Parasite: A parasite is an organism that lives on or in a host organism and gets its food from or

at the expense of its host. There are three main classes of parasites that can cause disease in
humans: protozoa, helminths, and ectoparasites.

Parasitic disease: A parasitic disease, or parasitosis is a infectious disease caused or transmitted

by parasites.

Parasite classification
Kingdom Animalia Protista
Sub Metazoa Protozoa
kingdom
phylum Platyhelminthes Nemathelminthes/ Nematoda Sarcodina Sporozoa Ciliata
(Flatworms) (Roundworms) (amebas) (sporozoa (Ciliates)
ns)
Class Cestoda Trematoda Chromadorea anoplea Secerne
(Tapeworm) (Flukes) ntea

❖ Topic-1: Common Parasitic Disease in Bangladesh.

A. Protozoa
a) Disease- Amoebiasis:
Pathogen’s Scientific Classification:
Domain: Eukaryota.
Phylum: Amoebozoa.
Subphylum: Conosa.
Class: Archamoebae.
Family: Entamoebidae.
Genus: Entamoeba.
Species: E. histolytica.

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 Disease Amoebiasis
Pathogen E. histolytica.
Reservoir/ Host Reservoir is only human- for several years. Incubation period- (2-4) weeks.
i. Contaminated water and food.
ii. Direct hand to mouth (Cysts under finger nails)
Mode of iii. Vegetable irrigated with sewage polluted water.
transmission ▪ Agency of flies, cockroaches, rats etc.
▪ Contact via oral rectal route.Faeco-oral route:
▪
▪ Most cases of amoebiasis have very mild symptoms or none. Wide spectrum,
from asymptomatic infection to luminal amoebiasis and amoebic colitis.
▪ Clinical symptoms are usually vague.
▪ More severe infection may cause fever, profuse diarrhea, vomiting,
abdominal pain, jaundice, anorexia, and weight loss.
▪ Invasive intestinal amoebiasis (dysentery, colitis, appendicitis, toxic mega
Symptoms colon, amoebomas)
Clinical presentation-
Amoebic colitis- Is presented with abdominal cramp to severe pain, fever,
vomiting, anorexia, mucus in stool, dysentery, flask shaped ulcer in intestine.
Prevention
▪ Sanitation-safe disposal of human excreta; good sanitary practice like washing
hands after defecation and before eating.
▪ Water supply& Food hygiene -water filtration (sand filters), boiling and wash
food well before eating.
Treatment ▪ Health education- food handlers and public
Treatment
Intestinal amoebiasis responds quickly to oral metronidazole (800 mg 8hourly for
five days) or tinidazole (2gm daily for 3 days) Diloxanide furoate 500mg should be
given orally 8 hourly for 10 days after treatment to eliminate luminal cysts.

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 b) Disease- Leishmaniasis:
Pathogen’s Scientific Classification:

Phylum: Euglenozoa
Class: Kinetoplastea
Order: Trypanosomatida.
Genus: Leishmania
Species: L. Donovani, L. Infantum etc.
Disease Leishmaniasis/ kala-azar ('black fever')
Pathogen L. Donovani, L. Infantum etc.
Reservoir/ Host In the Indian subcontinent, Man is the sole reservoir. Vector- Phlebotomine sandflies.
(P. argentipes, P. papatasi.). Incubation period: it is variable, generally 1-4 months;
range is 10 days to 2 years.
▪ Most transmission occurs by the bite of the female phlebotomine sand-fly.
Mode of (extrinsic incubation period in sand fly is 6-9 days).
▪ Transplacental
transmission
▪ Through blood transfusion

▪ Early symptoms of Kala-azar are:

i. Fever, cough, Diarrhoea
▪ Late symptoms of kala-azar are:
i. Splenomegaly
ii. Hepatomegaly
iii. Darkening of the skin of face, hands, feet and abdomen.
Symptoms iv. Weight loss and emaciation.
v. Anemia
vi. Lymphadenopathy may also occur.
Prevention
▪ Sand-fly control: Insecticide spraying, DDT is the first choice.
▪ Environmental Sanitation: Modification of physical environment such
as avoidance of muddy housing, elimination of breeding places of sand
flies.
▪ Personal protection: Use of repellants.
▪ Health education.
Treatment Treatment
Sodium stibogluconate is the drug of choice. The recommended schedule is a daily
injection (I/V or, I/M) of 20 mg / kg for 20 -30 days.

