MEDICAL PARASITOLOGY

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 1. Introduction to Medical Parasitology
• Parasitology: a science that deals with parasites

• Parasite: an organism which lives in or on ,

temporarily or permanently on another organism
(host) and takes an advantage in the expense of
the host without compensation

• Medical Parasitology: the study of parasites that

causes disease in man
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 Cont…
• Nature of parasites
Protozoa (unicellular)
Helminth (Worms)
Arthropods

• Features of parasites
 smaller than the host
It might exceed in number than the host
It has greater reproduction ability
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 Common Terms Used in Parasitology
• Diagnostic stage: a developmental stage of a parasite
that can be detected in stool, urine, blood, or CSF, etc

• Infective Stage: the stage of the parasite at which it is

capable of entering the host &continues development
with in the host

• Zoonosis: an infectious disease of animals that can be

transmitted to humans

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 Cont…
• Infection: Invasion of the body by any pathogenic
organism(except arthropods)

• Infestation: the establishment of arthropods upon or

with in a host

• Biological incubation period: time between infection

with the parasite and demonstration of the parasite in
stool, blood or diagnostic material

• Clinical incubation period: time between exposure

and earliest manifestation
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 Cont…
• Autoinfection:- is a re-infection of an infected
individual by the same parasite, an infected
individual acts as a source for the re-infection to
him/herself

• Mixed Infection (Multiple infections): When an

individual is infected with more than one parasite at
the same time

• Retroinfection:- A retrograde infection caused by the

newly hatched larva of E. vermicularis from the
perianal region to reach the colon, where the
adolescent form of the parasite develop
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 Association of Organisms
• A more or less permanent association of different
species : symbiosis

• The participants : symbionts

• Symbiosis can be

1. Mutualism: both partners derive benefits from

the relationship, when their life apart impossible
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 Cont..

.
2 Commensalisms: one partner may be
benefited ,but the other is neither harmed nor
benefited

3. Parasitism: one partner is benefited ,while there

can be harm to the other partner

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 Cont…
• Parasite can be classified:
1. According to their habitat
Ectoparasite
E.g. lice, tick

 Endoparasite
E.g. Leishmania species, Ascaris lumbricoides

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 Cont…
2. According to their dependence on the host
 Permanent (obligate) parasite
E.g. Plasmodium species

Temporary (Facultative) parasite

E.g. Strongloides stercolaris

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 Cont…
3. According to their pathogenecity
 Pathogenic Parasite: E.g. E. histolytica

 Non- pathogenic ( Commensal ) parasites: E.g.

Entameba coli

 Opportunistic parasites: E.g. I. belli

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 Cont…
• Host: are organisms that harbor the parasite

• Types of Host
1. Definitive host: a host harbors
the adult stage of a parasite or
e.g. Human for Taenia saginata
 sexually mature stages of a parasite and
fertilization takes place in it
e.g. Mosquito for Plasmodium species

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 Cont…
2. Intermediate host: harbors sexually immature or
larval stage of a parasite and in which no
fertilization takes place in it
E.g. Human for Plasmodium species
Cow is for Taenia saginata

3.Reservoir host: -A wild or domestic animal which

harbors a parasite and acts as sources of
infection to humans
E.g. Cattle for Cryptosporidium species 13
 Cont…

4.Accidental (Incidental) host: - Infection of a

host other than the normal host species
E.g. Human beings for H.diminuta

5. Paratenic host: - is an animal that harbors the

parasite in a dormant state of development
E.g. Toxoplasm species in cattle

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 Cont…
• Vector: any arthropod or other living carrier which
transports a pathogenic microorganism from an
infected to non- infected host

• Classified as

1.Biological vectors
2.Mechanical vector

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 Cont…
1. Biological vectors:
 Either development or multiplication of the parasite takes
place in it

– Propagative.
 E.g. Yersinia pestis in fleas
– Cyclodevelopmental
 E.g.Onchocerca volvulus in black flies
– Cyclopropagative
 E.g. Plasmodium species in Anopheles
mosquitoes.
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 Cont…

2. Mechanical Vectors
 are passive carriers of parasite

 No development or multiplication of parasites takes in

side the vector e.g. House fly for amoebae

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 Source of Exposure to parasitic infection
A. Contaminated soil with human excreta
e.g. Ascaris lumbericoides

