CLINICAL PARASITOLOGY (LECTURE) MODULE 1: INTRODUCTION TO PARASITOLOGY

INTRODUCTION PARASITES

Clinical Parasitology Endoparasite

• Parasitos = one who eats at another ones table • parasite living inside the body of a host
• logos = study of • most medically important parasites are considered
• is the are of biology concerned with the phenomenon of endoparasites (ex. ascaris)
dependence of one living organism on another • “Infection”
• Deals with the parasites that infect humans, the disease
caused by them, clinical picture and response generated Ectoparasite
by humans against them • parasite living outside the body of a host
• is considered primarily with parasites of humans and their • Ex. arthropods
medical significance as well as their importance in human • “infestation”
communities
Erratic Parasite
BIOLOGICAL RELATIONSHIPS • found in an organ which is not its usual habitat
• Ex. entamoeba histolytica
Symbiosis • Ascaris lumbricoides
• living together of unlike organisms
Forms: Obligate Parasite
o Commensalism • need a host at some stage of their life cycle to complete
o Mutualism their development and to propagate their species.
o Parasitism • Ex. tapeworms

Commensalism Facultative Parasite

• symbiotic relationship in which two species living together • may exist in a free-living state or may become parasitic
and one species benefits from the relationship without when the need arises
harming or benefiting the other. • with or without host
• “Commensal” • Ex. Strongyloides stercoralis
• Ex. Entamoeba coli in human GIT
Parthenogenesis
Mutualism
• capability of a certain organism of creation of male and
• two organisms mutually benefit from each other female gametes
• Ex. Flagellates in the termites GIT o female = pointy tail
o mal = coil
Parasitism
• Is a symbiotic relationship where one organism, the Accidental or Incidental Parasite
parasite lives in or on another, depending on the latter for • establishes itself in a host where it does not ordinarily live
its survival and usually at the expense of the host • Example:
• “Parasite” o Hymenolepis Diminuta: rat tapeworm
• Ex. Entamoeba histolytica in human GIT o Echinococcus granulosus
o Amebic colitis
o col = colon
o itis = inflamation Permanent parasite
• remans on or in the body of the host for its entire life
CLASSIFICATION OF PARASITES AND HOST
• Ex. Trichnella spiralis

Parasite
Temporary Parasite
• is an orgasnism that lives on or in a host organism and gets
• lives on the host only for a short period of time
its food from or at the expense of its host
• Ex. Ectoparasites

3 Main Classes:
Spurious Parasite
1. Metozoans (helminthes)
• is a free-living organism that passes through the
2. Protozoans
digestive tract without infecting the host
3. Ectoprasites (arthropods)
• Example:
o Entamoeba coli
Host
o Hymenolepis diminuta: similar to a male’s private
• is a human or an animal where the parasite lives or gets its
part (etits for short)
nutrients/food from

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 PARASITE LIFE CYCLE MEDICALLY IMPORTANT PARASITES
• adaptation to their hosts and the external environment
• simple or complicated Linnaean hierarchical scheme
• “Dizzy King Philip Came Over From Germany Sober”
COMMON COMPONENTS o Domain
1. Mode of transmission o Kingdom
2. Infective stage: morphologic form that invades humans o Phylum
3. Diagnostic stage: form the can be detected via laboratory o Class
retrieval methods o Order
➢ Simple – 1 o Family
➢ Complicated – many o Genus
o Species

HOST Nomenclature
• International Code of Zoological Nomenclature
Definitive or Final Host • Ex. Ascaris lumbricoides
• is one which the parasite attains sexual maturity • Genus = ascaris
• Species = lumbricoides
Intermediate Host
• harbors the asexual or larval stage of the parasite Classification
Metazoan & Protozoan
Paratenic Host
• parasites does not develop further to later stages but may Metazoan
still infect another susceptible host • Kingdom animalia
• Ex. Paragonimus westermani (raw wild boar meat) • Multicellular, macroscopic organisms
• Mainly undergo sexual reproduction
Reservoir host • Either helminths or arthropods
• allow the parasites life cycle to continue and become
additional sources of human infection Protozoan
• Ex. Balantidium coli (pigs) • Kingdom Protista
• Unicellular, microscopic organisms
• Mainly undergo both sexual and asexual reproduction
VECTORS • Provided with a nucleus, cytoplasm, an outer limiting
• are responsible for transmitting the parasite from one host membrane, organelles.
to another