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 c) Disease- Malaria:
Pathogen’s Scientific Classification:
Domain: Eukaryota
Phylum: Apicomplexa
Class: Aconoidasida
Order: Haemosporida
Family: Plasmodiidae
Genus: Plasmodium
Species: P. vivax, P. falciparum, P. malariae, P. ovale
Disease Benign tertian malaria, Quartan malaria, Cerebral malaria, Mild tertian malaria
Pathogen P. vivax, P. falciparum, P. malariae, P. ovale
Reservoir/ Host A person who harbours the sexual sexual forms (gametocytes) of the parasites.
Vectors- Aedes phillipinensis, A. sundica, A. minimus, A. balbacensis
Mode of ▪ Transmission by female anopheline mosquito- inoculation of sporozoites in
transmission to man by bite.

▪ Malaria presents with abrupt onset of frver and chills,accompanied by

Symptoms headache, myalgias, and arthralgia, about 2 weeks after the bite.
▪ Splenomegaly is seen in most patients.
▪ Hepatomegaly occurs in roughly one third cases, Anemia.
Preventive and control measure:
▪ The individual:
i. Chemoprophylaxis: Chloroquine 150mg base (2
tablets weekly). Mefloquine 250mg (one tablet) wkly.
ii. Chemoprophylaxis in pregnancy or lactation:
Chloroquine
▪ Other:
i. Use of mosquito net, protective clothing, repellent creams and sprays, screened
Treatment
windows.
▪ The vector:
i. Adult mosquito control, prevention of mosquito breeding by
larva control (larvicides- heavy oiling with anti-malarial oil,
spraying kerosene with 5% DDT)
Treatment:
▪ Chemotherapy of the acute attack:
i. Chloroquine is the drug of choice for acute malaria.600 mg of
the effective base (4 tablets) followed by 300 mg base in 6 hours
then 150 mg base twice daily for 2 more days. Mefloquine.

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 d) Disease-Giardiasis:

Pathogen’s Scientific Classification:

Domain: Eukaryota.
Phylum: Metamonada.
Order: Diplomonadida.
Family: Hexamitidae.
Genus: Giardia.
Species: G. lamblia.
Disease Giardiasis
Pathogen G. lamblia.
Reservoir/ Host Giardia infects humans
Mode of ▪ Ingestion of food or water contaminated with cysts.
transmission ▪ Incubation Period: 1 to 2 weeks (average 7 days) after an individual
becomes infected.
▪ Initial infection:
Acute diarrhea for 2 to 3 days, low grade fever, Anorexia, nausea, cramping.
▪ Later, more chronic infection:
Symptoms Diarrhea / foul smelling stool & flatus, Foul smelling belching, Cramping, nausea,
anorexia, fatigue, Abdominal distention. May progress to malabsorption, weight loss,
failure to thrive.

Treatment:
▪ Quinacrine (Atabrine)
Treatment Dose 100mg tid x 5 to 7 days (7 mg / kg / day)
▪ Metronidazole (Flagyl)
250 mg tid x 7 days (21 mg / kg / day).

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 B. Platyhelminthes
e) Disease-taeniasis:
Pathogen’s Scientific Classification:

Kingdom: Animalia
Phylum: Platyhelminthes
Class: Cestoda
Order: Cyclophyllidea
Family: Taeniidae
Genus: Taenia
Species: T. solium, T. saginata
Disease Taeniasis
Pathogen T. solium, T. saginata
Reservoir/ Host Definitive host: Human; intermediate host: Cattle, Pigs
Mode of ▪ Eating raw or undercooked pork containing encysted larval stage (Cysticercus
transmission cellulosae). Ingesting the parasites egg with contaminated food or water.

