Partners in Global Health Education

1. How to use this

module
2. Learning
outcomes
3. Key definitions
4. Epidemiology

E S 23
5. Burden of

6.
parasitic infections
Classification of
protozoa
B S
7. Classification of

MICROBIOLOGY
helminths
8. Schistosomiasis
9. Hookworm
10. Lymphatic
filariasis

AND
11. Sources of
information

PARASITOLOGY
 The Burden of Parasitic Infections
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1. How to use this

module
2. Learning
outcomes
3. Key definitions
4. Epidemiology
5. Burden of
parasitic infections
6. Classification of
protozoa
7. Classification of
helminths
8. Schistosomiasis
9. Hookworm
10. Lymphatic
filariasis
11. Sources of
information
 Parasite Diseases No. people Deaths/yr
infected

Plasmodium malaria 273 million 1.12 million

Partners in Global Health Education
Soil transmitted 2 billion 200,000
1. How to use this helminths:
module Pnemonitis, intestinal
2. Learning • Roundworm obstruction
outcomes
(Ascaris)
3. Key definitions Bloody diarrhoea, rectal
4. Epidemiology • Whipworm prolapse
5. Burden of (Trichuris)
parasitic infections • Coughing, wheezing,
6. Classification of • Hookworm abdominal pain and
protozoa
(Ancylostoma and anaemia
7. Classification of Necator)
helminths
8. Schistosomiasis Schistosoma Renal tract and intestinal 200 million 15,000
9. Hookworm disease
10. Lymphatic
filariasis Filariae Lymphatic filariasis and 120 million Not fatal but
11. Sources of elephantiasis 40 million
information
disfigured
or
incapacita
ted

Trypanasoma cruzi Chagas disease 13 million 14,000

(cardiovascular)

African trypanosomes African sleeping sickness 0.3 – 0.5 million 48,000

 Taxonomic classification of parasitic organisms

• The classification of parasites is

Partners in Global Health Education

controversial - there is no universally

1. How to use this
module
2. Learning
outcomes accepted system
3.
4.
Key definitions
Epidemiology
• Parasites form part of the animal kingdom
5. Burden of which comprises some 800,000 identified
6.
parasitic infections
Classification of species categorized into 33 phyla
7.
protozoa
Classification of
• The parasitic organisms that are of
8.
helminths
Schistosomiasis
importance for human health are eukaryotes
9. Hookworm - they have a well defined chromosome in a
10. Lymphatic
filariasis
nuclear membrane (as opposed to
11. Sources of
information
prokaryotes which have no nuclear
membrane, e.g. bacteria)
 Taxonomic classification of parasitic organisms
Partners in Global Health Education

1. How to use this

module
• Parasites are classified into 2 sub-kingdoms: protozoa
2. Learning (unicellular) and metazoa (multicellular)
3.
outcomes
Key definitions
• Protozoan (unicellular) parasites are classified according
4. Epidemiology to morphology and means of locomotion. There are
5. Burden of
parasitic infections
45,000 protozoa species. Most species that cause human
6. Classification of
disease belong to the phylums sarcomastigophora and
protozoa apicomplexa
7. Classification of
helminths • Metazoa (multicellular) include the worms (helminths)
8. Schistosomiasis and arthropoda (posses an external skeleton) e.g. ticks,
9.
10.
Hookworm
Lymphatic
lice
filariasis • Note that the genus starts with a capital letter and the
11. Sources of
information species is always written in italics, e.g. Plasmodium
falciparum, Giardia lamblia
 Taxonomic classification of protozoa
Partners in Global Health Education

1. How to use this

module Sub Phylum Sub-phylum Genus- Species-
2. Learning kingdom examples examples
outcomes
3. Key definitions
Protozoa Sarcomastig- Sarcodina-- - Entamoeba E. histolytica
4. Epidemiology ophora move by
5. Burden of further divided into pseudopodia
parasitic infections
6. Classification of
protozoa Mastigophora Giardia G. lamblia
move by flagella
7. Classification of
helminths
8. Schistosomiasis
Apicomplexa Plasmodium P. falciparum,
9. Hookworm no organelle of P. vivax,
10. Lymphatic locomotion
filariasis P. malariae,
11. Sources of P. ovale
information