Biologic Vector HOST-PARASITE RELATIONSHIP

• transmits the parasite only after the latter has completed EFFECTS OF THE PARASITE ON THE HOST
its development within the host • secretory and excretory products
• Ex. Aedes mosquito & filariasis • entamoeba histolytica in GIT
• secretes: cysteine proteinases
Mechanical or Phoretic Vector • digest cellular materials but also degrade epithelial
• only transports the parasite basement membrane facilitating tissue invasion
• Ex. flies & cockroaches
Invasion and Destruction of Host Tissue
Trivia: • plasmodium on RBC
Elephantiasis • invades red blood cells and multiply within causing cell
o wuchereria bancrofti rupture
o lymphatic system
o common in palawan Stimulates host’s immune response
• Schistosoma japonicum
• Cumulative deposition of eggs in the liver causing
“granuloma formation”

Intestinal obstruction
• Ascaris lumbricoides
• causes “ascaris bolus”

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Deprivation of essential nutrients and substances INFECTION
• Heavy hookworm infection: causes massive intestinal
bleeding which results in chronic blood loss and iron Autoinfection
deficiency • results when an infected individual becomes his own direct
• Hookworms source of infection
• Diphyllobothrium latum
• compete with its host for the available supply of Vitamin Superinfection or hyperinfection
b12 thus resulting in megaloblastic anemia • when the already infected individual is further infected with
o Vitamin B12 - creation of new red blood cells and the same specie leading to massive infection with
synthesis and formation of DNA parasite
• Enterobius vermicularis

HOST-PARASITE RELATIONSHIP SOURCES OF INFECTION

HOST’S GENETIC MAKEUP 1. Contaminated soil
• Sickle cell anemia confers immunity to Malaria o ascaris lumbricoides, trichuris trichuria,
(Plasmodium falciparum) strongyloides stercoralis
• people with duffy blood factor are more susceptible to 2. Contaminated water
malaria (plasmodium vivax) o amoeba
• Richard Duffy 3. Contaminated food
o Paragonimus infection
NUTRITIONAL STATUS OF THE HOST 4. Arthropods - mosquitos
• people wth protein-rich diet have lower chances of o Wuchereria bancrofti
developing intestinal protozoans 5. Wild and domesticated animals
• low protein diet: increase chance o pigs and cattle (tapeworms)
• high carbohydrate diet: favors the development of some 6. Human
tapeworms. o beddings and clothing, oneself, STI such as
Trichomonas vaginalis

DISEASE & EPIDEMIOLOGY DISEASE MODE OF TRANSMISSION

• impairs normal function.
Mouth most common portal of entry
Foodborne Tapeworms
PATHOGENICITY Waterborne Entamoeba histolytica and Giardia
lamblia
Pathogens Airborne Enterobius
• an organism that has demonstrated the ability to cause Vector borne malaria, filariasis
disease Skin Penetration
Soil Hookworms and Strongyloides
Pathogenicity
Congenital Toxoplasma gondii
• the capacity of the organism to cause disease transmission
Transmammary Ancylostoma and Strongyloides
Carrier Sexual
• harbors a particular pathogen without manifesting any Intercourse:
signs and symptoms

Exposure
• the process of inoculating the infective agent

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 EPIDEMIOLOGY Information-Education Communication (IEC)
• study of patterns, distribution and occurrence of disease • A health education strategy that aims to encourage people
to adapt and maintain healthy life practices
Incidence
• number of new cases of infection appearing in a Environmental management
population in a given period of time. • Planning, organization, performance, and monitoring of
activities for the modification and/or manipulation of
Prevalence (%) environmental factors
• number of individual in population estimated to be
infected Environmental sanitation
• Interventions to reduce environmental health risks
Intensity of Infection or Worm Burden
• burden of infection in which is related to the number of Sanitation
worms per infected person • Provision of access to adequate facilities for the safe
disposal of human excreta
Morbidity
• clinical consequences or disease that affect an individual Eradication
• Example: Diabetes • Permanent reduction to zero of the incidence of infection
caused by a specific agent, as a result of deliberate efforts
Deworming
• use of anthelminthic drugs in an individual or public health Elimination
program • Reduction to zero of the incidence of a specified disease in
• mebendazole, albendazole, pyrantel, etc. a defined geographic area as a result of deliberate efforts

Types of Deworming Protozoan

o selective treatment • Unicellular organism
o targeted treatment
o universal treatment Metazoan
• Multicellular organism
Morbidity Control
• constant deworming
Information - education-communication (IEC) INFORMATIVE
Cure rate (%) Environmental management
• Number of previously positive subjects found to be egg-
negative
Environmental sanitation (ex: fogging)
Egg reduction rate %
• fall in egg counts after deworming Disease Eradication- complete or permanent reduction to zero
of the worldwide incidence of infection (Ex: smallpox, 1980)
Selective treatment
• Individual-level deworming Disease Elimination- reduction to zero of the incidence of a
specified disease in a defined geographic area.
Targeted treatment
• Group-level deworming

Universal treatment
• Population-level deworming

Coverage
• Proportion of the target population reached by an
intervention

Efficacy
• Effect of a drug against an infective agent

Effectiveness
• Measure of the effect of a drug against an infective agent

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