Schistosomes

• They are digenetic trematodes

• They life cycle consisting of alternating
generations each with its own range of host
• Adult inhabits veins vertebrates, and larval
stage inhabits fresh water snail
• They are dioecious organism (i.e. sexes
separate)
• Eggs have no operculum
• There is no encysted or metacercarial stages
• Cercariae enter the definitive hosts through
the skin
• Adult worms attach to the wall of blood
vessels
 Schistosomes
 Classification
- Superfamily:- Schistosomatoidea
- Family:- Schistosomatidae
- Genus:- Schistosome
- Species:-
1:- Schistosoma haematobium
2:- Schistosoma mansoni
3:- Schistosoma japonicum
4:- Schistosoma intercalatum
5:- Schistosoma mekongi
 Morphology
 Oral sucker surrounds the mouth and is
prehensile
 Ventral suckers (acetabulum) is more
posterior on the ventral
 Mouth is near the anterior extremity
 They have no anus
 Alimentary system consists of an oral cavity
leading to the oesophagus and hence the
gut
 Excretory system: consist of 2 longitudinal
canals opening posteriorly and feed by
collecting tubules
 Morphology cont…
• Male reproductive organs consist of testes
dorsal to and posterior to the ventral suckers
• Male worms is flat and leaf – like but is
folded to form the GYNAECOPHORIC
CANAL, enfolding the very slander female for
almost its entire length.
• Female reproductive system consists of an
elongated ovary in the posterior half
• Female is longer and slender than the male
• The female is carried in a ventral groove, the
GYNAECOPHORIC, of the male
 Eggs morphology
• S. mansoni: – Eggs have a lateral spines
• S. japonicum and S. mekongi :- Eggs are
smaller, round or ovoid with a rudimentary
spine
• S. heamtobium and S. intercalatum :- Eggs
have a terminal spine
• Eggs contains embryo, the miracidium
• Eggs are passed through the walls of the
bladder, the urogenital or the colon to
excreted in urine or faeces and some are
retained in the tissues.
 Intermidiate host
• Intermidiate hosts of S.haematobium
- 30 nominal species of the genus Bulinus,
classified into 4 groups:-
1: Bulinus africanus – important in africa south of
sahara
2: Bulinus truncatus/tropicus – important in malawi

to East West and North africa and middle east

 Intermidiate host of S. intercalatum
1: Bulinus africanus – restricted in North – East
DRC
2: Bulinus forkalli – Occurs in cameroon and
Gabon
 Intermidiate host …
• Intermidiate host of S. mansoni
- Genus Biophalaria:- Biophalaria alexandria and
Biophalaria glabrata
- Distributed in Africa, the Nile valley and Arabian
peninsula, USA, Carribean islands, Brazil, Venezuela
 Intermidiate host of S. japonicum
- Genus Oncomelania:- Oncomelania hupensis in
china, Oncomelania quadrasi in Philipines,
Oncomelania hupensis nosophora in Japan,
O.hupensis lindoensis in Indonesia and
Oncomelania hupensis chiui in Taiwan
 Intermidiate host of S. mekongi
- Genus Tricula aperta
 Life cycle
• Adult live in as a pair within capillary blood vessels,
female held in gynaecophoric canals, copulate and
female lay eggs in the peripheral of branches of the
capillary venulles
• Eggs are passed out in faeces or urine and reach the
enviroments
• Viable eggs in water sources hatches, the
larvum ,the miracidium emerges and infect
intermidiate host, snails
• In the snails:- miracidium developd into mother
sporocyst and then, cercaria escape from the
daughter sporocyst from the snail
 Life cycle cont…
• Folk- tailed cercarie penetrate human skin
when a person is exposed to infected water
• After passage as Schistosomula through the
tissue, lymphatics and venules will develop
into a male or female schistosome
• Pairing of male and female schistosomes
takes place on sexual maturity with
subsequent migration to the preffered sites
for egg depositions
 Predilections sites of Schistosomes
• S. mansoni, S. japonicum and S.
mekongi :-Inhabits the pericolonic
venules within the distribution of the
portal venous system
• S. haematobium:- inhabits the terminal
venules and in the wall of the bladder,
the genitourinary system and the pelvic
plexus within the distribution of the
inferior vena cava
 Epidemiology
• Definitive host: Humans
• Intermidiate host: various species of aquatic
snails and a fresh water environments
• Transmissions: Through penetrations of the
cercariae into human/final host body
• Distributions: Tropical and subtropical areas.
Common in rural areas of developing
countries
• Host: children are important reservoirs of
infections because of their indiscrimate
excretory habits and water contact
• Animals reservoir: Dogs, human, cattle,
pigs , rats
 Clinical features
• S. haematobium ( urinary schistomiasis)
- Recurrent painless haematuria
- Burning on micturition and suprapubic discomfort or
pain
 S. japonicum and S. mekongi
- Hepatomegally
- General symptoms: Non specific abdominal
discomfort
 S. mansoni
- Chronic or intermittent diarrhea with blood in the
stool, abdominal discomfort or pain + colicky
cramps
 Diagnosis
• Demonstration of eggs in urine and feaces
• Hatching technique to demonstrate miracidia from
recovered eggs
• DIRECT COUNTING
- S. heamtobium
- Eggs are recovered from urine by microscopic
examinations of sedments
- Filtration technique:- Use of filter paper
polycarbonate or polyamide materials to filter
urine where urine is pumped through using
syringe
 Diagnosis cont..
• Intestinal dwelling schistosomes ( S.mansoni, S.
japonicum, S.menkongi and S. intercalatum)
- Eggs are excreted in the faeces, Methods:
1: Simple comminution of the stool and
sedimentation before microscopic examination
2: Concentration techniques involved removal of
fat, faecal debris and mucus
3: Cellophane thick faecal smear (The Kato tech)
becomes a standard techniques
4: Semi – concentration clearing staining process
 Diagnosis cont…
• Miracidials hatching tech :- most sensitive
• Rectal biopsy : Small specimens of mucosa
are soaked in water and examined
microscopically as a crush preparations
• INDIRECT DIAGNOSTIC TECHNIQUES
- Chemical reagent techniques:- detect RBC
and Hg in urine
- Immunodiagnosis: detection of either
specific Ab or genus specific Ag
- ELISA, RIA, IFAT, gel precipitation tech,
Latex agglutination test
 Diagnosis cont…

• Treatment
- Praziquantel
- Oxammiquine – effective only for S.mansoni
 Prevention and control
- Mass tre Diagnosis cont… atment in endemic
areas
- Public health educations : use of toilet, early
treatment
- Use of molluscinding in water bodies