТИ
АСКАРИДОЗОМ В РЕСПУБЛИКЕ УЗБЕКИСТАН И СОВЕРШЕНСТВОВАНИЕ
ПРОФИЛАКТИЧЕСКИХ МЕР
Ш.М. Расулов, А.Ю.Тошпулатов
Термезский филиал Ташкентской медицинской академии
Аннотация: В данной статье изложены результаты ретроспективного эпидемиологического
анализа заболеваемости аскаридозом в Республике Узбекистан за 2011–2021 годы, то есть по
Республике, по административным территориям, а также по возрасту и полу заболевания.
Кроме того, в статье разработаны предложения по совершенствованию профилактики
аскаридоза.
Ключевые слова: эпидемиология, аскаридоз, геогельминт, гельминт, инвазия,
ретроспективный эпидемиологический анализ, профилактика.
RETROSPECTIVE EPIDEMIOLOGICAL ANALYSIS OF THE INCIDENCE OF
ASCARIASIS IN THE REPUBLIC OF UZBEKISTAN AND IMPROVEMENT OF
PREVENTIVE MEASURES
Sh.M. Rasulo , A.Y. Tashpula o ,
Te mez b anch o he Tashken Medical Academy
Abs ac : This a icle p esen s he esul s o a e ospec i e epidemiological analysis o he incidence
o asca iasis in he Republic o Uzbekis an o 2011 – 2021, ha is, by Republic, by adminis a i e
e i o ies, as well as by age and gende o he disease. In addi ion, he a icle has de eloped p oposals
o imp o e he p e en ion o asca iasis.
Key wo ds: epidemiology, asca iasis, geohelmin h, helmin h, in asion, e ospec i e
epidemiological analysis, p e en ion.
Acco ding o WHO da a om Ma ch 2, 2020, mo e han 1.5 billion people wo ldwide — abou
24% o he global popula ion — a e in ec ed wi h soil- ansmi ed helmin h in ec ions. O e 267
million p eschool-aged child en and mo e han 568 million school-aged child en li e in a eas whe e
hese pa asi es a e highly p e alen and a e in need o ea men and p e en i e measu es [1,2,5].
Acu e asca iasis in ec ions cause nea ly 60,000 dea hs each yea , wi h mos a ali ies occu ing in
child en due o in es inal obs uc ion [6].
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Wo ldwide, 4.5 billion people a e in ec ed wi h helmin hiases [3]. Among hem, 1.269 billion ha e
asca iasis, 932 million ha e ankylos omiasis, 637 million ha e ichocephalosis, 353 million ha e
en e obiasis, 77 million ha e aeniasis, 39 million ha e hymenolepiasis, 15 million ha e
diphyllobo h iasis, and 10 million a e in ec ed wi h d acunculiasis [4,7].
Unde he in luence o helmin hs, child en’s men al and physiological de elopmen is delayed,
while adul s expe ience a decline in wo k capaci y. Helmin h in ec ions can also igge alle gic
eac ions, weaken he body’s esis ance o in ec ious diseases, and educe he e ec i eness o
accines in immunized indi iduals. Some helmin h in ec ions, such as echinococcosis and
al eococcosis, can lead o disabili y and e en dea h.
The aim o he s udy: To in es iga e he mode n epidemiological cha ac e is ics o asca iasis in
Uzbekis an and o imp o e p e en i e measu es based on hese indings.
Resea ch ma e ials: O icial epo s on asca iasis mo bidi y in Uzbekis an om 2011 o 2021
p o ided by he Sani a y-Epidemiological Wellbeing and Public Heal h Se ice o he Republic o
Uzbekis an. Epidemiological and s a is ical me hods we e used in he s udy.
The causa i e agen o asca iasis is he oundwo m Asca is. Asca iasis is a pe o al geohelmin hiasis
and an an h oponosis. The emale Asca is measu es 25–40 cm in leng h, while he male measu es
15–25 cm. The emale lays o al, memb ane-co e ed eggs in he human in es ine.
Since asca iasis is a geohelmin h, he ini ial pa o he pa asi e’s li e cycle occu s in he soil. I is
impo an o no e ha he de elopmen o Asca is in he ex e nal en i onmen equi es a o able
na u al condi ions. La ae begin o de elop om Asca is eggs when he ex e nal empe a u e is
be ween 13–30°C. This explains why Asca is is mo e common in wa m and ho coun ies.
