MEDICAL AND

PUBLIC HEALTH
PARASITOLOGY
Mr. Raymund J. Capagas, RMT
 COURSE OUTLINE
LECTURE
WEEK TOPICS / CONCEPTS
WEEK 1 Introduction and Concepts of Community and Public Health
WEEK 2 Communicable and Noncommunicable Diseases
WEEK 3 Medical and Public Health Microbiology
WEEK 4 Medical and Public Health Parasitology
WEEK 5 Community Organizing/Building and Health Promotion Programming
WEEK 6 Public Health Nutrition
WEEK 7 MIDTERM EXAMINATION
WEEK 8 Environmental and Occupational Health
WEEK 9 Alcohol, Tobacco, and other Drugs: A community concern
WEEK 10 Introduction to Biostatistics
WEEK 11 Introduction to Epidemiology I
WEEK 12 Introduction to Epidemiology II
WEEK 13 FINAL EXAMINATION
Parasite-Host
Relationship
 Main focus of the Parasite-Host Relationship

Development of
Search for
Recognition of methodologies to
patterns of the
these relationship study these
relationships
patterns.
 Type of parasite

Obligatory Parasite Endoparasite

- Parasite that cannot survive outside of a - Parasite that is established inside of a host
host.
Ex. Plasmodium
Ex. Virus

Ectoparasite
Facultative Parasite
- Parasite that is established in or on the
- Parasite that is capable of existing exterior surface of a host
independently of a host
Ex. Fleas
Ex. Strongyloides
 States of Parasitism
INFESTATION INFECTION
Organism involved Ectoparasites Endoparasites
Characteristics Lodgement of the parasite in the surface Invasion/Modification of the parasite within
of the susceptible host. the host’s body.

According to Pathogenicity: According to number of host required in the life

a. Pathogenic cycle:
b. Non-pathogenic a. Monoxenous
b. Heteroxenous
According to need for host:
a. Obligate
b. Facultative
c. Accidental/Incidental
 Type of Host

Accidental or incidental host Reservoir host

- Host other than the normal one that is harboring a - Host harboring parasites that are parasitic for
parasite humans and from which humans may become
infected

Definitive host
Transport host/Paratenic/Phoretic
- Host in which the adult sexual phase of parasite - Host responsible for transferring a parasite from one
development occurs location to another

Carrier
Intermediate host
- Parasite-harboring host that is not exhibiting any
- Host in which the larval asexual phase of parasite clinical symptoms but can infect others
development occurs
 Parasite-Host Relationship
Symbiosis
- Living together; the association of two
living organisms, each of a different
species
Commensalism
- Association of two different species of
organisms that is beneficial to one and
neutral to the other
Mutualism
- Association of two different species of
organisms that is beneficial to both
Parasitism
- Association of two different species of
organisms that is beneficial to one at the
other’s expense
Commensal
- Relating to commensalism; the
association between two different
organisms in which one benefits and
has a neutral effect on the other
Pathogenic
- Parasite that has demonstrated the
ability to cause disease
 Parasitic Life Cycle
Parasitic life cycle ranges from simple to
complex.

Three common components

1. Mode of transmission
2. Infective stage
3. Diagnostic stage

Some parasites require only a definitive

host, whereas others also require one or
more intermediate hosts.
 Parasitic Life Cycle
Direct Indirect
- Only one host in the entire life cycle. - Two or more hosts in the life cycle.
 Disease Processes and Symptoms
- A parasitic disease may affect
the entire body or any of its part.

Major body associated with such

processes
1. Gastrointestinal and Urogenital
tracts
2. Blood and tissue
3. Liver, Lung, and other major
organs
4. Miscellaneous locations
 Treatment

There are several options for

treating parasitic infections.
- Many of these drugs are toxic to
the host and care should be
exercised when selecting proper
course of treatment.
 Prevention and Control

Prevention and control measures

may be taken against every
parasite infective to humans.