Ciliophora Balantidium B. coli

move by cillia

Microspora Enterocyto- E. bienusi

Spore-forming zoa
 Examples of important intestinal
Partners in Global Health Education
protozoa
1. How to use this
module Transmitted by the fecal-
2. Learning
outcomes
oral route and cause
3. Key definitions diarrhea
4.
5.
Epidemiology
Burden of
• Giardia lambia: world-
6.
parasitic infections
Classification of
wide distribution, lives
protozoa in the small intestine Electron micrograph of G. lamblia
7. Classification of
helminths and results in trophozoites (feeding stage)
8.
9.
Schistosomiasis
Hookworm
malabsorption
10. Lymphatic • Entamoeba histolytica:
filariasis
11. Sources of may invade the colon
information
and cause bloody
diarrhea – amoebic
dysentery. Also causes
ameobic liver abscess. Typical flask-shaped ulcer due to E.
histolytica in the colonic mucosa
 Examples of important intestinal
Partners in Global Health Education
protozoa
1. How to use this
module
• Cryptosporidium parvum:
2. Learning more prevalent in the
3.
outcomes
Key definitions
immunocompromised
4. Epidemiology • Cyclospora cyatenensis -
5. Burden of
parasitic infections
parasitises the small intestinal
6. Classification of
mucosa and may cause
protozoa diarrhea for several weeks Electron micrograph of G. lamblia
7. Classification of
helminths • Balantidium coli: a large trophozoites (feeding stage)
8. Schistosomiasis motile ciliated parasite that
9.
10.
Hookworm
Lymphatic
lives in the colon of pigs,
filariasis humans and rodents and can
11. Sources of
information
lead to colonic ulceration
• Enterocytozoon bienusi: a
microsporidian that
parasitises the small intestine.
Also more common in the Typical flask-shaped ulcer due to E.
immunocompromised. histolytica in the colonic mucosa
 Examples of important systemic
Partners in Global Health Education
protozoa
1. How to use this
module
Detected in the blood
2. Learning

3.
outcomes
Key definitions
• Plasmodium: the cause of
4. Epidemiology malaria. There are 4 species
5. Burden of
parasitic infections
that infect man: P.
6. Classification of
falciparum, P. vivax, P. ovale
protozoa and P. malariae
7. Classification of
helminths
Typical lesion of
8. Schistosomiasis
cutaneous leishmaniasis • Toxoplasma gondi:
9. Hookworm
10. Lymphatic
transmitted by the ingestion
filariasis of oocysts from cat faeces.
11. Sources of
information Infection can lead to ocular
problems and is also a cause
Tsetse fly – the
of neonatal toxoplasmosis
vector of African
trypanosomiasis
It has a painful
bite!
 Examples of important systemic
Partners in Global Health Education
protozoa
1. How to use this
module • Leishmania: transmitted
2. Learning
outcomes by sand flies, can lead to
3. Key definitions
visceral, cutaneous and
4.
5.
Epidemiology
Burden of mucocutaneous
6.
parasitic infections
Classification of
leishmaniasis
protozoa
7. Classification of

8.
helminths
Schistosomiasis
Typical lesion of • Trypanosoma:
9. Hookworm
cutaneous leishmaniasis
haemoflagellates which
10. Lymphatic
filariasis cause
11. Sources of – In Africa - sleeping sickness
Tsetse fly – the
information
vector of African
trypanosomiasis
(transmitted by the Tsetse
It has a painful fly)
bite! – In South America - Chagas
disease (transmitted by the
Reduviid bug)
 Taxonomic classification of helminths
Partners in Global Health Education

