‫المستوى االول‬/ ‫الفصل الدراسي الثاني‬

Medical Biology ll (Theory)

Dr.Sajeda Shareef

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 ‫ﺍﻟﺪﻳﺪﺍﻥ ﺍﻟﺨﻄﺎﻓﻴﺔ‬

Hookworms

Lecture 7
17/5/2020

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 ‫ﺍﻟﺪﻳﺪﺍﻥ ﺍﻟﺨﻄﺎﻓﻴﺔ‬

‫‪Hookworm‬‬
‫ﻧﻮﻋﺎﻥ ﻣﻦ ﺍﻟﺪﻳﺪﺍﻥ ﺍﻟﺨﻄﺎﻓﻴﺔ ﻫﻤﺎ ﻃﻔﻴﻠﻴﺎﺕ ﺑﺸﺮﻳﺔ ‪ ،‬ﺍﻷﻧﻜﻠﺴﺘﻮﻣﺎ ﺍﻻﺛﻨﺎ ﻋﺸﺮﻳﺔ ﻭﺍﻟﻔﺘﺎﻛﺔ ﺍﻷﻣﺮﻳﻜﻴﺔ‬

‫‪• Two species of hookworms are human parasites,‬‬

‫‪Ancylostoma duodenale and Necator americanus.‬‬
‫‪• They have opened buccal cavity with teeth as in‬‬
‫‪A.duodenale or cutting plates as in N.americanus‬‬
‫ﻟﺪﻳﻬﻢ ﺗﺠﻮﻳﻒ ﺷﺪﻗﻲ ﻣﻔﺘﻮﺡ ﻣﻊ ﺍﺳﻨﺎﻥ ﻛﻤﺎ ﻓﻲ ﺍﻷﻧﻜﻠﺴﺘﻮﻣﺎ ﺍﻻﺛﻨﺎ‬
‫ﻋﺸﺮﻳﺔ ﺍﻭ ﺃﻟﻮﺍﺡ ﺍﻟﺘﻘﻄﻴﻊ ﻛﻤﺎ ﻓﻲ ﺍﻟﻔﺘﺎﻛﺔ ﺍﻻﻣﻴﺮﻳﻜﻴﺔ‬

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 ‫ﺍﻷﻧﻜﻠﺴﺘﻮﻣﺎ ﺍﻻﺛﻨﺎ ﻋﺸﺮﻳﺔ‬

Ancylostoma duodenale
‫ﺍﻟﻤﻮﻃﻦ‬ ‫ﺗﻌﻴﺶ ﺍﻟﺪﻳﺪﺍﻥ ﺍﻟﺒﺎﻟﻐﺔ ﻓﻲ ﺍﻷﻣﻌﺎء ﺍﻟﺪﻗﻴﻘﺔ‬
، ‫ ﻣﻌﻈﻤﻬﻢ ﻓﻲ ﺍﻟﺼﺎﺋﻢ‬، ‫ﻟﻸﺷﺨﺎﺹ ﺍﻟﻤﺼﺎﺑﻴﻦ‬
Habitat ‫ ﻭﻧﺎﺩﺭًﺍ ﻓﻲ ﺍﻟﻠﻔﺎﺋﻔﻲ‬، ‫ﻭﺃﻗﻞ ﻓﻲ ﺍﻻﺛﻨﺎ ﻋﺸﺮﻱ‬

• The adult worms live in the small intestines of

infected persons, mostly in the jejunum, less often
in the duodenum, and infrequently in the ileum.

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 ‫ﺍﻷﻧﻜﻠﺴﺘﻮﻣﺎ ﺍﻻﺛﻨﺎ ﻋﺸﺮﻳﺔ ﺍﻟﺸﻜﻞ‬