▪ Usually no symptoms, may cause abdominal discomfort, indigestion, diarrhea

Symptoms alternating with constipation and loss of appetite. • Cysticercosis (by cysticercus
cullulosae ) may occur in any organ.
Praziquantel and niclosamide single dose of 4 tablets of 500 mg for T. saginata and
Treatment T. solium. • Praziquantel high dose over 3-7 days for T. solium.

f) Disease-Hydatid disease(Echinococcosis):
Pathogen’s Scientific Classification:
Kingdom: Animalia
Phylum: Platyhelminthes
Class: Cestoda
Order: Cyclophyllidea
Family: Taeniidae
Genus: Echinococcus
Species: E. granulosus

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 Disease Hydatid disease(Echinococcosis)
Pathogen T. solium, T. saginata
Reservoir/ Host Definitive host- Dog and other canids., Intermediate host- sheeps, pigs
humans
Mode of ▪ The most common mode of transmission to humans is by the accidental
transmission consumption of soil, water, or food that has been contaminated by the fecal
matter of an infected dog.
▪ stomach upset, cough, diarrhea, anemia.
Symptoms ▪ unexplained weight loss, weakness and fatigue.
▪ swollen abdomen.
▪ blood or the fluid from a ruptured cyst – may be coughed up.
Surgery is the main form of treatment for hydatid disease. A risk of surgery is that a
Treatment hydatid cyst may rupture and spread tapeworm heads throughout the patient’s body.
To reduce this risk, the doctor may prescribe high doses of the drug albendazole in
conjunction with surgery.

g) Disease- Schistosomiasis (snail fever):

Pathogen’s Scientific Classification:
Kingdom: Animalia
Phylum: Platyhelminthes
Class: Trematoda
Order: Diplostomida
Family: Schistosomatidae
Genus: Schistosoma

Disease Schistosomiasis (snail fever)

Pathogen Schistosomes – (s.haematobium, s.japonicum, and s.mansoni -often affect humans)
Reservoir/ Host The primary host is humans; freshwater snails are the secondary host.
Mode of transmission The disease is spread by contact with fresh water contaminated with the parasites.
These parasites are released from infected freshwater snails.
Fever, abdominal pain, bloody feces, cough, aches, and skin irritation from where the
cercariae entered the skin. Include hepatosplenomegaly, frequent urination, dysuria,
Symptoms
and hematuria are the main symptom.

Treatment There are two drugs available, praziquantel and oxamniquine.

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 h) Disease-Fascioliasis:
Pathogen’s Scientific Classification:
Kingdom: Animalia
Phylum: Platyhelminthes
Class: Rhabditophora
Order: plagiorchiida
Family: Fasciolidae
Genus: Fasciola
Species: F. hepatica.

Disease Fascioliasis
Pathogen F.hepatica.
Reservoir/ Host Definitive host: man, Reservoir host: herbivorous animals, Intermediate host: snail
Lymnaea cailliaudi.
Mode of transmission Ingestion of metacercaria in crabs or cray fish.
During the acute phase manifestations include: abdominal pain, hepatomegaly, fever,
Symptoms vomiting, diarrhea, eosinophilia, and can last for months.
In the chronic phase (caused by the adult fluke within the bile ducts), the symptoms
are:
biliary obstruction, Inflammation, liver Rot.
Avoid eating raw vegetables before washing them. Avoid drinking infected water.
Treatment Avoid eating raw liver to prevent halzoun syndrome
The drug of choice in the treatment of fasciolosis is triclabendazole.

C. Nemathelminthes:

i) Disease-Hook worm disease(encyclostomiasis):

Pathogen’s Scientific Classification:
Kingdom: Animalia
Phylum: Nematoda
Class: Chromadorea
Order: Rhabditida
Family: Ancylostomatidae
Genus: Ancylostoma

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 Disease Hook worm disease(encyclostomiasis)
Pathogen Ancylostoma duodenale
Reservoir/ Host Definitive host: man, Reservoir host: herbivorous animals, Intermediate host: snail
Lymnaea cailliaudi.
Mode of transmission Contact with contaminated soil (walking barefoot over contaminated soil), oral (from
food)
Pathogenic effects: Ground itch or encyclostome dermatitis Pulmonary eosinophilia
Symptoms Due to small intestine infection: Vomiting, epigastric pain, loose stool. Anaemia.