1. How to use this

Sub Phylum Class Genus –
module kingdom examples
2. Learning Metazoa Nematodes Ascaris (roundworm)
outcomes Round worms; appear Trichuris (whipworm)
round in cross section, Ancylostoma
3. Key definitions they have body cavities, a (hookworm)
4. Epidemiology straight alimentary canal Necator (hookworm)
and an anus Enterobius (pinworm or
5. Burden of threadworm)
parasitic infections Strongyloides
6. Classification of
protozoa
Platyhelminthes Cestodes Taenia (tapeworm)
7. Classification of Flat worms; dorsoventrally Adult tapeworms are found
helminths flattened, no body cavity in the intestine of their host
8. Schistosomiasis and, if present, the They have a head (scolex)
alimentary canal is blind with sucking organs, a
9. Hookworm ending segmented body but no
10. Lymphatic alimentary canal
filariasis Each body segment is
hermaphrodite
11. Sources of
information
Trematodes Fasciolopsis (liver
fluke)
Non-segmented, usually
leaf-shaped, with two Schistosoma (not leaf
suckers but no distinct head shaped!)
They have an alimentary
canal and are usually
hermaphrodite and leaf
shaped
Schistosomes are the
exception. They are thread-
 Examples of important metazoa –
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intestinal nematodes
1. How to use this
module
2. Learning
outcomes
• Strongyloides
3. Key definitions – inhabits the small bowel
4. Epidemiology
5. Burden of – infection more severe in
parasitic infections
6. Classification of immunospressed people (e.g.
7.
protozoa
Classification of
HIV/AIDS, malnutrition, intercurrent
8.
helminths
Schistosomiasis
disease)
9. Hookworm
10. Lymphatic
filariasis • Enterobius (pinworm or threadworm)
11. Sources of
information – prevalent in cold and temperate
climates but rare in the tropics
– found mainly in children
 Examples of important metazoa –
Partners in Global Health Education
intestinal nematodes
1. How to use this
• Trichuris (whipworm) • Ascaris (roundworm)
module
– A soil transmitted – Found world-wide in
2. Learning conditions of poor hygiene,
outcomes helminth transmitted by the faecal-
3.
4.
Key definitions
Epidemiology
– prevalent in warm, oral route
– Adult worms lives in the
5. Burden of humid conditions small intestine

6.
parasitic infections
Classification of
– Can cause diarrhoea, – Causes eosinophilia
protozoa rectal prolapse and
7. Classification of
helminths
anaemia in heavily-
8. Schistosomiasis infected people
9. Hookworm
10. Lymphatic
filariasis • Ancylostoma and
11. Sources of
information
Necator (hookworms)
– A major cause of
anemia in the tropics Heavy intestinal infections may
occur with Ascaris. Adult worms
can be several cms long.
 Examples of important metazoa –
systemic nematodes
Partners in Global Health Education

1.
Filaria including:
How to use this
module
2. Learning
outcomes • Onchocerca volvulus – Transmitted by the
3. Key definitions
4.
5.
Epidemiology
Burden of
simulium black fly, this microfilarial parasite
parasitic infections
6. Classification of
protozoa
can cause visual impairment, blindness and
7. Classification of
helminths severe itching of the skin in those infected
8. Schistosomiasis
9. Hookworm • Wuchereria bancrofti – The major causative
10. Lymphatic
filariasis
11. Sources of
agent of lymphatic filariasis
information

• Brugia malayi – Another microfilarial

parasite that causes lymphatic filariasis
 Examples of important metazoa –
Partners in Global Health Education
systemic nematodes
1. How to use this

2.
• Toxocara
module
Learning
outcomes

A world-wide infection of dogs and

3. Key definitions
–
4. Epidemiology
5. Burden of

6.
parasitic infections
Classification of
cats
protozoa
7. Classification of
helminths
–
Human infection occurs when
8. Schistosomiasis
9. Hookworm
10. Lymphatic
embryonated eggs are ingested from
filariasis
11. Sources of
information
dog or cat faeces
–
It is common in children and can
cause visceral larva migrans (VLM)
 Examples of important flatworms -
cestodes
Partners in Global Health Education

1. 1. Intestinal - (“tapeworms”)
How to use this
module
2. • Learning
Taenia saginata
outcomes
–
3. Key definitions worldwide
–
4. Epidemiology
5. Burden of
acquired by ingestion of contaminated, uncooked beef
a common infection but causes minimal symptoms
– infections
parasitic

• protozoa
6. Classification of
Taenia solium
helminths worldwide
–
7. Classification of

–
8. Schistosomiasis acquired by ingestion of contaminated, uncooked pork
9. Hookworm
10. Lymphatic
that contains cystercerci
–
filariasis Less common, but causes cystercicosis – a systemic
information disease where cysticerci encyst in muscles and in the
11. Sources of

brain – may lead to epilepsy

 Examples of important flatworms -
Partners in Global Health Education
cestodes
2. Systemic
1. How to use this
module
2. Learning
• Echinococcus granulosus (dog tapeworm) and
3.
outcomes
Key definitions
4.
5.
Echinicoccus multilocularis (rodent tapeworm)
Epidemiology
Burden of
parasitic infections
6. Classification of
protozoa
7. –
Hydatid disease occurs when the larval stages
Classification
helminths
of