Asca is eggs a e exc e ed wi h human eces. Using human eces as e ilize o ege ables and
ui s, and consuming hem wi hou washing, can lead o in ec ion wi h asca iasis.
When Asca is eggs en e he diges i e sys em o ally, la ae ha ch and en e he bloods eam. They
a el h ough he po al ein o he li e , hen ia he in e io ena ca a o he igh hea , and om
he e h ough he pulmona y a e y o he lungs. In he lungs, hey each he b onchioles and b onchi.
When he pe son coughs, he la ae a e b ough up in o he mou h and, i he spu um is swallowed,
hey e-en e he diges i e sys em. Ma u e Asca is wo ms can su i e in he human in es ine o 1–2
yea s, whe e hey con inue o pa asi ize.
The epidemiological si ua ion o asca iasis in he coun y canno be conside ed s able. Al hough
cu en con ol measu es, he WHO-suppo ed “Child en F ee om Wo ms” p og am, and
medica ions p o ided h ough he UNICEF humani a ian sys em show some e ec i eness, hey a e
no su icien . This si ua ion is clea ly indica ed by he pe sis en annual incidence o he disease
among he popula ion, i s endency o become ch onic in mos cases, and he complica ions i causes.
Epidemiological analysis me hods we e employed o e eal epidemiological pa e ns and o
unde s and he speci ic cha ac e is ics o he epidemic p ocess o a pa icula disease.
Acco ding o he da a ob ained, a dec easing end in asca iasis incidence was obse ed in ou
coun y be ween 2011 and 2021.
Cu en ly, his si ua ion necessi a es he imp o emen o con ol measu es agains he disease, as
well as add essing issues ela ed o ea ly de ec ion and ea men o asca iasis, p e en ion o he
disease, and sani a ion o i s endemic a eas in he u u e.
Analysis o asca iasis cases egis e ed in he Republic o Uzbekis an om 2011 o 2021 shows ha
he incidence a e pe 100,000 popula ion anged om 4.7 o 25.2 in di e en yea s (Figu e 1). As
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seen in he igu e, in he ini ial yea o he analysis, 2011, he incidence a e o asca iasis in he
coun y was 18.9 pe 100,000 popula ion. O e he subsequen yea s, he incidence end luc ua ed,
eaching i s highes le el in 2015, wi h an incidence a e o 25.2 pe 100,000 popula ion.
The analysis o he subsequen yea s showed he ollowing incidence a es: in 2012, he a e sligh ly
dec eased o 18.6 pe 100,000 popula ion; in 2013, he incidence end g adually inc eased o 19.3,
and in 2014 i eached 24.2. The highes a e du ing he analyzed pe iod was eco ded in 2015 a
25.2 pe 100,000 popula ion.
F om 2016 o 2020, a declining end in asca iasis incidence among he popula ion was obse ed.
The a es we e as ollows: 16.3 in 2016, 10.7 in 2017, 9.8 in 2018, 6.4 in 2019, and 4.7 in 2020. In
he inal yea o he s udy, 2021, he incidence a e showed a sligh inc ease compa ed o 2020,
eaching 5.7 pe 100,000 popula ion.
18,9
18,6 19,3
24,2
25,2
16,3
10,7
9,8
6,4
4,7
5,7
0
5
10
15
20
25
30
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
Figu e 1. Dynamics o asca iasis incidence in he Republic
o Uzbekis an om 2011 o 2021
(100 000 aholiga nisba an)
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Figu e 2. A e age incidence a es o asca iasis by adminis a i e egions o he Republic o
Uzbekis an om 2011 o 2021 (pe 100,000 popula ion)
As seen in his igu e, he incidence a es o asca iasis by egion we e eco ded as ollows: Fe gana
– 83.3, Si da yo – 48.6, Su khanda ya – 39.7, Namangan – 33.8, Bukha a – 11.6, Andijan – 6.1,
Na oi – 5.1, Tashken egion – 4.8, Jizzakh – 4.6, Kashkada ya – 3.5, Tashken ci y – 2.2, Kho ezm
– 1.5, Sama kand – 1.1, and he lowes in he Republic o Ka akalpaks an – 1.0 pe 100,000
popula ion.