Sanitary disposal of faeces and health education with community participation.

Treatment The drug of choice for the treatment of hookworm disease is mebendazole which is
effective against both species.

j) Disease-Ascariasis:
Pathogen’s Scientific Classification:
Kingdom: Animalia
Phylum: Nematoda
Class: Secernentea
Order: Ascaridida
Family: Ascarididae
Genus: Ascaris
Species: A. lumbricoides

Disease Ascariasis
Pathogen A. lumbricoides
Reservoir/ Host Humans; ascarid eggs in soil
Mode of transmission Ingestion of infective eggs from soil contaminated with human faeces, uncooked
produce contaminated with soil containing infective eggs.
Symptoms correlate with worm load: light loads are asymptomatic; heavier loads
cause abdominal symptoms, diarrhea and malnutrition. A bolus of worms may obstruct
Symptoms
the intestine; migrating larvae may cause pneumonitis and eosinophilia.
Sanitary disposal of faeces and health education with community participation
Treatment Anthelminthic medications (drugs that rid the body of parasitic worms), such as
albendazole and mebendazole, are the drugs of choice.

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 k) Disease-Trichuriasis:
Pathogen’s Scientific Classification:
Kingdom: Animalia.
Phylum: Nematoda.
Class: Enoplea.
Order: Trichocephalida.
Family: Trichuridae.
Genus: Trichuris.
Species: T. trichiura

Disease Trichuriasis
Pathogen T. trichiura
Reservoir/ Host Humans.
Mode of transmission Ingestion of infective eggs by mouth contact with hands or food contaminated with
egg-carrying soil. It can be transmitted by sexual contact.
Symptoms: Abdominal pain, tiredness, diarrhea, growth retardation, weight loss,
nutritional deficiencies, and anemia.
Symptoms
Prevention: Improved sanitation, handwashing etc.
Treatment Medicines: highest clearance rates are obtained by combining mebendazole or
albendazole with ivermectin.

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 l) Disease-Lymphatic Filariasis:
Pathogen’s Scientific Classification:
Kingdom: Animalia.
Phylum: Nematoda.
Class: Secernentea
Order: Spirurida
Family: Onchocercidae
Genus: Wuchereria
Species: W. bancrofti.

Disease Lymphatic Filariasis

Pathogen W. bancrofti.
Reservoir/ Host Humans. Vector- Mosquitoes (Culex and Anopheles)
Mode of transmission By the bite of infected mosquitoes.
There are two forms of Filariasis:
Symptoms ▪ Classical: i) Inflammatory lesions (Lymphangitis, Lymphadenitis fever)
ii) Dilation of lymphatics causing lymphangiovarix.
iii) Rupture of lymphangiovarix may cause lymphorrhagia.
▪ Occult:
Tropical pulmonary eosinophilia, generalized lymph node enlargement,
hepatosplenomegaly and absence of microfilaria.

Prevention: Measures should be taken to control mosquitoes.

Treatment Medicines: The drug of choice, Diethylcarbamazine (9-12 mg/kg thrice daily orally for
14 days). Antihistamines may be given to control allergic phenomenon.

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 ❖ Topic-2: Common Helminthic Parasitic Disease in Bangladesh.

m) Disease-Cysticerocis:
Pathogen’s Scientific Classification:

Kingdom: Animalia
Phylum: Platyhelminthes
Class: Cestoda
Order: Cyclophyllidea
Family: Taeniidae
Genus: Taenia
Species: T. solium, T. saginata