8. of these organisms are ingested

Schistosomiasis
9. Hookworm
10. Lymphatic
filariasis
11. Sources of
–
information The larvae may develop in the human host and
cause space-occupying lesions in several
organs, e.g. liver, brain
 Examples of important metazoa –
Partners in Global Health Education
trematodes (flukes)
1. How to use this
module
Intestinal
2. Learning
outcomes
Fasciolopsis buski - A common
3. Key definitions parasite of humans and pigs in
4.
5.
Epidemiology
Burden of
South- east Asia. This parasite
parasitic infections is one of the largest trematodes
6. Classification of
protozoa to infect man (8cm in length)
7. Classification of
helminths
and lives in the upper intestine.
8. Schistosomiasis Chronic infection leads to
9. Hookworm
10. Lymphatic
inflammation, ulceration and
filariasis haemorrhage of the small
11. Sources of
information intestine

Adult Fasciolopsis buski trematode

© Dr. Peter Darben, Queensland
University of Technology
 Examples of important metazoa –
Partners in Global Health Education
trematodes (flukes)
1. How to use this • Fasciola hepatica (liver fluke)- Primarily, a parasite of sheep,
module humans become infected when they ingest metacercariae that
2. Learning
outcomes
have encysted on watercress. The adult trematode lives in the
3. Key definitions
intra-hepatic bile ducts of the liver. “Fascioliasis” can lead to
4. Epidemiology
severe anaemia in humans
5. Burden of
• Clonorchis sinensis (liver fluke)- Widespread in China, Japan,
parasitic infections
6. Classification of
protozoa Korea and Taiwan, this parasite is acquired by ingestion of
7. Classification of infective metacercariae in raw or pickled fish
helminths
8. Schistosomiasis
• Paragonimus westermani ( lung fluke)- Widespread in the Far
9. Hookworm
10. Lymphatic
East and South east Asia, the parasite is acquired by ingestion
filariasis of infective metacercariae in raw or pickled crustaceans
11. Sources of
information
• Schistosoma haematobium, S. mansoni and S. japonicum
 Schistosomiasis (bilharzia)
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1. How to use this

module
2. Learning
outcomes
3. Key definitions
4. Epidemiology
5. Burden of
parasitic infections
6. Classification of
protozoa
7. Classification of
helminths
8. Schistosomiasis
9. Hookworm
10. Lymphatic
filariasis
11. Sources of
information
 Schistosomiasis (1)
Partners in Global Health Education

1. How to use this

module
Epidemiology
2. Learning
• 200m people in 74
3.
outcomes
Key definitions
countries infected,
4. Epidemiology
85% of whom live in
5. Burden of sub-Saharan Africa
6.
parasitic infections
Classification of
• S. haematobium -
protozoa Africa and middle
7. Classification of
helminths east (most Bulinus globosus, the intermediate host snail for
8. Schistosomiasis prevalent) S. haematobium (source: WHO/TDR/Stammers)

9. Hookworm • S. Mansoni - Africa

10. Lymphatic
filariasis and Latin America
11. Sources of
information
• S. japonicum –
Pacific region
S. haematobium cercaria (differential
interference contrast microscopy; source:
WHO/TDR/Stammers)
 Schistosomiasis (1)
Partners in Global Health Education

1. How to use this

module Life cycle
2. Learning • Transmission occurs in
outcomes
3. Key definitions
fresh water
4. Epidemiology
• Infective cercariae released
5. Burden of from snails of the genera
parasitic infections Bulinus, Biomphalaria
6. Classification of
protozoa
Oncomelania
7. Classification of
• Cercariae penetrate the skin
helminths of people who drink, swim Bulinus globosus, the intermediate host snail for
S. haematobium (source: WHO/TDR/Stammers)
8. Schistosomiasis or bathe in infected water
9. Hookworm • Adult worm live in the veins
10. Lymphatic
filariasis
that drain the urinary
11. Sources of
system (S. haematobium) or
information mesentric blood vessels
intestines (S. mansoni, S.
japonicum) and release
eggs into water in urine or S. haematobium cercaria (differential
faeces interference contrast microscopy; source:
WHO/TDR/Stammers)
• Eggs develop into miracidia
which then infect snails
 Schistosomiasis (2)
Partners in Global Health Education

1. How to use this

module Pathology
2. Learning
outcomes
• Shistosoma eggs become trapped in the tissues of the urinary
3. Key definitions tract (S. haematobium) and intestines (S. mansoni, S.
4. Epidemiology japonicum)
5. Burden of
parasitic infections
• This results in inflammatory response and tissue damage
6. Classification of
protozoa
7. Classification of
helminths
8. Schistosomiasis
9. Hookworm
10. Lymphatic
filariasis
11. Sources of
information