Ancylostoma duodenale Morphology

‫ﺍﻟﺪﻭﺩﺓ ﺍﻟﺒﺎﻟﻐﺔ‬
Adult Worm . ‫ﺗﻜﻮﻥ ﻧﺴﺒﻴﺎ ﺩﻳﺪﺍﻥ ﺳﻤﻴﻜﺔ ﺍﺳﻄﻮﺍﻧﻴﺔ‬
• They are relatively stout cylindroidal worms.
• The body is curved with the dorsal aspect concave
and the ventral aspect convex. The anterior end is
somewhat constricted and bent dorsally in the
same direction of general body curvature. This
cervical curvature gave it the name hookworm
‫ ﺍﻟﻨﻬﺎﻳﺔ ﺍﻷﻣﺎﻣﻴﺔ ﻣﻘﻴﺪﺓ ﺇﻟﻰ ﺣﺪ ﻣﺎ ﻭﺗﻨﺤﻨﻲ‬. ‫ﺍﻟﺠﺴﻢ ﻣﻨﺤﻨﻲ ﻣﻊ ﺗﻘﻌﺮ ﻇﻬﺮﻱ ﻭﺟﺎﻧﺐ ﺑﻄﻨﻲ ﻣﺤﺪﺏ‬
‫ ﺃﻋﻄﻰ ﻫﺬﺍ ﺍﻻﻧﺤﻨﺎء ﺍﻟﻌﻨﻘﻲ ﺍﺳﻢ ﺍﻟﺪﻭﺩﺓ ﺍﻟﺨﻄﺎﻓﻴﺔ‬.‫ﻇﻬﺮﻳًﺎ ﻓﻲ ﻧﻔﺲ ﺍﺗﺠﺎﻩ ﺍﻧﺤﻨﺎء ﺍﻟﺠﺴﻢ ﺍﻟﻌﺎﻡ‬

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 ‫ﺍﻷﻧﻜﻠﺴﺘﻮﻣﺎ ﺍﻻﺛﻨﺎ ﻋﺸﺮﻳﺔ ﺍﻟﺸﻜﻞ‬

Ancylostoma duodenale Morphology

.‫ ﺍﻟﻄﺮﻑ ﺍﻟﺨﻠﻔﻲ ﻟﻠﺬﻛﺮ ﻳﺘﻢ ﺗﻮﺳﻴﻌﻪ ﺇﻟﻰ ﺟﺮﺍﺏ ﺍﻟﺠﻤﺎﻉ‬.‫ﺍﻟﺪﻭﺩﺓ ﺍﻟﺬﻛﻮﺭﻳﺔ ﺃﺻﻐﺮ ﻣﻦ ﺍﻟﺪﻭﺩﺓ ﺍﻷﻧﺜﻮﻳﺔ‬
• The male worm is smaller than female worm . The
posterior end of the male is expanded into a
copulatory bursa.
.‫ ﻣﻊ ﻓﺘﺤﺔ ﺍﻟﺸﺮﺝ ﺍﻟﻔﺮﻋﻴﺔ ﺗﻘﻊ ﺑﻄﻨﻴًﺎ‬، ‫ ﺍﻟﻨﻬﺎﻳﺔ ﺍﻟﺨﻠﻔﻴﺔ ﻣﺨﺮﻭﻃﻴﺔ‬.‫ﺍﻟﺪﻭﺩﺓ ﺍﻷﻧﺜﻮﻳﺔ ﺃﻛﺒﺮ‬
• The female worm is larger. It is posterior end is
conical, with a sub terminal anus situated ventrally.

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 ‫ﺍﻟﺴﻤﺎﺕ ﺍﻟﻤﻤﻴﺰﺓ ﻝ ﺫﻛﺮ ﻭﺃﻧﺜﻰ ﺍﻟﺪﻳﺪﺍﻥ ﻣﻦ ﺍﻷﻧﻜﻠﺴﺘﻮﻣﺎ ﺍﻻﺛﻨﺎ ﻋﺸﺮﻳﺔ‬