B. Contaminated water e.g. Amaebiasis

Schistosomiasis

C. Raw or Insufficiently cooked meat of pork, beef and

fish e.g. Taenia spieces

D. Blood sucking arthropods e.g. female anopheles

mosquito for malaria

E. Animals e.g. Dogs for Hydatid cyst (E. granulosus) 18

 Cont…
F. Human beings: e.g. E. vermicularis

G. Sexual intercourse : e.g. Trichomonas vaginalis

H. Autoinfection: e.g. E. vermicularis

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 Route of Transmission of parasites
A. By the ingesting the infective stage
 in water e.g. E. histolytica
 in raw or uncooked meat e.g. Taenia saginata
 Contaminated hands or soil e.g Ascaris
lumbericoides

B. By penetration of skin through contact with

 Faecally polluted soil e.g. Hook worm
 water containing the infective stage of the
parasites e.g. cercaria of schistosoma
 Infective blood sucking arthropod e.g. anopheles
mosquito for malaria
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 Cont…
c. Transplacental e.g. T. gondii

D. Sexual contact e.g. Trichomonas vaginalis

E. Transmammary, e.g. S. stercoralis

F. Inhalation of contaminated air e.g. E.

vermicularis

G. Blood transfusion e.g. malaria 21

 Host Parasite Relationship
Effects of Parasites on their Hosts

1.Consumption of the nutritive elements of the

host E.g. Hookworm –sucks blood

2.Obstruction of passages
E.g. Heavy infection with adult Ascaris

3.Bleeding E.g. Schistosomes eggs

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 Cont…
4. Destruction of tissues
E.g. Trophozoites of E. histolytica causes necrosis of liver

5. Compression of organs
E.g. Hydatid cysts in liver, brain cause pressure

6. Allergy development
E.g. Bite of arthropod

7. Opening pathway to secondary infections

E.g. Ulcer formed as a result of D. medinensis

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 Cont…

8. Transmission of pathogens to man

E.g. Anopheles mosquito transmitting malaria

9. Predisposition to malignancy
E.g. Infection with bilharziasis

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 Cont…

Host Susceptibility Factors

 Not all parasitic infections cause disease of clinical

significance

 Both host and parasitic factors are involved

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Host Factors
1. Genetic factors

2.Age

3. Sex

4. Level of immunity

5. Nutrition (malnutrition or under nutrition)

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6. Presence of co-existing disease or conditions,

which reduces immune response. e.g.
Pregnancy, HIV

7. Life style and occupation

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Parasite factors
1. Strain /species of the parasite & adaptation to
human host

2. Parasite load ( number of parasite )

3. Site (s) occupied in the body

4. the nature of any waste products or toxins produced

by the parasite during its growth and reproduction
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 Host immune Responses to parasitic infection
• Has two main parts
1. Nonspecific immune response
2. specific immune response

1. Nonspecific immune response - First line defense

 Physical and chemical barriers of infection

Skin, mucous secretion , cilia, acidic environment of
stomach and other

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 Cont.
 Phagocytosis ( endocytosis) :
– PMNs leukocytes , monocytes , macrophages
– For small protozoa

 Inflammation
– If the invader is large , for helminths

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2. Specific Immune response

• Humeral response: Formation of antibodies or
immunoglobulin s(Ig) by B cells.
– IgE elevated in helminth infection and eosinophiles
release granules to damage worms
– IgM and IgG important against protozoans

• Cell mediated response: uses T-cells

-CD4 Th1,CD8 T cells and activation of macrophages: for
intracellular parasite
- CD4 Th2 antibody response : for extracellular parasites
 Escape mechanism of parasites from the
immune system
1. Site
 Protected against action Abs
 Intracellular parasite : T. cruzi, Leishmania
 Forming cysts as T. gondii and larva of T. solium, Echinococcus
granulosus

 avoid or inactivate the lysosomal enzymes in

macrophages
 Leishmania species , Toxoplasma gondii, T. cruz

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2. Avoidance of recognition
• Production of successive waves of progeny with different
surface antigens
 African trypanosomes

• Molecular mimicry: Certain parasites are recognized as

self and consequently do not stimulate immunologic
reactions in their host
Schistosome worms

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 Cont…
3. Suppression of immune response
e.g , Plasmodium, Toxoplasm, Trypanosoma and Trichinella
species

 This sometimes, results in an increase in the severity of any

viral or bacterial infection

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 Parasites in immune compromised hosts
• Immuno compromization can be due to
– HIV/AIDS…..
– Chemotherapy
– Radiotherapy

• Cause mild to moderately serious infection in healthy

individuals

• Include
– Protozoa : T. gondii, Pneumocystis carinii, C. parvum , I.
belli
– Helminth : S. stercoralis 35
Distribution of helminths and HIV in Africa
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