S. haematobium eggs measure 140 x 50 μm

Adult worms of S. haematobium are 1-2 (differential interference contrast microscopy;
cm long (source: WHO/TDR/Stammers) source: WHO/TDR/Stammers)
 Schistosomiasis (3)
Partners in Global Health Education

1. How to use this

module
Symptoms and signs
2. Learning
• Urinary Schistosomiasis:
outcomes – S. hamatobium
3. Key definitions – Gross haematuria
4. Epidemiology
– Dysuria
5. Burden of
parasitic infections – Bladder, ureters and kidneys damaged Cancer of the bladder is
6. Classification of common
protozoa
• Intestinal schistosomiasis
7. Classification of
helminths – S. mansoni, S. japonicum
8. Schistosomiasis – Gradual enlargement of liver and spleen intestines
9. Hookworm
– hypertension of the abdominal blood vessels which begin to bleed
10. Lymphatic
filariasis – Blood in the stools
11. Sources of • Diagnosis
information
• Microscopy for eggs:
– urine sediment for S. haematobium
– concentrated stool samples for S. mansoni, S. japonicum
• Serology – all species
• Rectal biopsy - S. mansoni, S. japonicum
 Schistosomiasis (3)
Partners in Global Health Education

1. How to use this

module Treatment
2. Learning

3.
outcomes
Key definitions
• Praziquantel: effective against all
4.
5.
Epidemiology
Burden of
species
6.
parasitic infections
Classification of
• S. haematobium: single dose (40
protozoa
7. Classification of mg/kg)
helminths
8. Schistosomiasis • S. mansoni, S. japonicum: 2-3 doses of
9. Hookworm
10. Lymphatic
filariasis
30mg/kg
11. Sources of
information

Haematuria due to S. haematobium

(source: WHO/TDR)
 Schistosomiasis (4)
Partners in Global Health Education

1. How to use this

module
2. Learning Prevention and control
outcomes
3. Key definitions
• Educate people to not urinate
4. Epidemiology or defecate in fresh water
5. Burden of
parasitic infections
supplies
6. Classification of • Eliminate snail vectors by
protozoa
7. Classification of
making the water habitat
helminths unsuitable (increase water
8. Schistosomiasis
9. Hookworm
flow, remove vegetation)
10. Lymphatic • Provide piped water to avoid
filariasis
11. Sources of
direct contact with cercariae
information • Mass drug treatment of
communities to reduce
reservoir of infection
Concrete irrigation ditches do not allow
breeding of Oncomelania snails (source:
WHO/TDR/Crump)
 Hookworm (1)
Partners in Global Health Education

1. How to use this

module
2. Learning Epidemiology
outcomes
3. Key definitions
• >1200m infections each year of
4. Epidemiology which 100m are symptomatic
5. Burden of
parasitic infections • It is due to 2 parasites both of
6. Classification of
protozoa
which occur worldwide:
7. Classification of – Necator americanus -
helminths
8. Schistosomiasis predominant species in sub-
9. Hookworm
Saharan Africa, south Asia
10. Lymphatic
filariasis and the Pacific
11. Sources of
information – Ancylostoma duodenale –
predominant in S. Europe, N.
Africa, western Asia,
Hookworm is a major cause
northern China, Japan and of anaemia
the west coast of America
 Hookworm (2)
Partners in Global Health Education

1. How to use this

module
Life cycle
• Adult worms live in the intestine and excrete eggs in the faeces
2. Learning
outcomes • In the absence of latrines, eggs contaminate soil and develop
3. Key definitions in warm, damp conditions
4. Epidemiology • eggs hatch and infective filariform larvae develop in about one
5. Burden of week and remain infective in soil for many weeks
parasitic infections • filariform larvae penetrate the skin when a person walks
6. Classification of
protozoa
barefoot in the soil
7. Classification of
• larva migrate from the skin to the lungs via the lymphatic and
helminths blood systems
8. Schistosomiasis
9. Hookworm
10. Lymphatic
filariasis
11. Sources of
information

Egg of A. duodenale in faecal smear

(size 57-76 µm by 35-47 µm) Filariform larvae
© Dr. Peter Darben, Queensland © Dr. Peter Darben, Queensland
University of Technology University of Technology
 Hookworm (2)
Partners in Global Health Education

