1. Lecture 27,28,29,30: Parasitology
4 lectures titled L 27: Intestinal protozoa L 28: Blood and tissue protozoa L 29: Intestinal helminths
L 30: Tissue helminths.
OBJECTIVES:
The objectives of this lecture are to
introduce students to the basic concepts of parasitology
introduce the various terms related to parasitology
highlight the significance of life cycle in the laboratory diagnosis of parasitic infections

2. Learning Outcomes
At the end of these lectures, students should be able to:
restate the basic concepts of parasitology
define of the various terms related to basic parasitology
discuss briefly the life cycle and pathogenesis of medically important parasites
apply the knowledge of the life cycle to the principles of laboratory diagnosis

3. 6B-parasitology-CHECK SLO
General properties of parasites
General properties of protozoa/helminth
Helminth-cestode/trematode/nematode
Life cycle Entamoeba/ Malaria/ Giardia
Life cycle Ascariasis/Ankylostoma/Filarial worms
Lab diagnosis-sample collection
Microscopy-egg/cyst/trophozoite
Culture/PCR/ag detection/ab detection

4. Assignment-Wormy world symposium
, ,
restate the basic concepts of parasitology
define of the various terms related to basic parasitology (do not just google-it may show layman definitions)
discuss briefly the life cycle and pathogenesis of Plasmodium, Babesia, Toxoplasma, Leishmania etc
apply the knowledge of the life cycle to the principles of laboratory diagnosis (How the knowledge of life cycle will help in diagnosis?)

5. Introduction-Filaria
Filariasis is one of the FIVE major parasitic diseases to which WHO devotes much attention (malaria, shistosomiasis, filariasis, leishmaniasis, trypanosomiasis) .
Wuchereria bancrofti and Brugia malayi are the common species of filarial nematodes involved (helminths).
Dr.P.K.Rajesh.M.D.

6. Eight Species of Filariae Parasitizing Humans _____________________________________________________________________________ Species Site of inhabitation Vector Pathogenesis Distribution _______________________________________________________________________ W. bancrofti lymphatic tissues mosquito lymphatic damage worldwide ____________________________________________________________________ Brugia malayi lymphatic tissues mosquito lymphatic damage Asian Brugia timori lymphatic tissues mosquito lymphatic damage Island of timor ____________________________________________________________________ Onchocerca subcutaneous; eye black fly river blindness Africa volvulus Loa loa subcutaneous deer fly skin swellings Africa Dipetalonema subcutaneous midge indefinite Africa streptocerca Dipetalonema thoracic and midge indefinite Middle and perstans abdominal cavities South America Mansonella peritoneal cavity midge indefinite South America ozzardi

7. para-lab by l. wafa menawi
Adult worm: White and thread-like.
Female:5~10cm in length
Male: 2.5~4cm and a curved tail with two copulatory spicules.
para-lab by l. wafa menawi

8. Adult worm of filaria-habitat-lymphatics

9. para-lab by l. wafa menawi
Microfilaria: 177~296 µm in length
Observable in peripheral blood smear
Wuchereria bancrofti
Brugia malayi
para-lab by l. wafa menawi

10. Microfilaria of B. malayi

11. Intermediate host-Mosquito
Anopheles
Intermediate host-Mosquito
Aedes
W.bancrofti is transmitted by Culex, Aedes, and Anopheles species
B.malayi is transmitted by Anopheles and Mansonia species.
Culex
Mansonia

12. Life cycle
Link the diagnosis to the life cycle-the stage in which parasites are seen in peripheral blood smears are diagnostic

13. para-lab by l. wafa menawi
Wuchereria Life Cycle
para-lab by l. wafa menawi

14. Clinical stages Asymptomatic Amicrofilaremia
Asymptomatic Microfilaremia
Acute Adenolymphangitis (ADL)
(NOCTURNAL PERIODICITY)
Chronic/Irreversible lymphedema
Superimposed upon repeated episodes of ADL
Dr.P.K.Rajesh.M.D.

15. Diagnostic Peripheral blood smear-nocturnal DEC provocation test
Dr.P.K.Rajesh.M.D.

16. Dr.P.K.Rajesh.M.D.

17. Morphological Differences of Microfilariae between W. bancroti and B
Morphological Differences of Microfilariae between W. bancroti and B. malayi
________________________________________________________________
Species W. bancrofti B. malayi
Appearance graceful, sweeping curves irregular, stiff curves
Size larger × 7 µm smaller × 6 µm
Cephalic space shorter(1:1 or1:2) longer(2:1)
(length:width)
________________________________________________________________ Nuclei body nuclei equal sized, clearly unequal sized, coalescing,
defined, countable uncountable
Terminal nuclei no two

18. para-lab by l. wafa menawi
Drugs
Diethylcarbamazine (DEC)
reduces microfilariae concentrations
kills adult worms
Used for prevention (Fortified with salt)
Albendazole
Ivermectin
kills the microfilariae produced by adult worms
para-lab by l. wafa menawi

19. Prevention Vector-Antilarval/Antiadult Screening carriers
Screening Blood donors
Bottom’s up
Chemoprophylaxis
Immunoprophylaxis
Yes, with admin duties and voluntary advisory duties I am not in my room 24/7, please for genuine queries
Dr.P.K.Rajesh.M.D.

20. Dr.P.K.Rajesh.M.D.

21. Dracunculus medinensis
Dr.P.K.Rajesh.M.D.

22. Life Cycle-GUINEA WORM
Adult females in subcutaneous tissues of the legs and arms.
Blister forms over nematode. Breaks when exposed to water.
Nematode uterus ruptures and discharges first stage juveniles into the water (ovoviviparous).
Juveniles ingested by copepod (intermediate host, 2 molts within copepod).
Copepod swallowed by human.
Juveniles migrate via lymph system.
Develop to adults in subcutaneous tissues.

23. To prepare for symposium/CA3
Entamoeba/Giardia
Malaria-Plasmodium/Toxoplasma
Cestodes (T.saginata, T.solium/ Echinococcus)
Trematodes-Liver fluke-Schistosomes
Dracunculosis/Trichinella spiralis/Filaria/Enterobius vermicularis
Ancylostoma/Ascariasis
Dr.P.K.Rajesh.M.D.

24. Tomorrow 14.02.2012 Demonstration of parasites Interactive session
Bring micro log books
Total revision of parasitology relevant to element 6 B
Dr.P.K.Rajesh.M.D.