Classification, General Characteristics of parasites

and Medically important Parasites

 Parasites

Endoparasite Ectoparasite

Protozoa Metazoa Arthropods

 Sub Phylum Sub-phylum Genus- Species-
kingdom examples examples

Protozoa Sarcomastig- Sarcodina-- - Entamoeba E. histolytica

ophora move by
pseudopodia
further divided into

Mastigophora Giardia G. lamblia

move by flagella

Apicomplexa Plasmodium P. falciparum,

no organelle of P. vivax,
locomotion
P. malariae,
P. ovale

Ciliophora Balantidium B. coli

move by cillia

Microspora Enterocyto- E. bienusi

Spore-forming zoa
 Classification of Metazoa
Sub Phylum Class Genus –
kingdom examples
Metazoa Nematodes Ascaris (roundworm)
Round worms; appear round Trichuris (whipworm)
in cross section, they have Ancylostoma (hookworm)
body cavities, a straight Necator (hookworm)
alimentary canal and an Enterobius (pinworm or
anus threadworm)
Strongyloides

Platyhelminthes Cestodes Taenia (tapeworm)

Flat worms; no body cavity Adult tapeworms are found in
and, if present, the the intestine of their host
alimentary canal is blind They have a head (scolex) with
ending sucking organs, a segmented
body but no alimentary canal
Each body segment is
hermaphrodite

Trematodes Fasciolopsis (liver fluke)

Non-segmented, usually leaf- Schistosoma (not leaf
shaped, with two suckers but shaped!)
no distinct head, they have an
alimentary canal
Schistosomes are the
exception, thread-like, and
have separate sexes
The most common parasitic infection
Parasite Diseases No. cases Deaths/yr
Plasmodium malaria 273 million 1.12 million

Soil transmitted helminths: 2 billion 200,000

• Roundworm (Ascaris) intestinal obstruction

• Whipworm (Trichuris) Bloody diarrhoea, rectal prolapse

• Hookworm Coughing, wheezing, abdominal pain

(Ancylostoma and and anaemia
Necator)
Schistosom Renal tract and intestinal disease 200 million 15,000

Filariae Lymphatic filariasis and elephantiasis 120 million Not fatal but
40 million disfigured
or
incapacitated
Trypanasoma cruzi Chagas disease (cardiovascular) 13 million 14,000
African trypanosomes African sleeping sickness 0.3 – 0.5 million 48,000
Leishamania Cutaneous, mucocutaneous and 12 million; 50,000
visceral leishmaniasis 2 million new
cases/yr
• Intestinal
– Amebiasis .............................. Entamoeba histolytica
– Giardiasis ...............................Giardia lamblia
– Balantidiasis .......................... Balantidium coli
– Crytosporidosis ..................... Cryptosporidium parvum
– Cyclosporiasis …………………….. Cyclospora cayetanensis
• Genitourinary tract
– Trichomoniasis ....................... Trichomonas vaginalis
• Blood and Tissue
– Malaria ................................... Plasmodium spp
– Meningoencephalitis ............. Naegleria fowleri
– Toxoplasmosis ........................ Toxoplasma gondii……….. (Eye)
• Cardiovascular system
– African Sleeping Sickness ...... Trypanosoma brucei…….. (CNS)
– Chagas Disease ...................... Trypanosoma cruzi
• Skin and mucous membrane
– Visceral leishmaniasis( Kala-azar) ... Leishmania donovani
– Cutaneous leishmaniasis .......... Leishmania topica/braziliensis
Medically important Protozoan Diseases
• Gastrointestinal infections
– Amebiasis
 Observed ingegsted RBCs indicate pathogenic E. histolytica
– Giardiasis
 By Giardia lamblia, an intestinal flagellate
 A diarrheal disease
 + Person to person by soiled hands to mouth
– Balantidiasis
 By Balantidium coli , the only ciliated protozoan that causes human infection
– Crytosporidosis
 By Cryptosporidium parvum
 A diarrheal disease
 + Person to person + animal to person
– Cyclosporiasis
 By Cyclospora cayetanensis
 Transmission is Primarily waterborne but + ingestion of contaminated raspberries,
basil and lettuce
Medically important Protozoan Diseases
• Genitourinary tract infections
– Trichomoniasis
 By Trichomonas vaginalis
 A flagellate that has no cyst form
 Sexually transmitted disease, STD
 Symptomatic in females and Asymptomatic in males
 Saline wet mount examination of vaginal or urethral discharge – motile trophozites
Medically important Protozoan Diseases

