MEDICAL

HELMINTHOLOGY

Bushehr University of Medical Sciences

Department: Microbiology and Parasitology
Module: Medical Parasitology (Introduction)
Instructor: Dr. Mohammad Rayani, Ph.D

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 ‫طبقً بىذی کرم ٌا (پسشکی)‬

‫‪َ ‬اژي کرم «َرم» بً جاوُران کرم ماوىذی اشاري دارد کً متعلق بً سً شاخً ی زیر‬
‫ٌستىذ‪:‬‬

‫‪ -1 ‬کرمٍای وخی (کرمٍای گرد) یا وماتُدا‬

‫‪ -2 ‬کرمٍای پٍه (کرمٍای تخت) کً شامل دَ ردي است‪:‬‬

‫‪ -1‬سستُدا (کرمٍای وُاری)‬ ‫‪‬‬
‫‪ -2‬ترماتُدا (کرمٍای برگی شکل)‬ ‫‪‬‬

‫)‪Dr. M. Rayani (Bushehr University of Medical Sciences‬‬ ‫‪2‬‬

 HELMINTH - a multicellular organism (metazoa)

 helminths do not multiply within hosts

 cause different diseases in humans; (human suffering)
 cause of high morbidity and mortality of people worldwide
 few helminthic infections cause life threatening diseases

Medical Helminthology
is concerned with the study of helminthes or parasitic worms

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Characteristics

 Multicellular
 Well developed organ systems

 Worldwide
 Tropical, subtropical
 Survival of eggs, larval stages
 Less developed
 Sanitation, intermediate host survival

 Severity of disease depends on:

parasite burden and immunologic response to parasites

 Pathological complications is depend to:

reaction of organs and parasitic population

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 Classification
 1. Platyhelminths (Flat worms)
- Cestoda (Tape worms)
- Trematoda (Flukes)
- Turbelaria (Free living, Rarely parasite)

 2. Nematohelminthes
- Nematoda (Roundworms)

 3. Nematomorpha
(Rarely human parasite, mail and female separate, threadlike,
Unsegmented, symmetrical)

 4. Acantocephala
(Unsegmented, Rarely parasite, mail and female separate)

 5. Annelida (Segmented, symmetrical, Leech, earthworm)

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 Classification of helminths

Nematodes (roundworms)
Platyhelminthes (flatworms):
 Trematodes )“flukes”(
 Cestodes )“tapeworms”(
CLASSIFICATION OF MEDICALLY IMPORTANT PARASITES

METAZOA (HELIMINTHS)

 1- Platyhelminthes
1-1 Trematoda
(a) Genus Fasciola E.g. F. hepatica
(b) Genus Schistosoma E.g. S. hematobium
1-2 Cestoda
(a) Genus Taenia E.g. T. saginata
(b) Genus Echinococcus E.g. E. granulosus
(c) Genus Hymenolepsis E.g. H. nana
(d) Genus Diphylobotrium E.g. D. latum

 2- Nemathelminthes
Nematodes
(a) Intestinal Nematodes E.g. Ascaris lumbricoides
(b) Somatic Nematodes E.g. Wuchereria bancrofti
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 Helminthic diseases

 Intestinal
 Strongyloidiasis (autoinfection cycle)
roundworms  Invasive
 Trichinosis (muscle pain, uncooked carnivores)
 Filariasis (worms in lymphatics or under skin)

flukes (liver or urinary tract

 Schistosomiasis
granulomas and fibrosis)

 Cysticercosis (cysts in brain, seizures)

tapeworms
 Echinococoosis (massive cysts in liver or lung)
 Modes of transmission

 Exposure of humans to the parasites may occur in one of the following

ways:

1. Contaminated soil (Geo-helminthes)

2. Blood sucking insects or arthropods (as in filarial worms)
3. food (Taenia saginata in raw meat)
4. Water-snail (cercariae of blood flukes)
5. Person to person (as in Enterobius vermicularis, Hymenolopis nana)

 They enter the body through different routes including:

mouth, skin and the respiratory tract

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 Classification based on modes of transmission

 Soil transmitted helminths (Ascaris, Hookworms)

 Arthropod transmitted helminths (Filaria, Dracunculus)

 Food –animal transmitted helminths (Taenia)

 Snail transmitted helminths (Fasciola, Schistosoma)

 Direct or contagious transmitted helminths (Enterobius,

Hymenolopis)

Dr. M. Rayani (Bushehr University of Medical Sciences) 10

 Pathogenesis Clinical manifestation
 Direct Damage  Asymptomatic
 Blockage  Symptomatic
 Pressure  Acute
 Anemia  Chronic
 Malnutrition  Complication
 Tissue Necrosis
 Tissue destruction  Pathology produced due to
Adult, Larvae, Eggs
 Indirect Damage
 Host response
 Inflammation
 Hypersensitivity
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 Diagnosis  Naked eye, microscopy
 Parasitological
 Qualitative and
 Parasitological
Quantitative  Smear
 Direct
 Sample  Blood
 Stool, blood, tissue biopsy,  Concentration techniques
duodenal aspiration,
sputum, urine  Stool culture
 Histopathological findings

 Diagnostic stage
 Adult
 Proglottid or segment  Non parasitological
 Eggs  Clinical
 Larvae (cysticercus,  Serum
rabditiform, filariform and
microfilariae) ELISA
 Molecular
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 Control and Prevention

 Primary prevention – (before infection occur)

 Health education
 Environmental improvement, e.g. Sanitary control of drinking
water and food; Proper waste disposal
 Specific protection

 Secondary prevention – (when infection occur)

 Early diagnosis: history, clinical, lab

 Prompt treatment: symptomatic, antihelminthic

Dr. M. Rayani (Bushehr University of Medical Sciences) 13