Preventive measures designed to

break the transmission cycle are
crucial for successful parasite
eradication.
 Parasite Nomenclature and Classification
Writing the name of Parasites:
1. The scientific name of parasites are written in italics and consist of two
components, genus and species.
Ex. Giardia lamblia

2. When a parasite name first appear in a document, the entire parasite name
is written.

3. Referencing of parasite can be abbreviated by recording only the first letter

of the genera followed by a period, followed by the entire species name.
Ex. Giardia intestinalis (G. intestinalis)
 Entamoeba histolytica
Subkingdom
(Protozoa)
Entamoeba hartmanni

Entamoeba coli
Phylum Intestinal
(Sarcomastigophora) Species
Entamoeba polecki

Subphylum Endolimax nana

(Sarcodina)
Iodamoeba butschlii
Class
Entamoeba gingivalis
(Lobosea)
Naegleria fowleri

Amoebas
Acanthamoeba species
Extraintestinal
Species
Subkingdom Giardia intestinalis
(Protozoa)
Chilomastix mesnili

Phylum Dientamoeba fragilis

Intestinal
(Sarcomastigophora) Species
Trichomonas hominis

Subphylum
(Mastigophora) Enteromonas hominis

Retortamonas intestinalis
Class
(Zoomastigophora) Trichomonas tenax

Trichomonas vaginalis

Flagellates Extraintestinal
Species
 Leishmania brazilienses
Subkingdom
(Protozoa)
Leishmania donovani

Leishmania mexicana

Phylum
Leishmania tropica
(Sarcomastigophora)
Trypanosoma brucei
Subphylum gambiense
(Mastigophora) Class Trypanosoma brucei
(Zoomastigophora) rhodesiense

Trypanosoma cruzi

Trypanosoma rangeli

Hemoflagellates
 Subkingdom
(Protozoa)

Phylum
(Ciliophora)

Class
(Kinetofragminophorea)

Ciliates Balantidium coli

Subkingdom
(Protozoa)
Isospora belli

Intestinal Sarcocystis species

Species
Phylum
(Apicomplexa) Cryptosporidium parvum

Class
(Sporozoa)
Toxoplasma gondii
Tissue Species

Sporozoa
 Enterobius vermicularis
Subkingdom
(Metazoa)
Trichuris trichiura

Intestinal Ascaris lumbricoides

Phylum Species
(Nemathelminthes) Necator americanus
Class
Ancyclostoma duodenale
(Nematoda)
Strongyloides stercoralis

Intestinal- Trichinella spiralis

Tissue Species

Roundworms Dracunculus medinensis

Subkingdom
(Metazoa)
Wucheriria bancrofti

Brugia malayi

Phylum Loa loa

(Nemathelminthes)
Class Oncocerca volvulus
(Filariae)
Intestinal
Species Mansonella ozzardi

Mansonella perstans

Tissue
Roundworms
 Taenia saginata
Subkingdom
(Metazoa)
Taenia solium
Intestinal
Species
Hymenolepis nana
Phylum
(Platyhelminthes) Hymenolepis diminuta

Dipylidium caninum
Class
(Cestoda) Diphyllobothrium latum

Tapeworms Extraintestinal
species
Echinococcus granulosus
 Fasciolopsis buski
Subkingdom Intestinal Species
(Metazoa)
Heterophyes heterophyes

Metagonimus yokogawai
Phylum
(Platyhelminthes)
Fasciola hepatica
Liver species
Class Clonorchis sinensis
(Trematoda)

Lung Specie Paragonimun westermanii

Schistosoma mansoni

Flukes
Schistosoma janponicum
Blood Species
Schistosoma haematobium
 Arthropods
Class
Centipedes
(Chilopoda)

Tongueworms
Class
Pentastomida Ticks
Mites
Phylum Class Spiders
(Arthropoda) Arachnida
Scorpions
Crabs
Crayfish
Class
Copepods Mosquitoes
Crustacea
Flies
Lice
Fleas
Class
Insecta Bugs
General
Characteristics of
Protozoans
• Eukaryote, Unicellular, with
Ectoplasm and Endoplasm

Locomotory apparatus:
Flagella – thread-like, long whip-
like structure arising from the
surface of the cell.

Cilia – shorter, needle-like/hair-

like structures, found all
throughout the cell.
 General Characteristics
of Protozoans
Locomotory apparatus:
Pseudopods / Pseudopodia
- false-feet, temporary cytoplasmic
extensions.

Undulating membrane
– Flexible sheet of material that joins
the flagella to the surface of the cell.

