Introduction to Parasitology

Sitti Wahyuni, MD, PhD

Parasitology Department Faculty of Medicine
Hasanuddin University

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Upon completion of this part, the learner is expected to
• Understand the term of parasite and parasitology
• Define an organism that qualifies as a parasite
• Describe the type of parasite and hosts
• Understand parasite life-cycle and incubation periode
• Understand the results of interaction between parasite and host
• Understand the mechanism of pathology in parasite infection
• Define the symptoms that may occur during parasite infection
• Describe laboratory diagnosis for parasite infection

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 7 Characteristic of living organisms
1) Nutrition: Taking in nutrients absorbing and assimilating them for growth and
tissue repair
2) Excretion: Removal from organisms of toxic materials, the waste products of
metabolism and substances in excess.
3) Respiration: Chemical reactions that break down nutrient molecules in living
cells to release energy.
4) Sensitivity: The ability to detect or sense changes in the environment and to
make responses.
5) Reproduction: Progresses that make more of the same kind of organism.
6) Growth: The permanent increase in size and dry mass by an increase in number
of cells, cell size, or both.
7) Movement: An action by an organism or part of an organism that changes
position or place.
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 A parasite
Is an organism that lives in or on other organism,
called the host, and often harms it.

A parasite depends on its host for survival.

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 Why an organism become parasite?
• The lack of necessary organs for assimilating raw food
materials
• The lack of ability to adapt to free living environment for
digestion, excretion, respiration, and reproduction functions

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 Parasitology
is the study of parasites, their hosts, and the
relationship between them

Medical parasitology
Include four major groups of organisms:
Protozoa, Helminths, Arthropods and Fungal

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 Parasite characteristic
• Most go through complex life cycles
• Most are chronic because its ability to evade innate
immunity and the ability of parasites to resist elimination by
adaptive immune responses.
• Able to survive and replicate in their hosts because they are
well adapted to resisting host defenses
• Many anti-parasite are not effective at killing the organisms.
• Vaccine are not available for most of cases
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 HELMINTH PROTOZOA ARTHROPODA FUNGI

Biliary Ascaris (Singh D Erythrocyte infected by Plasmodium Pediculus sp Candida albicans

et al., 2016)

Loaloa (Moffet S, 2010) Giardia Female Anopheles Malazzea furfur

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Classification of parasite based on
pathogenicity
• Pathogenic parasite: An organisms that cause a wide array of clinical
diseases, example Malaria by Plasmodium
• Opportunistic parasite: An organism that is not typically a parasite
but may become parasitic under specific conditions. Candida are
usually life in human body but may become opportunistic parasite
when the immune system of the host compromised
• Commensal parasite: An organism that lives continuously on, or in
certain parts of the body of other organisms, without causing disease

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Classification of parasite based on location in
human body (endoparasite-ectoparasite)

Taenia saginata Phytirus pubis

Endoparasite Ectoparasite
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Classification of parasite based on dependence to
other organisms
• Facultative parasite: An organism • Obligate parasite: An organism
that may resort to parasitic that is entirely dependent upon
activity, but does not absolutely host for its survival
rely on any host for completion of
its life cycle

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 Host type
Intermediate and definitive host

Definitive host
Human
Definitive host
Taenia saginata life cycle
COW
Intermediate
host

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 Host type:
Reservoir host
Reservoir:
An organism that harbors a
pathogen and serves as a source
of infection to other species that
are susceptible, with important
implications for disease control.

Cat is reservoir host for Human

Toxoplasmosis

https://www.vet.cornell.edu/departments-centers-and-
institutes/cornell-feline-health-center/health-information/feline-
health-topics/toxoplasmosis-cats

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Host type:
Incidental host
• An organisms/ individual that,
though infected, is not necessary
for the survival or development
of the parasite.
• Example: The human being is an
incidental host in the
development of Trichinella
spiralis. The encysted larvae are
transmitted to other rats, pigs or
humans when eaten in uncooked
flesh

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 Life cycle
• Is the results of parasite adaptation to their hosts & external
environment.
• A parasite has special adaptation to one/ few animal species including
human
• The adaptation depends upon :
–invasive power of the parasite
–susceptibility of the host
–opportunity for contact between parasite & host
• Hosts play a role in the continuity of the parasite's life cycle
• The knowledge of the life cycle is important to cut transmission and to
do prevention
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 Life cycle: Simple versus complicated
Trichomonas vaginalis life cycle: Schistosoma life cycle:
Simple Complicated

Simple:
• Only need one host
• Have cosmopolitan
(worldwide) distribution
• Higher survival

Complicated:
• Need 2 or more hosts
• Restricted area
distribution
• Low survival
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 Parasite transmission
Mode of transmission

Source of Susceptible
infection person

• Diagnosis & treatment • Immunization

• Isolation • Increase cleanliness &
• Detection of carriers hygiene

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 The increase of infection risks
• Factors that if it present will increase the risk to become exposed and
then infected
• External risk factors
• Associate with the mode of transmission (external risk factor) and
organ affected (internal risk factors)

Movement Environment Overcrowded Lack of sanitation

& personal hygiene
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 Incubation
Interval between exposure and when the
parasite can be detected in clinical
specimen
Biological incubation