1. How to use this

module
2. Learning
• Larvae penetrate the capillary wall to enter the alveolus
outcomes • Larvae are propelled up the respiratory tree to the
3. Key definitions epiglottis where they are swallowed
4. Epidemiology
• Develops to adult stage in upper intestine; adult worms
5. Burden of
parasitic infections are fully mature after about 5 weeks
6. Classification of • Eggs are excreted in the faeces
protozoa
7. Classification of
• Note: eating soil (pica) is a common practice. Ingested
helminths filariform larvae of A. duodenale can pass directly to the
8. Schistosomiasis gut mucosa
9. Hookworm
10. Lymphatic
filariasis
11. Sources of
information

Egg of A. duodenale in faecal smear

(size 57-76 µm by 35-47 µm) Filariform larvae
© Dr. Peter Darben, Queensland © Dr. Peter Darben, Queensland
University of Technology University of Technology
 Hookworm (3)
Partners in Global Health Education

1. How to use this

module Pathology
2. Learning
outcomes
• Hookworms move several
3.
4.
Key definitions
Epidemiology
times a day to different
5. Burden of attachment sites in the upper
parasitic infections
6. Classification of intestinal mucosa to ingest
7.
protozoa
Classification of
blood
8.
helminths
Schistosomiasis
• They secrete an anticoagulant
9. Hookworm which causes the old
10. Lymphatic
filariasis attachment sites to continue
11. Sources of
information to bleed
• Heavy hookworm infection
results in chronic Adult male and female worms of A. duodenale
© Dr. Peter Darben, Queensland University of
haemorrhage from the Technology

duodenal and jejunal mucosa

 Hookworm (3)
Partners in Global Health Education

1. How to use this • The combination of constant

module
2. Learning blood loss due to hookworm
outcomes
3. Key definitions
infection and poor iron
4. Epidemiology intake in the diet results in
5. Burden of
parasitic infections iron deficiency anaemia
6. Classification of
protozoa • A. duodenale ingests 4-5
7. Classification of
helminths times more blood each day
8.
9.
Schistosomiasis
Hookworm
than N. americanus
10. Lymphatic
filariasis
• In a child, the continued
11. Sources of
information
daily loss of 10ml of blood
can lead to severe anaemia
Adult male and female worms of A. duodenale
© Dr. Peter Darben, Queensland University of
Technology
 Hookworm (4)
Partners in Global Health Education

1. How to use this

module Symptoms and signs
2. Learning
outcomes Minor
3.
4.
Key definitions
Epidemiology
• Often itchy papules are found at the site where
5. Burden of
parasitic infections
the larva penetrated the skin
Classification of •
6.
protozoa
There may be cough and wheezing as the larva
7. Classification of
helminths
migrates through the lungs
8. Schistosomiasis Major
9. Hookworm
10. Lymphatic • Hookworm anaemia
filariasis
11. Sources of – Tiredness, aches and pains
information
– Pallor
– Breathlessness
– Oedema
 Hookworm (4)
Partners in Global Health Education

1.

2.
How to use this
module
Learning
Diagnosis
3.
outcomes
Key definitions • Microscopic examination of
4. Epidemiology
5. Burden of
parasitic infections faecal smears to demonstrate
significant numbers of hook
6. Classification of
protozoa
7. Classification of

worm eggs
helminths
8. Schistosomiasis
9. Hookworm
10. Lymphatic
filariasis
• Measure Hb, serum ferritin, iron
11. Sources of
information
• Exclude other causes of anaemia
 Hookworm (4)
Partners in Global Health Education

1. How to use this

2.
module
Learning
Treatment
outcomes
3. Key definitions • Mebendazole (cheap) – 100mg,
4. Epidemiology
5. Burden of
parasitic infections twice daily for 3 days
6. Classification of
protozoa • Mebendazole is contraindicated in
7. Classification of

8.
helminths
Schistosomiasis pregnancy – use Bephenium
9. Hookworm
10. Lymphatic hydroxynaphthoate “alcopar”
filariasis
11. Sources of
information
• For anaemia: ferrous sulphate 200-
400 mg three times a day for 3
months (adult regimen)
 Hookworm (4)
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1. How to use this

