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Hymenolepis Nana Group 5 Write Up-1
Hymenolepis Nana Group 5 Write Up-1
DR PATRICK. WERE
GROUP 5
Teresa Mundia-P29s/11900/2022
Susan Gachukia-P292/1367/2022
Ayaga Stephen-P29s/11865/2022
HYMENOLEPIS NANA
INTRODUCTION
HISTORY
Domain - Eukaryota
Kingdom -Animalia
Phylum -Platyhelminthes
Class- Cestoda
Order -Cyclophyllidea
Family -Hymenolepididae
Genus-Hymenolepis
Species-H.nana
EPIDEMIOLOGY
-It is cosmopolitan in distribution but found in warm areas than cold areas.
-It's found in temperate than tropical countries.
It's highly prevalent in South Africa, South Europe, Central America and Middle East Asia.
-Infection is most common in school children,persons living in institutional settings, crowded
environments and in people who live in areas where sanitation and personal hygiene is
inadequate.
MODE OF TRANSMISSION
MORPHOLOGY
EGGS
-Colourless, oval,30-50mm in size
-It has two membranes; outer membrane that's thin and colourless, inner membrane that
encloses oncosphere.
- On the inner membrane are two poles from which 4-8 polar filaments spread out between the
two membranes, the space also has yolk granules.
-The oncosphere has three pairs of hooks.
-They are non- bile stained and float in saturated solution of salt.
-They are immediately infective when shed in faeces and can only survive for not more than 10
days in external environment.
ADULT WORM
3.(https://colab.research.google.com/drive/
1p1hPoxNaVMPi3MGaotenZQBNOV7yTbxP#scrollTo=bab9a9a9)
LIFE CYCLE:-
HOSTS
–Definitive host : Rat and mice
-Intermediate host: Rat fleas- Xenopsylla cheopis - Pulex irritans.
-Mode of transmission: Men acquire the infection rarely by accidental ingestion of insects
containing cysticercoid larvae.
√ Eggs of Hymenolepis nana are immediately infective when passed with the stool and cannot survive
more than 10 days in the external environment.
-When eggs are ingested by an arthropod intermediate host (various species of beetles and
fleas may serve as intermediate hosts), they develop into cysticercoids, which can infect
humans or rodents upon ingestion and develop into adults in the small intestine.
- After ingestion of eggs (in contaminated food or water or from hands contaminated with feces),
the oncospheres contained in the eggs are released.
-The oncospheres (hexacanth larvae) penetrate the intestinal villus and develop into
cysticercoid larvae .
- Upon rupture of the villus, the cysticercoids return to the intestinal lumen, evaginate their
scoleces.
- They can then attach to the intestinal mucosa and develop into adults that reside in the ileal
portion of the small intestine producing gravid proglottids.
- Eggs are passed in the stool when released from proglottids through its genital atrium or when
proglottids disintegrate in the small intestine.
~An alternate mode of infection consists of internal autoinfection, where the eggs release their
hexacanth embryo, which penetrates the villus continuing the infective cycle without passage
through the external environment .
~The life span of adult worms is 4 to 6 weeks, but internal autoinfection allows the infection to
persist for years.
4.)(https://www.cdc.gov/dpdx/hymenolepiasis/index.html)
PATHOGENESIS
-Infection occurs by ingestion of food and water contaminated with eggs released along with the
feces of an infected man or rodent.
-Internal autoinfection may also occur when the eggs released in the intestine hatch there itself.
-External autoinfection occurs when a person ingests their own eggs by fecal-oral route.
-Light infections are asymptomatic.
-In heavy infections [where there are many worms present] the symptoms are; anorexia,
nausea, abdominal pain, diarrhea, weight loss and irritability.
SYMPTOMS
-The symptoms of infection with H. nana vary depending on the severity of the infection.
- In mild cases, there may be no symptoms at all.
-In more severe cases, there may be abdominal pain, diarrhea, nausea, and vomiting.
-In some cases, the infection may cause cysticerci, which are small, round cysts in the organs
or tissues of the body.
- These cysts can cause tissue damage and may need to be surgically removed.
LABORATORY DIAGNOSIS
SPECIMEN
-Stool sample
-Rectal swab
-Serum
MICROSCOPY
-The eggs can readily be concentrated by the salt flotation and formalin ether sedimentation
technique.
-Microscopic examination reveals eggs with polar filaments between the shell membranes that
emanate from little knobs at either end of the embryophore (distinguishing feature from
H.diminuta).
-The outer membrane is thin and colorless while the inner embryophore encloses an
oncosphere with three pairs of lancet shaped hooklets.
-It is the only cestode egg that is not stained by bile when passed through intestines.
• HEMATOLOGY
-Eosinophilia of more than 5% is seen in 1/3rd of the infected children.
• ENDOSCOPY
Adult worm can be identified during endoscopic examination in the intestines.
•ELISA TEST
Used to detect antibodies directed against H.nana in serum It has 80% sensitivity.
7.(https://www.sciencedirect.com/topics/medicine-and-dentistry/hymenolepis-nana)
TREATMENT.
-Treatment for H. nana infection typically involves the use of anti-parasitic medications, such as
Niclosamide -
-These medications can be taken orally or injected, depending on the severity of the infection.
-In cases where cysticerci are present, surgery may be necessary to remove them.
-In some cases, the cysts may be treated with anti-parasitic medications as well.
8.)(https://www.cdc.gov/parasites/hymenolepis/health_professionals/index.html)
● The best way to prevent infection with H. nana is to practice good hygiene and food
safety.
-This includes washing hands thoroughly after handling rodents, avoiding contaminated food
and water, cooking food thoroughly, keep grains cereals, and flour stored properly in household
kitchens.
● It is also important to practice good rodent control, such as trapping and removing
rodents from homes and other areas where they may be found.
-This can help reduce the risk of infection.
9.)Saki J, Khademvatan S, Foroutan-Rad M, Gharibzadeh M. Prevalence of intestinal parasitic
infections in Haftkel County, southwest of Iran. International Journal of Infection. 2017;4(4)
[Google Scholar]
CASE REPORT:
Three children, aged 9, 12, and 13 years, living in a marginal urban area of Guayaquil, Guayas
province, Ecuador, presented symptoms of diarrhea, low body weight, abdominal discomfort,
anorexia, paleness, and anal itching. Subsequently, their fecal samples were analyzed by direct
coproparasitic methods, flotation and sedimentation with centrifugation using saline solution; the
presence of H. nana eggs was determined. Blood biometry was performed. Further, 10 rodents
were captured and necropsied to obtain intestinal contents. The powdered milk consumed by
the children was analyzed, the same powder that contained rodent feces. Subsequently, these
were studied with the above-mentioned coproparasitic methods. H. nana eggs were identified in
the 6 trapped rodents, the powdered milk, and the feces of rodents found in the milk powder.
CONCLUSIONS:
REFERENCES.
3.(https://colab.research.google.com/drive/
1p1hPoxNaVMPi3MGaotenZQBNOV7yTbxP#scrollTo=bab9a9a9)
4.(https://www.cdc.gov/dpdx/hymenolepiasis/index.html)
6.)(Namrata K Bhosale
Textbook of Parasitic Zoonoses, 385-392, 2022)
8.(https://www.sciencedirect.com/topics/medicine-and-dentistry/hymenolepis-nana)
9.)(https://www.cdc.gov/parasites/hymenolepis/health_professionals/index.html)