The highes incidence a es we e obse ed in Fe gana, Si da yo, Su khanda ya, and Namangan
egions. The high p e alence in hese a eas is p ima ily due o wo ac o s: i s , he soil p o ides
su icien empe a u e condi ions o he ma u a ion o Asca is eggs; second, a la ge po ion o he
popula ion in hese egions is engaged in ag icul u e, which inc eases di ec con ac wi h
con amina ed soil, he main sou ce o in ec ion.
0,0
10,0
20,0
30,0
40,0
50,0
60,0
70,0
80,0
90,0
2,2 6,1 11,6 4,6 3,5 5,1
33,8
1,1
39,7 48,6
4,8
83,3
1,5 1,0
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Figu e 3. Dis ibu ion o asca iasis in ec ion by gende in he Republic o Uzbekis an om 2011 o
2021 (in pe cen ages)
As shown in his igu e, a e ospec i e analysis o asca iasis incidence in he Republic o
Uzbekis an by gende e ealed ha men accoun ed o he majo i y o cases, 60.5%, while women
accoun ed o 39.5%. The incidence among men was 1.5 imes highe han among women. This is
p ima ily explained by he ac ha men a e mo e equen ly in di ec con ac wi h soil du ing hei
daily ac i i ies, such as a ming, cul i a ing ege ables and ui s, ending ield c ops, and
pe o ming household and li es ock wo k—ac i i ies ha inc ease exposu e o Asca is-
con amina ed soil, a key sou ce o in ec ion.
39,50%
60,50% Ayolla
E kakla
77%
23%
14 yoshgacha bo‘lgan bolala
14 yoshdan ka ala
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Figu e 4. Analysis o asca iasis in ec ion by age g oups in he popula ion o he Republic o
Uzbekis an om 2011 o 2021 (in pe cen ages)
As shown in he igu e abo e, a e ospec i e analysis o asca iasis incidence in he Republic o
Uzbekis an om 2011 o 2021 by age g oups e ealed ha he majo i y o cases, 77%, occu ed in
child en unde 14 yea s o age, while he emaining 23% we e obse ed in indi iduals aged 14 and
olde . This dis ibu ion is na u ally explained by he ac ha child en o en do no ully ollow
pe sonal hygiene ules. Howe e , he occu ence o in ec ion among hose aged 14 and abo e is a
se ious conce n.
This si ua ion places a esponsibili y on heal hca e wo ke s no only o conduc e ec i e sani a y
and educa ional campaigns among he popula ion bu also o os e medical cul u e and awa eness.
Imp o ing he popula ion’s le el o hygiene, cul u e, and li ing s anda ds plays a c ucial ole in he
success ul implemen a ion o p e en i e measu es agains asca iasis.
To achie e his goal, he ollowing asks need o be ca ied ou .
• S eng hen sani a y and educa ional campaigns among all segmen s o he popula ion,
especially child en;
• In ol e he wide communi y and local neighbo hood ac i is s o ensu e con inuous
implemen a ion o p e en i e measu es;
• S ic ly adhe e o pe sonal hygiene p ac ices;
• Con inuously imp o e he quali ica ions o doc o s and medical pe sonnel, including mid-
le el and junio s a , in he ield o pa asi ology;
• Ac i ely iden i y and ea pa ien s wi h asca iasis du ing scheduled mass sc eenings;
• De ec pa ien s wi hin popula ion g oups ha play a key ole in he sp ead o he in ec ion;
• P e en con amina ion o he ex e nal en i onmen wi h pa ien s’ eces and o he biological
exc e ions du ing ea men ;
• Regula ly moni o soil o he isk o con amina ion wi h Asca is eggs;
• Imp o e access o quali y d inking wa e and p ope sani a ion sys ems o he popula ion;
• Cons uc oile s in public o ganiza ions, pa ks, ec ea ional a eas, and boule a ds acco ding
o sani a y and hygiene s anda ds; ins all was e bins in e e y ya d and ensu e hei egula cleaning;
collec was e in special co e ed conc e e con aine s and ensu e imely disposal;
• Wash ui s and ege ables ho oughly; main ain egula medical, sani a y, and
epidemiological con ol o public ca e ing acili ies and hei s a a leas once a yea .