2.
module
Learning
Prevention and control
outcomes
3. Key definitions • Health education and improve sanitation
4. Epidemiology
5. Burden of facilities – install pit latrines
parasitic infections
6. Classification of
protozoa
• Encourage use of protective footwear
7. Classification of
helminths • Discourage soil eating (pica)
• Mass drug treatment of communities
8. Schistosomiasis
9. Hookworm
10. Lymphatic
filariasis • Iron supplementation in areas of low
11. Sources of
information
iron intake
 Lymphatic filariasis (1)
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1. How to use this

module Epidemiology
2. Learning
outcomes • 120m people infected in >80
3. Key definitions
4. Epidemiology countries in Africa, Asia, the
5. Burden of
parasitic infections
Pacific islands and South
6. Classification of

7.
protozoa
Classification of
and Central America
helminths
8. Schistosomiasis
• 40m of those infected are
9. Hookworm
10. Lymphatic disfigured or severely
filariasis
11. Sources of incapacitated
information
• 95% cases due to Wuchereria
bancrofti, other species A female Anopheles mosquito taking
a blood meal
include Brugia malayi and
Brugia timori
 Lymphatic filariasis (2)
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1. How to use this

module
Life cycle
2. Learning • Wuchereria bancrofti is
3.
outcomes
Key definitions
mainly transmitted by
4. Epidemiology – Culex mosquitoes in
5. Burden of
parasitic infections
India
6. Classification of – Anopheline
protozoa
7. Classification of
mosquitoes in Africa
helminths • B. malayi and B. timori Microfilaria of B. malayi in thick
blood film (H&E stain; source: CDC)
8. Schistosomiasis
9. Hookworm
are transmitted mainly
10. Lymphatic by Mansonia mosquitoes
filariasis
11. Sources of
• Larval forms of the
information parasite (microfilariae)
are taken up by a female
mosquito when it takes a
blood meal from a
Adult worms of B. malayi in section in a
human infected with lymph node (source: Univ South
adult worms Carolina)
 Lymphatic filariasis (2)
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1. • The microfilariae develop

How to use this
module
2. Learning inside the mosquito
3.
outcomes
• When the mosquito takes
Key definitions
4. Epidemiology
another blood meal the
infective filariform larvae
5. Burden of
parasitic infections
6.
enter the bite wound
Classification of
protozoa
7. • Filariform larvae migrate
Classification of
helminths
Microfilaria of B. malayi in thick
blood film (H&E stain; source: CDC)
8. Schistosomiasis to the lymphatics and
9. Hookworm
10. Lymphatic
lymph glands
filariasis
11. Sources of
• Larvae develop into
information
sexually mature adult
worms over 3-12 months
depending on the species
of filarial worm Adult worms of B. malayi in section in a
lymph node (source: Univ South
Carolina)
 Lymphatic filariasis (3)
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1. How to use this

module Pathology
2. Learning
outcomes • Adult worms live in
3. Key definitions
4. Epidemiology
the afferent lymphatic
5. Burden of
parasitic infections
vessels and cause
6. Classification of severe disruption to
protozoa
7. Classification of the lymphatic system
helminths
8. Schistosomiasis • Scrotal damage and
9. Hookworm
10. Lymphatic
massive swelling may
filariasis
occur when adult
11. Sources of
information Wuchereria bancrofti
lodge in the
lymphatics of the Elephantiasis of the leg
(source: WHO/TDR/Crump)
spermatic cord
 Lymphatic filariasis (3)
Partners in Global Health Education

1. How to use this

module • Late stage disease
2. Learning

3.
outcomes
Key definitions
is typified by
4. Epidemiology elephantiasis –
5. Burden of
parasitic infections painful and
6. Classification of

7.
protozoa
Classification of
disfiguring
8.
helminths
Schistosomiasis
swelling of the
9. Hookworm limbs
10. Lymphatic
filariasis
11. Sources of
• Trauma and
information
secondary
bacterial infection Elephantiasis of the leg
of affected tissues (source: WHO/TDR/Crump)

is common
 Lymphatic filariasis (4)
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1. How to use this

module Symptoms and signs –
3 stages
2. Learning
outcomes
3. Key definitions
4. Epidemiology 1. Asymptomatic stage
5. Burden of
parasitic infections • There is internal damage to
6. Classification of
protozoa the lymphatics and kidneys
7. Classification of
helminths 2. Acute stage – Filarial
8.
9.
Schistosomiasis
Hookworm
lymphangitis
10. Lymphatic
filariasis
• Characterised by bouts of
11. Sources of
information
fever
• heat, redness, pain,
Elderly male with massive hydrocoele,
swelling and tenderness of and elephantiasis of the leg. Also has
nodules in the groin due to
the lymph nodes and ducts onchocerciasis (source:
WHO/TDR/Crump)
 Lymphatic filariasis (4)
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1. How to use this

