Sept2022_Basic

Introduction to medical parasitology

Outline
Definition of common concepts
Epidemiology of parasitic diseases (pattern,
distribution & burden of parasitic infections)
Classification of parasites of medical importance
Protozoa classification
General characteristics of protozoa
How protozoa are transmitted
Focus on one example of a protozoa of medical
importance (life cycle, Associated pathology, clinical
presentation, treatment , prevention and control )
Assignment
 Definitions
Medical parasitology is the study of parasites and their implications on
human life.
The parasitic organisms that are of importance for human health are
eukaryotes - they have a well defined chromosome in a nuclear membrane
(as opposed to prokaryotes which have no nuclear membrane, e.g.
bacteria)
Parasites are living organisms that obtain thir nutritional requirements
through an intimate contact with another living organism
Parasites can either be endoparasites or ectoparasites
Endoparasites are those that live within another living organism e.g
Giardia and Malaria
Ectoparasites live on external surface of another living organism
Hosts are organisms on which parasites live and cause harm
Definition of terms
Intermediate hosts are organisms in which parasites
live during their period of development.
Definitive hosts are organisms in which parasites live
during their adult or sexually mature stage
Zoonosis: a parasitic disease in which an animal is
normally the host - but which also infects man e.g
rabies
Vector: “a living carrier (e.g.an arthropod) that
transports a pathogenic organism from an infected to a
non-infected host”. A typical example is the female
Anopheles mosquito that transmits malaria
Burden of parasitic infections
Parasitic infections occur globally
Parasitic infections are common in tropical regions
where there is poverty, poor sanitation and poor
hygiene.
This is worsened by limited access to quality
healthcare
Effective prevention and control requires use of a
combination of strategies including,
 Improved sanitation (use of latrines, fresh water wells & piped
water)
 Vector control e.g use of insecticide impregnated bednets &
spraying of houses, proper drainage, landfills etc
 Mass screening and drug administration programmes
 Health education of the public on healthy practices to prevent
parasitic infections
 Burden of parasitic infections globally
Parasite Diseases No. people infected Deaths/yr
Plasmodium malaria 273 million 1.12 million

Soil transmitted helminths: Pnemonitis, intestinal obstruction 2 billion 200,000

• Roundworm (Ascaris) Bloody diarrhoea, rectal prolapse
• Whipworm (Trichuris) Coughing, wheezing, abdominal
• pain and anaemia
• Hookworm (Ancylostoma
and Necator)

Schistosoma Renal tract and intestinal disease 200 million 15,000

Filariae Lymphatic filariasis and 120 million Not fatal but 40

elephantiasis 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; 2 million new 50,000
visceral leishmaniasis cases/yr
Classification of parasites
Although there is universally accepted way of classifying
worms, they can be classified as,
a) Protozoa (unicellular parasites) and
b) Helminths/worms/Metazoa ( multicellular parasites)
i. Nematodes ( roundworms) e.g Ascaris lumbricoides, Enterobius
vermicularis, Ankylostoma duodenale, Necator americanus,
Strongiloides stercolaris, Trichuris trichura, Filarial worms and
Drancunculus medinensis (guinea worm)
ii. Cestodes (flatworms) e.g Diphyllobotrium latum (fish tapeworm),
Taenia solium, Taenea saginata, Hymenolepis nana and
Echinococcus granulosus)
iii. Trematodes (flukes) e.g Schistosomes (blood flukes) among others
c) Arthropoda i.e. parasites with external skeleton e.g.
Ticks and Lice
A) Protozoa

 Unicellular organisms that are mostly found in the tropical

regions
 Most of its members are free living
 Cause infections that range from asymptomatic to life
threatening depending on the type of protozoa involved
 Some produce sexually and others asexually
 There are over 64,000 species of protozoa but emphasis is
on those of medical importance
 They are of wide ecological diversity i.e widely
geographically distributed
Protozoa species of medical importance

Amebae

Flagellates

Sporozoites

Ciliates
 General characteristics of protozoa
Are unicellular organisms
Are larger than bacteria
Have no chlorophyll thus they cant make own food
Some freely live in soil & water, others on decaying
matter
Some are parasitic & others symbiotic
Have oval, spherical and elongated shapes. Some keep
changing their shape as they move (pseudopodia) e.g
amoeba species
Have a nucleus within the cytoplasm surrounded with
a membrane
 General characteristics of protozoa
Some exist in form of cysts outside the host e.g amoeba
cysts
Have relatively complex internal structure and carry out
complex metabolic activities
Although unicellular, protozoan cell organelles are highly
specialised
They are microscopic i.e. only visible under a microscope
Some have structure for propulsion/movement e.g. cilia and
flagella
Can exist in either trophozoite or cyst forms; In
trophozoite stage there is active feeding and multiplication.
Cysts have protective outer memberanes
Classification of protozoa
The classification is based on multiple factors,
a) On morphology basis, protozoa can be classified as,
 Pseudopodia protozoa i.e one without cilia or flagella for
locomotion. The common example for this is amoeba which moves
using false foot and it feeds by phagocytosis & pinocytosis
 Flagellates protozoa i.e they move using flagella e.g Trypanosoma
gambiense (causes sleeping sickness), Trichomonas vaginalis (causes
trichomoniasis in male and female genital tract) and Giardia lamblia
(causes intestinal infection)
 Ciliates protozoa i.e protozoa that use cilia for movement e.g
Balatidum coli which causes severe intestinal infections
 Sporozoa protozoa which have a more complicated lifespan with
both sexual and asexual modes of reproduction e.g malarial parasites
( Plasmodium ovale, Plasmodium.vivax & Plasmodium.falciparum)
Classification of protozoa cont….
b) Classification based on residence of the protozoa (it is based on
where the protozoa of medical importance i.e. the pathogenic protozoa
are found)
 Haemoprotozoa i.e pathogenic protozoa found in blood e.g malaria

causing protozoa (plasmodium) ,Leishmania, Trypanosomes etc

 Intestinal protozoa i.e pathogenic protozoa found in the digestive

system e.g Entamoeba histolytica.Leishmania spp etc

 Urogenital protozoa i.e protozoa found in the uro-genital system the

Trichomonas vaginalis
A flagellate type of protozoa
A slide showing trypanosomes
 Transmission of protozoa
Mainly by vectors ( both mechanical and biological vectors)

e.g fleas, cockroaches, ticks, lice, cats, bats etc

Through sexual intercourse e.g for the case of Trichomonas

vaginalis
Through eating contaminated food or poorly cooked food

probably harbouring cysts

Through drinking water that is contaminated

Through eating using contaminated or poorly washed hands

The Entamoeba Histolytica

Causes amoebiasis
It has an irregular shape and usually moves with aid
of pseudopodia (false foot)
It is motile
It grows in 3 stages
 The trophozoite stage (active feeding and multiplication stage)
 The precsytic stage
 The cystic stage (where it forms cysts)

• Trophozoite is 10 µm- 40 µm
• The cyst is 10µm -20µm
Amoeba trophozoite and cyst under a microscope