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Classification, General Characteristics of parasites and Medically important Parasites Parasites Endoparasite Protozoa Metazoa Ectoparasite Arthropods Sub kingdom Phylum Protozoa Sarcomastigophora further divided into Sub-phylum Sarcodina-- - Genusexamples Speciesexamples Entamoeba E. histolytica Giardia G. lamblia Plasmodium P. falciparum, P. vivax, P. malariae, P. ovale Balantidium B. coli Enterocytozoa E. bienusi move by pseudopodia Mastigophora move by flagella Apicomplexa no organelle of locomotion Ciliophora move by cillia Microspora Spore-forming Classification of Metazoa Sub kingdom Metazoa Phylum Class Genus – examples Ascaris (roundworm) Trichuris (whipworm) Ancylostoma (hookworm) Necator (hookworm) Enterobius (pinworm or threadworm) Strongyloides Nematodes Round worms; appear round in cross section, they have body cavities, a straight alimentary canal and an anus Platyhelminthes Cestodes Flat worms; no body cavity and, if present, the alimentary canal is blind ending Adult tapeworms are found in the intestine of their host They have a head (scolex) with sucking organs, a segmented body but no alimentary canal Each body segment is hermaphrodite Trematodes Non-segmented, usually leafshaped, with two suckers but no distinct head, they have an alimentary canal Schistosomes are the exception, thread-like, and have separate sexes Taenia (tapeworm) Fasciolopsis (liver fluke) Schistosoma (not leaf shaped!) The most common parasitic infection Parasite Plasmodium Diseases malaria Soil transmitted helminths: • Roundworm (Ascaris) intestinal obstruction • Whipworm (Trichuris) Bloody diarrhoea, rectal prolapse • Hookworm (Ancylostoma and Necator) Coughing, wheezing, abdominal pain and anaemia No. cases Deaths/yr 273 million 1.12 million 2 billion 200,000 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 visceral leishmaniasis 12 million; 2 million new cases/yr 50,000 • 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 a parasite Mosquito in the transmission of filariasis C- Definitive host in the life cycle of a parasite Female Anopheles mosquito in the life cycle of malarial parasites D- Vector (either mechanical/biological) in the transmission of an infectious disease Tick in the transmission of Rocky Mountain spotted fever and Lyme 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 • Amebiasis • Balantiadiasis • Cryptosporidiosis • Cyclosporiasis • Giardiasis Observation required for Diagnosis • Trophozites (amebas) and/or cyst • Trophozites and/or cyst • Oocycts • Oocycts • Trophozites and/or cyst Intestinal protozoal infections diagnosed by examining stool specimens Infection • Amebiasis • Balantiadiasis • Cryptosporidiosis • Cyclosporiasis • Giardiasis Observation required for Diagnosis • Trophozites (amebas) and/or cyst • Trophozites and/or cyst • Oocycts • Oocycts • Trophozites and/or cyst Examples of protozoal infections diagnosed by examining stained blood smears Infection • African trypanosomiasis Observation required for Diagnosis • 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