‫‪Distinguishing Features of Male and‬‬

‫‪Female worms of Ancylostoma duodenale‬‬

‫ﺍﻟﺬﻛﺮ‬ ‫ﺍﻻﻧﺜﻰ‬
‫ﺍﻟﺤﺠﻢ‬ ‫ﺍﺻﻐﺮ‬ ‫ﺍﻛﺒﺮ‬

‫ﺟﺮﺍﺏ ﺍﻟﺠﻤﺎﻉ‬ ‫ﻏﺎﺋﺐ ﺍﻭ ﻏﻴﺮ ﻣﻮﺟﻮﺩ‬

‫ﻣﻮﺟﻮﺩ‬

‫ﻳﻔﺘﺢ ﻋﻨﺪ ﺗﻘﺎﻃﻊ ﺍﻟﺜﻠﺚ ﺍﻷﻭﺳﻂ ﻭﺍﻟﺨﻠﻔﻲ ﻣﻦ ﺍﻟﺠﺴﻢ‬

‫ﻓﺘﺤﺔ ﺍﻷﻋﻀﺎء ﺍﻟﺘﻨﺎﺳﻠﻴﺔ‬ ‫ﻳﻔﺘﺢ ﻓﻲ ﺑﺎﻟﻮﻋﺔ ﻣﻊ ﻓﺘﺤﺔ ﺍﻟﺸﺮﺝ‬

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 ‫ﺍﻟﻔﺘﺎﻛﺔ ﺍﻻﻣﻴﺮﻳﻜﻴﺔ‬

Necator americanus
‫ﺍﻟﺸﻜﻞ‬
• Morphology ‫ﺍﻟﺪﻳﺪﺍﻥ ﺍﻟﺒﺎﻟﻐﺔ ﺃﺻﻐﺮ ﺑﻘﻠﻴﻞ ﻣﻦ ﺍﻷﻧﻜﻠﺴﺘﻮﻣﺎ ﺍﻻﺛﻨﺎ ﻋﺸﺮﻳﺔ‬
• The adult worms are slightly smaller than
A.duodenale. .ً‫ﺍﻟﺬﻛﺮ ﺃﺻﻐﺮ ﻣﻦ ﺍﻷﻧﺜﻰ ﺃﻳﻀﺎ‬
• the male smaller than‫ﻣﻦ‬female also.
‫ﻟﺪﻳﻬﺎ ﻛﺒﺴﻮﻟﺔ ﺷﺪﻗﻴﺔ ﺻﻐﻴﺮﺓ ﻣﻊ ﺯﻭﺟﻴﻦ‬
• They have a smaller buccal capsule with 2 pairs of
‫ﺍﻟﻮﺍﺡ ﺍﻟﺘﻘﻄﻴﻊ ﺍﻟﻬﻼﻟﻴﺔ ﺑﺪﻻ ﻣﻦ ﺍﻷﺳﻨﺎﻥ ﺍﻟﺘﻲ ﺗﻜﻮﻥ‬

semilunar cutting plates instead of teeth which

‫ﻣﻮﺟﻮﺩﺓ ﻓﻲ ﺍﻷﻧﻜﻠﺴﺘﻮﻣﺎ ﺍﻻﺛﻨﺎ ﻋﺸﺮﻳﺔ‬

present in A.duodenale. ‫ﺍﻟﺠﺮﺍﺏ ﺍﻟﺠﻤﺎﻋﻲ ﻟﻠﺬﻛﻮﺭ ﻃﻮﻳﻞ ﻭﻭﺍﺳﻊ‬

• The copulatory bursa of the male is long and wide.
.‫ ﻳﺘﻢ ﻭﺿﻊ ﺍﻟﻔﺮﺝ ﻓﻲ ﻣﻨﺘﺼﻒ ﺍﻟﺠﺴﻢ ﺃﻭ ﺃﻣﺎﻣﻪ‬، ‫ﻓﻲ ﺍﻹﻧﺎﺙ‬
• In female, the vulva is placed in the middle of the
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 ‫ﺩﻭﺭﺓ ﺣﻴﺎﺓ ﺍﻟﺪﻳﺪﺍﻥ ﺍﻟﺨﻄﺎﻓﻴﺔ‬

‫‪Hookworm life cycle‬‬

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 ‫ﺩﻭﺭﺓ ﺣﻴﺎﺓ ﺍﻟﺪﻳﺪﺍﻥ ﺍﻟﺨﻄﺎﻓﻴﺔ‬