• Protozoal infections of the eyes

– Amebic Eye infection
– Toxoplasmosis
 By Toxoplasma gondii , intracellular sporozoan
 Ingestion of raw or undercooked meat containing the cyst
 Typically diagnosed by Immuno-Diagnostic Procedures, IDPs
 Stained biopsy
Medically important Protozoan Diseases
• Cardiovascular system infections
– African Sleeping Sickness (African trypanosomiasis)
 By Trypanosoma brucei, Hemoflagellates
 Transmitted by Tsetse flies
 Diagnosed by observing trypomastigotes in blood, lymph
node aspirates or CSF

– Chagas Disease (American trypanosomiasis)

 By Trypanosoma cruzi, Hemoflagellates
 Transmitted by infected reduviid bugs, or blood transfusion
 Diagnosed by observing trypomastigotes in blood, lymph
node biopsies or tissue
Medically important Protozoan Diseases

• Skin and mucous membrane

– Visceral leishmaniasis( Kala-azar)
 Leishmania donovani
– Cutaneous leishmaniasis
 Leishmania topica/braziliensis

 Leishmania spp.
 Tissue flagellates
 Usually transmitted by sandfly
 Many animal reservoirs
 Diagnosis usually by microscopic identification of non-motile amastigote form
inside macrophages
 Some diagnosis by IPDs
Medically important Protozoan Diseases

• Blood and Tissue

– Malaria
 Causing 1.5 million deaths annually
 Plasmodium spp:
• P. vivax, P. falciparum, P. ovale, P. malariae

 Intraerythrocytic sporozoan parasites

 Transmitted by the bite of infected Anopheles mosquitoes
 Mosquitoes are definitive hosts, and humans are intermediate hosts
 Malaria is diagnosed by observing trophozoites, sporozoites, or gametocytes
in stained blood smears
Medically important Protozoan Diseases
 Arthropod Involvement in Human Diseases

Type of involvement Examples

A- Cause of the disease Scabies, microscopic mites lives in
subcutaneous tunnels and cause intense
itching

B- Intermediate host in the life cycle of Mosquito in the transmission of filariasis

a parasite

C- Definitive host in the life cycle of a Female Anopheles mosquito in the life
parasite cycle of malarial parasites

D- Vector (either mechanical/biological) Tick in the transmission of Rocky

in the transmission of an infectious Mountain spotted fever and Lyme disease
disease
 Arthropods that serve as vectors of human
infectious diseases
Vectors Disease(s)
Blackflies (Simulium spp.) Onchocerciasis (River blindness) (H)
Cyclops spp. Fish tapeworm infection (H), guinea worm infection (H)
Fleas Dog tapeworm infection (H), endemic typhus (B), murine
typhus (B), Plague (B)
Lice Epidemic relapsing fever (B) epidemic typhus (B), trench
fever (B)
Mites Rickettsial pox (B), scrub typhus (B)
Mosquitoes Dengue fever (V), filariasis (elephantiasis) (H), malaria (P),
viral encephalitis (V), yellow fever (V)
Sandflies (Phebotomus spp.) Leishmaniasis (P)
Tsetse flies (Glossina spp.) African Trypanosomiasis (P)
Ticks Babesiosis (P), Lyme disease (B), tularemia (B), Colorado tick
fever (V)
 laboratory Methods For Parasites In stool