Disease Cysticerocis
Pathogen T. solium.
Reservoir/ Host Definitive host- Human, Intermediate host- Pigs
Mode of transmission Eating raw or undercooked pork containing encysted larval stage (Cysticercus
cellulosae). Ingesting the parasites egg with contaminated food or water.
Usually no symptoms, may cause abdominal discomfort, indigestion, diarrhea
alternating with constipation and loss of appetite. Cysticercosis (by cysticercus
Symptoms
cullulosae ) may occur in any organ.
Prevention: Isolation of the Hospitalized Patient, Eating raw or undercooked beef or
Treatment pork should be avoided. Persons known to harbor the adult tapeworm of T solium
should be treated immediately and use careful hand washing and care in the disposal of
fecal material.
Medicines: Praziquantel and niclosamide single dose of 4 tablets of 500 mg for T.
saginata and T. solium. • Praziquantel high dose over 3-7 days for T. solium.

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 n) Disease-Loiasis:
Pathogen’s Scientific Classification:

Kingdom: Animalia
Phylum: Nematoda
Class: Chromadorea
Order: Spirurida
Family: Onchocercidae
Genus: Loa
Species: L. loa

Disease Loiasis
Pathogen Loa loa
Reservoir/ Host Humans are the primary reservoir for Loa loa.
Mode of transmission Loa loa infective larvae are transmitted to humans by deer fly vectors, Chrysops silica
and C. dimidiata. The vectors are blood-sucking and day-biting,
o Swelling (usually near joints) that can also be itchy as well
o Worms that visibly crawl under the skin
Symptoms
o Worms that can be seen crawling across the eyes
o Muscle and joint pain
o Tiredness and fatigue
Prevention: Using insect repellents (including permethrin-impregnated clothing) and
wearing long-sleeved and long-legged clothing may reduce the number of bites by
Treatment
infected flies. Because the flies are day-biting, mosquito (bed) nets do not help.

Medicines: Diethylcarbamazine. For heavy infections, initial treatment with

albendazole and/or apheresis

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 o) Disease-Clonorichiasis:
Pathogen’s Scientific Classification:

Kingdom: Animalia
Phylum: Platyhelminthes
Class: Rhabditophora
Order: Plagiorchiida
Family: Opisthorchiidae
Genus: Clonorchis
Species: C. sinensis

Disease Clonorichiasis
Pathogen C. sinensis / Opisthorchis viverrini
Reservoir/ Host Main host- dogs, cats, swine etc. Humans may be substitute reservoir hosts. Vector-
Snails.
Mode of transmission Ingestion of raw or improperly cooked freshwater fish or crayfish containing encysted
larvae.
Mostly don’t present any symptoms.
o Abdominal pain, nausea, and diarrhea
Symptoms
o Jaundice
o Intermittent biliary duct obstruction can cause abdominal pain (biliary colic)
o Cholangitis - infection and inflammation of the bile duct
o Cholecystitis - infection and inflammation of the gall bladder
o Pancreatitis (inflammation of the pancreas)

o Treatment of clonorchiasis is with one of the following:Praziquantel or

albendazole
Treatment
o Biliary obstruction may require surgery.
o Prevention: Thoroughly cooking freshwater fish from endemic waters and not
eating it raw, pickled, or wine-soaked.

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 p) Disease-Paragoniasis:
Pathogen’s Scientific Classification:

Kingdom: Animalia
Phylum: Platyhelminthes
Class: Rhabditophora
Order: Plagiorchiida
Family: Paragonomidae
Genus: Paragonimus
Species: P. westermani

Disease Paragoniasis
Pathogen P. westermani
Reservoir/ Host Animals such as pigs, dogs, and a variety of feline species can also harbor P.
westermani.

Mode of transmission Transmission of the parasite P. westermani to humans and mammals primarily occurs
through the consumption of raw or undercooked seafood.
o Acute- abdominal pain, diarrhea, fever
o Chronic- Cough, Rusty sputum
Symptoms
o Eosinophilic meningitis
o Seizure
o Paralysis

o paragonimiasis is usually treated with a drug called praziquantel. (95%

efficiency)
Treatment
o Salting does not kill parasite, cooking and freezing does.
o After ingestion, takes about 3 months for lung fluke to start laying.
o Host might stay infected up to 20 years.

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