JVMM NOTES | PARASITOLOGY| INTRODUCTION & TECHNIQUES IN PARASITOLOGY

INTRODUCTION TO PARASITOLOGY
November 2013
Lecturer: Dr. Borromeo
Parasite
general types:
1. facultative
2. obligate
life cycle:
1. simplex
2. complex
Host
reservoir
- maintains parasite
essential reservoir - cats in toxoplasmosis
intermediate
- asexual stage
definitive
- adult; sexual stage
Vectors
biological
both vector and host
Ex Anopheles
mechanical
transmits parasite only
Ex flies in Trachoma
Important Groups of Animal Parasites
I. Sarcomastigophora
a. Sarcodina = Amoeba
b. Mastigophora = Flagellates
II. Apicomplexa (Sporozoa) = tissue parasites
a. Plasmodia = blood
b. Isospora, Cyclospora, Cryptosporidium, Sarcocystis
= GIT
c. Toxoplasma (and Sarcocystis) = organs and tissues
III. Microspora = Microsporidia (intracellular parasites)
IV. Ciliospora = ciliates
V. Platyhelminthes = Flatworms, Trematodes and Cestodes
VI. Aschelhelminthes = Nematodes
VII. Acanthocephala = thorny headed worms; endoparasites
VIII. Anthropoda
IX. Pentastomida = tongue worms
Adaptations to Parasitism
1. absence of locomotor organelles = parasitic protozoa
2. absence of cilia = trematodes and cestodes
3. reduced or absence of GIT = flatworms
4. highly developed reproductive tract = flatworms
5. specialized suckers and hooks
6. larger size than free living
7. streamlining or loss of biochemical pathways =
Leishmania and Entamoeba histolytica
8. mechanisms affecting entrance into host = E. histolytica
has proteolytic enzymes; Hymenolepis nana embryo has
hooklets
Effects of the Parasite on the Host
1. interference of the vital processes of the host
- Diphyllobotrium latum = megaloblastic anemia
- Fasciolopsis buski = toxemia
2. invasion/destruction
- Entamoeba histolytica = ulcers
- Malaria = RBC destruction
- Ascariasis = perforation
3. immunosuppression = Schistosoma
4. host-like antigens and antigenic variation = escape from
immune-mediated response
5. secretions and excretions of protozoa and helminthes =
stimulates host resistance

UST FMS 2016 | SECOND SEMESTER, 2013-2014 |joelvergilmmendiola@yahoo.com

Effects of the Host on the Parasite

1. Duffy blood group = negativity confers resistance to P.
vivax ; seen among Africans
2. SS Trait = increased resistance to P. falciparum
3. high-protein diet = unfavorable to amoebas
4. carbohydrate-rich diet = favorable to tapeworms
5. immunity
a. only to a limited degree = Leishmania
b. premonition = resistance to hyperinfection in
endemic areas
i. Plasmodia
ii. Hookworm
c. pass immunity = maternal Abs
i. Malaria
ii. Schistosomiasis
iii. Filariasis
6. eosinophils = kills young Schistosomes and microfilariae
- eosinophilia in ascariasis: seen only in larval
stage during migration
- persistent eosinophilia vs. on/off eosinophilia
7. cytokines = TNF and Cachetin
a. protective in experimental malaria in mice
b. stimulates killing of Schistosomes by
eosinophils in vitro
c. cachexia in trypanosomiasis
The Compromised Host

surgery

intubation

immunosuppressives

chemotherapy

aggressive treatment

corticosteroids

AIDS

transfusions

prolonged hospitalization
Infections Notably Seen in Immunocompromised States

Amoebiasis

Stronglyoidiasis and disseminated strongyloidiasis

Trichinosis

Toxoplasmosis

Cryptosporidiosis

Cyclosporiasis

Isosporiasis
Prevalance of Parasitic Infections (WHO 1975 1995)
Ascariasis, Hookworm 1.3 B each
Amebiasis
1.0% worlds pop
Giardiasis
200 M
Malaria
400-490M; annual deaths 2.2 to 2.5 M
Leishmaniasis
1.2 M
Schistosomiasis
150M; annual deaths 500K to 1 M
Clornorchiasis
13.5 M
Paragonimiasis
2.1 M
Fasciolopsiasis
10 M
Filiariasis(lymphatic)
128 M
Onchocerciasis
17.7 M
Characteristics of Parasitic Diseases
Symptoms are usually proportional to parasitic burden
Reinfections may come from the environment, or
autoinfection (Strongyloides and Enterobius)
Chronic infection= Chagas disease
Immunocompromising conditions may cause
reactivation of latent infection(Toxoplasmosis),
increased susceptibility and severe disease
Eosinophilia= larval migration thru vasculature or tissue
1

JVMM NOTES | PARASITOLOGY| INTRODUCTION & TECHNIQUES IN PARASITOLOGY

TECHNIQUES IN PARASITOLOGY
Examination of Stool
1. Direct Wet Film: NSS and iodine
- iodine: not used in direct smear; used only in
the presence of trophozoids
2. Concentration Method: Sedimentation and Flotation
- used when no ova is observed
3. Permanent Stained Slides: E. histolytica
4. Serologic testing plus stool examination: E. histo/dispar,
Giardia, Cryptosporidium
5. Modified AFB: Crytosporidium, Cyclospora, Isospora
6. Special procedures for recovery of helminth larvae and
ova:
a. Baermann Apparatus: Strongyloides larva
b. Filter Paper Strip Procedure (Harada and
Mori): Strongyloides or Trichostrongylus larvae
c. Agar method for evaluation of larval tracts:
whiplike (Strongyloides) ; snakelike (Hk)
d. Cellophane Tape Swab for Enterobius and
Taenia ova
7. Schistosomal Hatching Test: miracidia
- operculum opens at pH 7.0
8. Duodenal Sampling and Biopsy
a. Enterotest (String Test): hepatic flukes;
Strongyloides, Giardia, Isospora,
Cryptosporidium
o patient swallows a gelatin containing
a string onto which, upon reaching
the duodenum, parasites attach; the
string is then pulled out through the
mouth
Examination of Blood and other Tissues
- thin smear: detection of P. vivax or P
falciparum
- thick smear: determination of parasite load
o gametocytes are excluded in the
count
1. Fresh blood: whiplike (microfilariae), undulating and
twisting (trypansosomes)
2. Thin and thick blood smear: Plasmodium
3. Concentration methods: Leishmania, Trypanosomes,
Microfilariadae
4. CSF: Naegleria
5. Tissue imprints after FNAB: Leishmania, Toxoplasma
6. Biopsy and Aspiration
7. Examination of the sputum: Entamoeba, Ascaris
Strongyloides, Paragonimus, Cryptosporidium
8. Urine: Trichomonas, Schistosoma, Wuchereria, Brugia,
Loa, Onchocerca

UST FMS 2016 | SECOND SEMESTER, 2013-2014 |joelvergilmmendiola@yahoo.com