• Faecal specimens may contain several stages of Parasites

• The stages of protozoa found in stools are trophozoites and

cysts

• The stages of helminthes usually found in stools are eggs,

larvae, adult’s worms or segments of worms
 Intestinal protozoal infections diagnosed by
examining stool specimens
Infection Observation required for Diagnosis
• Amebiasis • Trophozites (amebas) and/or cyst
• Balantiadiasis • Trophozites and/or cyst
• Cryptosporidiosis • Oocycts
• Cyclosporiasis • Oocycts
• Giardiasis • Trophozites and/or cyst
 Intestinal protozoal infections diagnosed by
examining stool specimens
Infection Observation required for Diagnosis
• Amebiasis • Trophozites (amebas) and/or cyst
• Balantiadiasis • Trophozites and/or cyst
• Cryptosporidiosis • Oocycts
• Cyclosporiasis • Oocycts
• Giardiasis • Trophozites and/or cyst
 Examples of protozoal infections diagnosed by
examining stained blood smears
Infection Observation required for Diagnosis
• African trypanosomiasis • Extracellular trypomastigotes

• American trypanosomiasis • Extracellular trypomastigotes

• Babesiosis • Intraerythrocytic protozoa

• Malaria • Intraerythrocytic protozoa

Laboratory Methods For Parasites diagnosis

• Collection of faecal specimens:

 The container should be free from antiseptics and

disinfectants

 Add some form of preservative

• Microscopic Examination of Wet Mount

• The basic types of wet mount that should be used for each
faecal examination are saline, iodine, and buffered
methylene blue
 General aspects about parasite treatment and
control
• Importance of understanding parasite life cycles for effective
treatment and control
– Life cycle involves one or more species of vector
– Life cycle involves one or more intermediate hosts
– Parasite has a variety of definitive hosts
– Parasite has life cycle stages that are exposed to the
environment
– Sequence and timing of life cycle stages within a host
– Location within host
 General aspects about parasite
treatment and control
Direct life cycle
– Importance in treatment/ control

• Provision of sanitation and basic hygiene practices can

prevent many gastrointestinal parasitic diseases

– Application of life cycle knowledge

• Washing fruit and vegetables in clean water can

remove protozoan cysts and helminth eggs
 General aspects about parasite
treatment and control
Life cycle involves one or more species of vector

– Importance in treatment/ control

• Disease transmission can be controlled by targeting the vectors

– Application of life cycle knowledge

• Bed-nets can prevent mosquitoes transmitting malaria
 General aspects about parasite
treatment and control
Life cycle involves one or more intermediate host

• Importance in treatment/ control

– Disease transmission can be controlled by targeting the

intermediate hosts

• Application of life cycle knowledge

– Drainage to remove the habitat of snail intermediate hosts

of Fasciola hepatica
 General aspects about parasite
treatment and control
Parasite has a variety of definitive hosts

• Importance in treatment/ control

– Reservoir hosts are a potential source of infection

• Application of life cycle knowledge

– Schistosoma japonicum has numerous reservoir hosts

which can contaminate paddy field etc with eggs
 General aspects about parasite
treatment and control
Parasite has life cycle stages that are exposed to the
environment

• Importance in treatment/ control

– Environmental conditions can promote or limit infection

• Application of life cycle knowledge

– Composting can kill the infective stages of many

gastrointestinal parasites
 General aspects about parasite
treatment and control
Sequence and timing of life cycle stages within a host

• Importance in treatment/ control

– Optimal time for diagnosis

• Application of life cycle knowledge

– Mf of Wuchereria bancrofti exhibits periodicity

 General aspects about parasite
treatment and control
Location within host

• Importance in treatment/ control

– Optimal time for diagnosis

• Application of life cycle knowledge

– Cattle should be treated for warble fly infections before

the larvae reach their resting site