Hookworm life cycle

‫ ﺍﻛﺘﻤﺎﻝ ﺩﻭﺭﺓ ﺍﻟﺤﻴﺎﺓ ﻓﻲ ﻣﻀﻴﻒ ﻭﺍﺣﺪ‬.‫ ﺍﻟﺒﺸﺮ‬:‫ﺍﻟﻤﻀﻴﻒ ﺍﻟﻄﺒﻴﻌﻲ‬
.
• Natural host: Humans. Life cycle is completed in a
single host. .‫ ﻳﺮﻗﺔ ﺧﻴﻄﻴﺔ ﻣﻦ ﺍﻟﻤﺮﺣﻠﺔ ﺍﻟﺜﺎﻟﺜﺔ‬:‫ﺍﻟﺸﻜﻞ ﺍﻟﻤﻌﺪﻱ‬
• Infective form: Third-stage filiform larva.
.‫ ﺍﺧﺘﺮﺍﻕ ﺍﻟﺠﻠﺪ‬: ‫ﺑﻮﺍﺑﺔ ﺍﻟﺪﺧﻮﻝ‬
• Portal of entry: Penetration of skin.

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 ‫ﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻟﺪﻭﺩﺓ ﺍﻟﺨﻄﺎﻓﻴﺔ‬

Prophylaxis of Hookworm
.‫ﻣﻨﻊ ﺗﻠﻮﺙ ﺍﻟﺘﺮﺑﺔ ﺑﺎﻟﺒﺮﺍﺯ ﻭﺍﻟﺘﺨﻠﺺ ﺍﻟﺴﻠﻴﻢ ﻣﻦ ﺍﻟﺘﺮﺑﺔ ﺍﻟﻠﻴﻠﻴﺔ ﻭﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﻤﺮﺍﺣﻴﺾ ﺍﻟﺼﺤﻴﺔ‬

• Prevention of soil pollution with feces and proper

disposal of night soil and use of sanitary latrines.
‫ ﺗﻮﻓﺮ ﺍﻟﻘﻔﺎﺯﺍﺕ ﺣﻤﺎﻳﺔ ﻣﻤﺎﺛﻠﺔ ﻷﻳﺎﺩﻱ ﻋﻤﺎﻝ ﺍﻟﻤﺰﺍﺭﻉ‬.‫ﺍﺳﺘﺨﺪﺍﻡ ﺍﻷﺣﺬﻳﺔ ﻟﻤﻨﻊ ﺩﺧﻮﻝ ﺍﻟﻴﺮﻗﺎﺕ ﻣﻦ ﺧﻼﻝ ﺟﻠﺪ ﺍﻟﻘﺪﻡ‬
• Use of footwear to prevents entry of larva through.
the skin of the foot. Gloves give similar protection
to the hands of farm workers.
.‫ ﻳﻘﺘﺼﺮ ﻋﻠﻰ ﻣﺼﺪﺭ ﺍﻟﻌﺪﻭﻯ‬، ‫ ﻭﻳﻔﻀﻞ ﺃﻥ ﻳﻜﻮﻥ ﺟﻤﻴﻌﻬﻢ ﻓﻲ ﻧﻔﺲ ﺍﻟﻮﻗﺖ‬، ‫ﻋﻼﺝ ﺍﻟﻤﺮﺿﻰ ﻭﺍﻟﻨﺎﻗﻠﻴﻦ‬
• Treatment of patients and carriers, preferably all at
the same time, limit to the source of infection.

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 ‫ﺍﻟﺘﺸﺨﻴﺺ ﺍﻟﻤﺨﺘﺒﺮﻱ ﻟﻠﺪﻳﺪﺍﻥ ﺍﻟﺨﻄﺎﻓﻴﺔ‬

‫‪Laboratory diagnosis of hookworm‬‬

‫ﺍﻟﺘﺸﺨﻴﺺ ﺍﻟﻤﺨﺘﺒﺮﻱ ﻟﻠﺪﻳﺪﺍﻥ ﺍﻟﺨﻄﺎﻓﻴﺔ‬

‫ﻃﺮﻕ ﻏﻴﺮ ﻣﺒﺎﺷﺮﺓ‬

‫ﻃﺮﻕ ﻣﺒﺎﺷﺮﺓ‬

‫ﻓﺤﺺ ﺍﻟﺪﻡ‬
‫ﻓﺤﺺ ﺍﻟﺒﺮﺍﺯ‬

‫ﺍﻻﺷﻌﺔ ﺍﻟﺴﻴﻨﻴﺔ‬
‫ﻟﻠﺼﺪﺭ‬

‫ﺑﺮﻫﻨﺔ ﺍﻟﺒﻴﻀﺔ‬ ‫ﺑﺮﻫﻨﺔﺍﻟﺪﻭﺩﺓ ﺍﻟﺒﺎﻟﻐﺔ‬ ‫ﺛﻘﺎﻓﺔ ﺍﻟﺒﺮﺍﺯ‬

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 ‫ﺍﻟﻤﻈﺎﻫﺮ ﺍﻟﺴﺮﻳﺮﻳﺔ ﻟﻠﺪﻳﺪﺍﻥ ﺍﻟﺨﻄﺎﻓﻴﺔ‬