In he p e en ion o helmin hiasis, including asca iasis, h ee s ages a e ecognized.
In he i s s age, pa icula a en ion is ocused on iden i ying he e iological agen o he disease
and p e en ing i s occu ence. De e mining he e iological cause o helmin hiasis allows o
a ge ed e io opic and pa hogene ic ea men measu es, which can achie e posi i e esul s.
In he p e en ion o asca iasis, os e ing and adhe ing o a heal hy li es yle is especially impo an .
I s main di ec ions include he heal h o pa en s, he amily’s ma e ial well-being, and he le el o
cul u al awa eness. Special a en ion should be gi en o he in e ac ion be ween mo he and child.
Timely b eas eeding o a newbo n is c ucial, as b eas milk no only suppo s he child’s
ha monious physiological de elopmen bu also plays a key ole in p o ec ing agains bac e ial,
i al, and o he in ec ious diseases.
The e o e, p ope nu i ion is pa icula ly impo an in he p ima y p e en ion o helmin hiasis.
Achie ing his goal equi es ensu ing ha he die con ains su icien i amins, an ioxidan s, and
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mine al elemen s. P ope meal o ganiza ion and culina y p ocessing o ood a e also essen ial.
Special a en ion should be paid o he handling o ege ables, g eens, and ui s o ensu e sa e y.
To p e en asca iasis and implemen planned con ol measu es, imp o ing he quali y o d inking
wa e and adhe ing o sani a y and epidemiological s anda ds is necessa y. Neglec ing sani a y and
hygiene equi emen s can c ea e a o able condi ions o he widesp ead ansmission o helmin h
in ec ions, simila o in ec ious diseases. This isk is pa icula ly signi ican o p eschool
ins i u ions and o he o ganiza ions ca ing o child en. Such ins i u ions mus p o ide each child
wi h a sepa a e owel, bedding, and pe sonal hygiene i ems o main ain p ope hygiene s anda ds.
I is also necessa y o pay a en ion o domes ic animals, especially dogs and ca s. These animals
can ac as hos s (sou ces o in asion) o helmin hs. The e o e, i is impo an o egula ly moni o
he heal h o dogs and ca s, pe o m dewo ming, and accina e hem acco ding o epidemiological
guidelines, as hese measu es play a c ucial ole in p e en ing he sp ead o helmin h in ec ions.
E e y child’s daily ou ine should include su icien ime ou doo s. This ensu es hey ecei e he
ul a iole ays essen ial o no mal g ow h and de elopmen . Du ing he wa m mon hs, child en
spend a lo o ime in na u e, which inc eases he isk o helmin h in ec ions h ough con amina ed
wa e , soil, plan s, and wild ui s. This isk is especially high du ing ips and long excu sions o
egions wi h di e en clima ic and geog aphical condi ions.
Founda ions o Seconda y P e en ion o Asca iasis
Va ious me hods a e used o he imely diagnosis o asca iasis. These me hods a e applied bo h o
he child and o he child’s amily membe s. Du ing pe iods o high asca iasis p e alence, child en
and adul s a e pu pose ully sc eened. In child en, his p e alence may be sligh ly highe (a ound 6–
7%). When he in ec ion a e exceeds 5%, mass sc eening o he popula ion o helmin h in ec ions
is conside ed app op ia e.
E e y pe son in ec ed wi h asca iasis should unde go dewo ming ea men . Dewo ming se es wo
main pu poses: on one hand, i allows he ea men o indi iduals in ec ed wi h helmin hs, and on
he o he , i enables imely implemen a ion o p e en i e measu es among hem. S ic adhe ence o
hese measu es is c ucial o p e en ing con amina ion o he ex e nal en i onmen wi h helmin h
eggs.
Asca id eggs accumula e in he en i onmen un il hey ma u e, allowing in ec ion oci o pe sis o
long pe iods. The e o e, en i onmen al sani a ion is a c i ical componen o asca iasis p e en ion.