module
3. Chronic stage
2. Learning
outcomes
• Usually results in
3. Key definitions
elephantiasis as a result of
4. Epidemiology
5. Burden of chronic lymphoedema
parasitic infections
6. Classification of • There is a massive
protozoa
7. Classification of overgrowth of tissue
helminths
8. Schistosomiasis
resulting in severe
9. Hookworm deformities
10. Lymphatic
filariasis • The legs are often affected
11. Sources of
information and result in inability to walk
• The scrotum is often
affected in men and the Elderly male with massive hydrocoele,
and elephantiasis of the leg. Also has
breasts and vulva in women nodules in the groin due to
onchocerciasis (source:
WHO/TDR/Crump)
 Lymphatic filariasis (5)
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1. How to use this

module Diagnosis
• Microscopic examination of Giemsa
2. Learning
outcomes
3. Key definitions
4. Epidemiology stained thick blood films for the
5. Burden of
parasitic infections presence of microfilariae
6. Classification of

7.
protozoa
Classification of
• W. bancrofti shows marked nocturnal
8.
helminths
Schistosomiasis
periodicity, so it’s best to collect
9. Hookworm
10. Lymphatic
blood samples between 10pm and 1
filariasis
11. Sources of
am
information
• Serology
 Lymphatic filariasis (5)
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1. How to use this

module Treatment
• Diethylcarbamazine (DEC) rapidly kills
2. Learning
outcomes
3. Key definitions
4. Epidemiology microfilariae and will kill adult worms if
5. Burden of
parasitic infections given in full dosage over 3 weeks
6. Classification of

7.
protozoa
Classification of
• Release of antigens from dying
8.
helminths
Schistosomiasis
microfilaria causes allergic-type
9. Hookworm
10. Lymphatic
reactions – add an antihistamine and
filariasis
11. Sources of
aspirin to treatment regimen
information
• Other treatment options are
– ivermectin
– combination of DEC and albendazole
 Lymphatic filariasis (5)
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1. How to use this

module Prevention and control
• Rapid diagnosis and treatment of
2. Learning
outcomes
3. Key definitions
4. Epidemiology infected individuals
5. Burden of
parasitic infections • Mass drug administration to at risk
6. Classification of

7.
protozoa
Classification of
communities
8.
helminths
Schistosomiasis • Vector control: eliminate mosquito
breeding sites through improved
9. Hookworm
10. Lymphatic
filariasis
11. Sources of sanitation and enviromental
information
management
• Personal protection against mosquito
bites by insecticides, bednets and
repellants
 Sources of information
Partners in Global Health Education

1. How to use this • The Special Programme for

module Research and Training in Tropical
2. Learning
outcomes
Diseases (TDR UNICEF, UNDP,
3. Key definitions
World Bank, WHO) website:
4. Epidemiology
ww.who.int/tdr/media/image.html
5. Burden of • University of South Carolina
parasitic infections School of Medicine:
6. Classification of http://pathmicro.med.sc.edu/book/
protozoa
parasit-sta.htm
7. Classification of
helminths • Lecture notes on Tropical
8. Schistosomiasis Medicine, Dion R Bell,
9. Hookworm Fourth edition, 1996, Blackwell
10. Lymphatic Science.
filariasis
11. Sources of
• Parasites and human disease, W.
information Crewe and D.R.W. Haddock,
1985, First edition, Edward Arnold.
Partners in Global Health Education

1. How to use this

module
2. Learning
outcomes
3. Key definitions
4. Epidemiology
5. Burden of
parasitic infections
6. Classification of
protozoa
7. Classification of
helminths
8. Schistosomiasis
9. Hookworm QUESTION CLARIFICATIO
10. Lymphatic
S NS
filariasis
11. Sources of SUGGESTION
information
S
1. How to use this
TO GOD BE THE
Partners in Global Health Education

GLORY...
module
2. Learning
outcomes
3. Key definitions
4. Epidemiology
5. Burden of
parasitic infections
6. Classification of
protozoa
7. Classification of

THANK YOU
helminths
8. Schistosomiasis
9. Hookworm
10. Lymphatic
filariasis
11. Sources of
TEACHING IS A WORK OF HEART
information

Maam CRIS :)