Apical complex
- Consist of polar rings, subpellicular
tubules, conoid, rhoptries, and
micronemes, for penetration and
invasion of target cell.
General
Characteristics of
Metazoans
• Multicellular with complex
structure

• Life stages
Egg > Larva > Adult

• Size – relatively larger than

unicellular protozoans.

• Separate sexes
 Specimen Colleting, Processing and Examining
of Stool Specimens
Considerations in specimen collection:
ü Fecal specimen should be collected before any radiologic procedures that use barium sulfate because
it will obscure the visualization of the parasite.
ü Some medications intake that may interfere with detection include:
a. Certain antibiotics – tetracycline
b. Antimalarial medications
c. Antidiarrheal products that are not absorbed – Loperamide
d. Mineral oil
e. Bismuth
ü Contamination of water that may contain free-living parasites
ü Contact with urine through toilet bowl collection is discouraged because urine may destroy motile
parasites.
 Specimen Colleting, Processing and Examining
of Stool Specimens

Considerations in specimen collection:

ü The stool specimen should be collected into a clean,
waxed, cardboard container, with a wide opening and
tight fitting lid.
ü The number of specimen required to diagnose a
parasitic infection depends on
a. Type and severity of infection
b. Quality of the sample submitted
c. Examination performed.

ü General rule, before the therapy at least three fecal

specimens should be collected.
ü Castor oil or mineral oil laxative should be avoided
because oil decreases the motility of the trophozoite
form of intestinal protozoa.
 Specimen Colleting, Processing and Examining
of Stool Specimens
Considerations in specimen collection:
ü Ensure proper, accurate, and correct labeling of the specimen.
ü For the collection of trophozoite forms of amoeba and flagellates, freshly passed stool is needed.
ü Cyst form is readily observed in formed stools.
ü Trophozoites are observed in liquid or watery stool.
ü Liquid sample should be examined within half hour of collection.
ü Soft and semisoft stools should be examined within 1 hour of collection.
ü If examination is not possible right a way, the specimen can be refrigerated at 3 degrees Celsius or 5
degrees Celcius for up to 4 hours.
ü Stool must not be left at room temperature, incubated, or frozen.
ü When stool examination within these time constraints is not possible, the stool should be placed into a
preservatives such as Polyvinyl alcohol (PVA) to maintain the morphology characteristics, glacial acetic
acid for protozoan cysts and trophozoites.
 Specimen Colleting, Processing and Examining
of Stool Specimens

Considerations in specimen collection:

ü A gross macroscopic examination of feces
includes examination for proglottids and adult
worms which may be visible on the specimen’s
surface.
ü Areas containing mucus and blood should be
examined more carefully.
 Specimen Processing and Laboratory Diagnosis
Proper specimen collection and processing are crucial to parasite recovery.
SPECIMEN USE
STOOL - Most commonly submitted sample for each studies
- Microscopic (Ova and Parasites) and macroscopic techniques
- Fresh or preserved sample
CSF Molecular, Culture, Microscopic exam (Ex. Angiostrongylus cantonensis)
BLOOD Microscopic (Ex. Plasmodium)
TISSUE BIOPSY Microscopic (Ex. Acanthamoeba)
SPUTUM Microscopic (Ex. P. westermanii)
URINE Microscopic (Ex. S. haematobium, T. vaginalis)
GENITAL MATERIAL Microscopic (Ex. T. vaginalis)
 Specimen Processing and Laboratory Diagnosis
Examination procedures and methods:
1. Macroscopic examinations - color,
consistency, visualization of adult worms
or proglottids
2. Microscopic examinations – for
identification of parasitic eggs, cysts,
trophozoites
3. Direct Smear – detection of motile
trophozoites of amoebas and flagellates
4. Concentration methods – for enhanced
detection of smaller parasites that may not
be detected in the direct mount
 Specimen Processing and Laboratory Diagnosis

Examination procedures and methods:

5. Permanently stained mount –
recommended for identification of ova and
parasites.
6. Blood smears – thick and thin blood
smears
7. Cellophane tape procedure – for detection
of E. vermicularis
8. Entero string test – for detection of G.
lamblia
REFERENCES

Delost (2015), Introduction to Diagnostic Microbiology for the Laboratory Science

Zeibig (2013), Clinical Parasitology: A practical Approach, 2nd edition
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