Clinical incubation
Interval between exposure and the earliest
symptoms produced as a result of the
infection (or infestation)

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 Parasite-host interaction

No damage

Damage

Local Systemic
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 The ways in which damage may be produced
by parasite (patho-mechanisms)
1. Physical damage
2. Lytic necrosis
3. Stimulation of host-tissue reactions
4. Neoplasma growth
5. Hypersensitive reactions and intolerance
6. The opening of pathways for entry of other pathogens into the
tissues.
7. Nutritional problem
8. Anemia
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 Systemic symptoms
Symptoms Parasite (probably)
Fever (chills) Blood protozoa, Tissue helminth
Headache
Muscle and joint pains
Lymphangitis and lymphadenitis Lymphatic helminth
Weakness (fatigue, languor, prostration, Helminth
neurasthenia, syncope)
Debility (loss of weight, malnutrition, Chronic helminthiasis, chronic
cachexia) giardiasis

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 Local Symptoms
System Symptoms Parasite
Gastrointestinal Intestinal and liver helminths,
Loss appetite, hunger or gnawing Intestinal protozoa
sensations, anorexia, nausea, vomiting,
abdominal discomfort, constipation,
diarrhea or dysentery, pains and cramps

Respiratory Coughing, sneezing, dyspnea, wheezing, Hookworm, Ascaris,

slight hemoptysis, transient thoracic pain Paragonimus, Wuchereria
atau Brugia
Urogenital Pruritus, floor albus, urethral discharge Trichomonas
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 Local Symptoms
System Symptoms Parasite
Eye Low vision, dry eye, conjunctivitis Loaloa, Onchocerca
Cutaneous & Pruritus, erythematous, macular, Trypanosoma, Leshmania,
Subcutaneous papular, urticaria, edema & calabar Pediculus ssp, Sarcoptis,
swellings Phytirus, Hookworm, cercaria of
Schistosoma, Loaloa,
Onchocerca, Insecta
Neurology Visceral larva migrane,
Headache, vertigo, vomiting,
Plasmodium falciparum,
convulsions, epilepsy, sleeping
Toxoplasma gondii, Taenia
sickness
solium
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 Laboratory diagnosis
• Clinical manifestations are general
• Final diagnosis & proper methods of treatment require the
identification of the parasite in the laboratory
• Successful laboratory diagnosis requires a knowledge of
certain fundamental laboratory procedures
• Direct and indirect laboratory laboratory diagnosis

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Specimen for laboratory direct diagnosis
Specimen Protozoa Helminth Arthropoda
Blood Plasmodium, Wuchereria and ,
Trypanosoma Brugia spp.
Liquor cerebro- Trypanosome
spinalis Toxoplasma
Hair Pediculus spp, Phytirus
pubis
Sputum Trichomonas Paragonimus
westermanii
Saliva E. gingivalis
Duodenal fluid Giardia lamblia Hepatic trematode
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Specimen for laboratory direct diagnosis
Specimen Protozoa Helminth Arthropoda
Anal swab Enterebius
vermicularis
Stool Intestinal Intestinal nematode, ,
protozoa intestinal Trematode,
blood Trematode
Urine S. haematobium
Vagina/ urethral fluid Trichomonas
Skin scraping Hookworm larvae Sarcoptis scabies
Muscle biopsy Trichinella
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Laboratory indirect diagnosis
• Routine blood analysis
• Eosinophilia→ helminth infection?
• Anemia microcytic hypochrome→ hookworm?
• Antigen antibody based test
• Elisa
• Immunofluorescence
• Skin test:
• Casoni test→ hydatid cyst
• Montenegro test→ leshmaniasis
• Parasite DNA detection by polymerase chain reaction
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 Resume
• Parasite- host interaction may result no damage or damage
• The damage is caused by several mechanisms
• The damage may local or systemic
• Symptoms due to damage are vary and depend on the species and
number of parasite, organ affected, host health condition and
sensitivity
• To diagnose it is important to understand the life-cycle of the parasite
in order to decide the collection of specimen collected and the
methods of approached

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References
• WHO. https://www.cdc.gov/dpdx/index.html
• John.W. Ridley. Parasitology for medical and clinical laboratory
professionals. 5 Maxwell Drive Clifton Park, NY 12065-2919 USA. 2012
• Bogitsh, B. Human parasitology. 1998. Published by Academic press,
Incorporated (ISBN 0121108708)
• Tristan Legris et al, Ameboma: an unusual cause of gastrointestinal
bleeding during severe leptospirosis. BMC Infectious Diseases 2014,
14:299

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References
• Dupinder Singh, Sung Yang, and Mitchell S. Cappell. Biliary Ascariasis Diagnosed and Extracted by
ERCP in the United States. ACGCaseRepJ2016;3(4):e188.doi:10.14309/crj.2016.161.
• Shannon Moffett and Charlotte Page Wills. Young Man with Foreign-Body Sensation in the Right
Eye. Annals of Emergency Medicine 2010: 55; 578-583
• WHO. Dpdcdx
• John.W. Ridley. Parasitology for medical and clinical laboratory professionals. 5 Maxwell Drive
Clifton Park, NY 12065-2919 USA. 2012
• Bogitsh, B. Human parasitology. 1998. Published by Academic Press, Incorporated (ISBN
0121108708)

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