This includes p ope disposal and ea men o eces, was ewa e , and o he was e, as well as la ge-
scale soil cleaning o elimina e helmin h eggs. Cu en ly, biological, na u al, and a i icial me hods
a e used o achie e hese goals.
Humans a e he p ima y sou ce o asca iasis, and non-compliance wi h pe sonal hygiene ules is he
main ac o in he sp ead o hese helmin h in ec ions. P e en i e measu es should ocus on
s opping he eme gence and ansmission o helmin hs among he popula ion. Imp o ing pe sonal
hygiene and sani a ion cul u e among he popula ion, especially child en, is o g ea impo ance in
helmin h p e en ion.
Ea ly diagnosis o asca iasis also equi es a en ion o addi ional isk ac o s p esen in he
popula ion, which should be iden i ied and add essed p omp ly. These isk ac o s include acu e
espi a o y i al in ec ions (ARVI), seconda y immunode iciency, ailu e o ollow accina ion
schedules, li ing in unsani a y condi ions, popula ion mig a ion, and o he simila ac o s.
Founda ions o Te ia y P e en ion o Asca iasis
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Te ia y p e en i e measu es o asca iasis a e aimed a alle ia ing he cou se o he disease,
p e en ing i om p og essing o ch onic o ms, and ea ing i s complica ions. In his con ex ,
e ia y p e en ion also encompasses p ima y and seconda y p e en i e measu es. The basis o
e ia y p e en ion includes main aining a heal hy li es yle, p ope nu i ion, and imely
implemen a ion o accina ion p og ams.
I pa ien s exhibi signs o anemia, i is necessa y o p esc ibe i on p epa a ions, mul i i amins,
p obio ics, and cy op o ec o s. To manage alle gode ma osis symp oms associa ed wi h asca iasis,
he use o las -gene a ion an ihis amine medica ions is ad isable.
Acco ding o mode n epidemiological s anda ds, p e en i e measu es agains helmin hiasis should
be planned and implemen ed based on he p inciples o epidemiological su eillance. Obse a ions
show ha epidemiological moni o ing o helmin hiasis in he egions whe e ou esea ch was
conduc ed has signi ican sho comings. F om his pe spec i e, based on ou esea ch esul s and o
ob ain comple e in o ma ion on helmin hiasis p e alence, we p opose he ollowing di ec ions o
imp o ing he heo e ical, me hodological, and o ganiza ional ounda ions o helmin hiasis
epidemiological con ol, in addi ion o exis ing p e en i e measu es:
• Main aining comple e egis a ion and epo ing o helmin hiasis iden i ied du ing cu en
examina ions, including e lec ing he da a in epo s om bo h ins i u ional and p i a e heal hca e
acili ies.
• Con inuous moni o ing o he ea men and e-examina ion o pa ien s iden i ied h ough
sc eening o popula ions belonging o high- isk g oups.
• Analyzing he dynamics o key socio-ecological ac o s ha de e mine he epidemiological
si ua ion o helmin hiasis (e.g., con amina ion o wa e , soil, ui s, and ege ables wi h helmin h
eggs, and imp o ing he quali y o such examina ions).
• Iden i ying high- isk pe iods, g oups, egions, and ac o s based on analysis o helmin hiasis
incidence dynamics ( h ough cu en and e ospec i e epidemiological analysis).
• E alua ing he p e alence and socio-economic signi icance o ce ain helmin h in ec ions.
• O ganizing moni o ing o implemen ed measu es, assessing hei quali y and e ec i eness.
• Pe iodically p edic ing in ec ion and disease incidence o ce ain helmin hiases, including
asca iasis.
In conclusion, based on he esul s analyzed du ing ou s udy, i is ecommended ha , in addi ion o
exis ing measu es o p e en ing asca iasis, he imp o ed measu es we p opose, as well as he
p inciples o p ima y, seconda y, and e ia y p e en ion, should be u ilized. I is also ad isable o
conduc dewo ming in asca iasis-endemic a eas and moni o he p ocess. Fu he mo e, analyzing
he dynamics o key socio-ecological ac o s de e mining he epidemiological si ua ion o asca iasis
(such as con amina ion o wa e , soil, ui s, and ege ables wi h Asca is eggs) and imp o ing he
quali y o hese assessmen s yields be e esul s.
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