‫‪Clinical features of Hookworm‬‬

‫ﺣﻜﺔ ﺗﺮﺍﺑﻴﺔ ‪ ،‬ﻃﻔﺢ ﺟﻠﺪﻱ )ﺩﺍء ﻫﺠﺮﺓ ﺍﻟﻴﺮﻗﺎﺕ ﺍﻟﺠﻠﺪﻱ(‪.‬‬
‫‪• Ground itch, creeping eruption (cutaneous larva‬‬
‫‪migrans).‬‬ ‫ﺍﻟﺘﻬﺎﺏ ﺍﻟﺸﻌﺐ ﺍﻟﻬﻮﺍﺋﻴﺔ ﻭﺍﻟﺘﻬﺎﺏ ﺍﻟﺮﺋﻮﻱ ﺍﻟﻘﺼﺒﻲ ﻓﻲ ﺍﻟﺮﺋﺔ‪.‬‬
‫‪• Bronchitis and broncho pneumonia in lung.‬‬
‫ﻓَﻘْﺮُ ﺍﻟﺪَّﻡِ ﺍﻟﻨَّﺎﻗِﺺُ ﺍﻟﺼِّﺒﺎﻍِ ﺍﻟﺼَّﻐﻴﺮُ ﺍﻟﻜُﺮَﻳَّﺎﺕ ﺍﻭ ﻓَﻘْﺮُ ﺍﻟﺪَّﻡِ ﺍﻟﺜُّﻨﺎﺋِﻲُّ ﺍﻟﺸَّﻜْﻞ‬
‫‪• Hypochromic microcytic or dimorphic anemia‬‬
‫ﺍﻷﻋﺮﺍﺽ ﺍﻟﻤﻌﻮﻳﺔ ﻣﺜﻞ ﺃﻟﻢ ﺷﺮﺳﻮﻓﻲ ﻭﻋﺴﺮ ﺍﻟﻬﻀﻢ ﻭﺍﻟﻐﺜﻴﺎﻥ‪.‬‬
‫‪• Intestinal symptoms like epigastic pain, dyspepsia‬‬
‫‪and nausea.‬‬

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 ‫ﺗﺸﺨﻴﺺ ﺍﻟﺪﻳﺪﺍﻥ ﺍﻟﺨﻄﺎﻓﻴﺔ‬

Diagnosis of Hookworm
‫ﻳﺘﻢ ﺫﻟﻚ ﻣﻦ ﺧﻼﻝ ﺇﻇﻬﺎﺭ ﺍﻟﺒﻴﻀﺔ ﺍﻟﻤﻤﻴﺰﺓ ﻓﻲ ﺍﻟﺒﺮﺍﺯ ﻋﻦ ﻃﺮﻳﻖ‬
‫ﺍﻟﻔﺤﺺ ﺍﻟﻤﺠﻬﺮﻱ ﺍﻟﻤﺒﺎﺷﺮ ﺃﻭ ﻋﻦ ﻃﺮﻳﻖ ﻃﺮﻕ ﺍﻟﺘﺮﻛﻴﺰ‬
• Done by demonstration of characteristic egg in the
feces by direct microscopy or by concentration
methods ‫ﻣﻦ ﺧﻼﻝ ﺇﻇﻬﺎﺭ ﺍﻟﺪﻳﺪﺍﻥ ﺍﻟﺒﺎﻟﻐﺔ ﻓﻲ ﺍﻟﺒﺮﺍﺯ ﺃﻭ ﻧﻀﺢ ﺍﻻﺛﻨﻲ ﻋﺸﺮ‬
• By demonstration of adult worms in stool. or
duodenal aspirate.

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