1. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Blood Parasites
Raed Z. Ahmed, Medical Parasitology Lab.,2012

2. Comparison Thick smear Thin smear Lysed RBCs, many layer
Fixed RBCs, single layer
( large volume )
0.25 μl blood/100 fields
( small volume )
0.005 μl blood/100 fields
Good screening test
( positive or negative )
Good species differentiation
Save time in examination
Requires more time to read
Low density infection can be detected as blood elements more concentrate
(more sensitive)
Low density infections can be missed
(less sensitive)
Raed Z. Ahmed, Medical Parasitology Lab.,2012

3. Either thick or thin films may be used depending on the circumstances.
The thick film is more sensitive in detecting parasite and also saves time in examination.
The thin film technique cause very little distortion of the parasite, and permits species identification when it may not be possible in thick films, but many fields must be examined to detect parasite when they are few in number.

4. Plasmodium falciparum
Blood Protozoa
Blood Parasite
Microfilariae
Trypanosoma
Leishmania
Plasmodium
Plasmodium falciparum
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae
Raed Z. Ahmed, Medical Parasitology Lab.,2012

5. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Blood Parasites
Trypanosoma spp.
Raed Z. Ahmed, Medical Parasitology Lab.,2012

6. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Life cycle
Raed Z. Ahmed, Medical Parasitology Lab.,2012

8. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Trypanosoma spp.
Trypanosoma cruzi (Americans) cause Chaga’s disease.
Trypanosoma bruzi (Africans) cause sleeping sickness disease.
Trypanosoma have many stages:
Amastigote, Promastigote, Epimastigote and Trypomastigote.
Reservoir host: mammalian animal.
Intermediate host:
Tsetse fly (Glossina spp.) for Trypanosoma bruzi
Reduviidae bug(kissing bug) for Trypanosoma cruzi
Definitive host: Human.
Infective stage: Metacyclic trypomastigote.
Diagnostic stage: Trypomastigote.
Raed Z. Ahmed, Medical Parasitology Lab.,2012

9. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Continue ……
Diagnosis:
Detection of Trypanosoma chancer after bite
Blood smear within 21 days from the bite, it will show the parasites.
Lymph node aspiration (most reliable).
Lumber puncture if brain affected.
Undulating membrane
Flagellum
Nucleus
kinetoblast
Raed Z. Ahmed, Medical Parasitology Lab.,2012

10. Trypanosoma Trypomastigotes
Raed Z. Ahmed, Medical Parasitology Lab.,2012

11. Trypansoma brucei ssp. in thick blood smears stained with Giemsa

12. Trypansoma brucei ssp. in thin blood smears stained with Giemsa

15. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Blood Parasites
Leishmania spp.
Raed Z. Ahmed, Medical Parasitology Lab.,2012

16. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Life cycle
Raed Z. Ahmed, Medical Parasitology Lab.,2012

17. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Leishmania spp.
There is many species affect man:
Leishmania tropica : cause skin lesion ( cutaneous )
Leishmania braziliense : cause muco-cutaneous lesion.
Leishmania donovani : cause visceral lesion.(kala azar)
Leishmania have two stages:
Amastigote (Leishmania stage), in man (reticuloendothelial cell).
Promastigote (Leptomonas stage), the infective stage and present in the lumen gut of the sand fly.
Reservoir host: dogs and rodents.
Intermediate host: Sand fly (Phlebotomus).
Definitive host: Human.
Raed Z. Ahmed, Medical Parasitology Lab.,2012

18. Cutaneous leishmaniasis

19. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Continue ……
Diagnosis:
Thick and thin blood film
Skin scraping
Blood culture on N.N.N media*
(Novy-MacNeal-Nicolle)
Serological tests
Nucleus
Flagellum
* Culture media used to growth leishmania is Novy, MacNeal and Nicolle's “NNN” or Schneider's Drosophila medium, supplemented with 30% fetal bovine serum,
Raed Z. Ahmed, Medical Parasitology Lab.,2012 19

20. Leishmania promastigotes
Raed Z. Ahmed, Medical Parasitology Lab.,2012

21. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Blood Parasites
Plasmodium spp.
Raed Z. Ahmed, Medical Parasitology Lab.,2012

22. Malaria Blood parasites of the genus Plasmodium.
There are approximately 156 named species of Plasmodium which infect various species of vertebrates.  Four species are considered true parasites of humans, as they utilize humans almost exclusively as a natural intermediate host: P. falciparum, P. vivax, P. ovale  and P. malariae. 

23. Clinical features
fever and chills, which can be accompanied by headache, myalgias, arthralgias, weakness, vomiting, and diarrhea. 
Other clinical features include splenomegaly, anemia, thrombocytopenia, hypoglycemia, pulmonary or renal dysfunction, and neurologic changes.
The clinical presentation can vary substantially depending on the infecting species, the level of parasitemia, and the immune status of the patient
  Infections caused by P. falciparum can progress to severe, potentially fatal forms with central nervous system involvement (cerebral malaria), acute renal failure, severe anemia, or adult respiratory distress syndrome.
  Complications of P. vivax malaria include splenomegaly (with, rarely, splenic rupture), and those of P. malariae include nephrotic syndrome.

24. Laboratory Diagnosis
Microscopic identification is the method most frequently used to demonstrate an active infection.
Morphological comparison and images of Plasmodium species
Molecular diagnosis techniques can complement microscopy, especially in species identification.
Antibody Detection can detect past (not necessarily active) infections.
Immunologic/Biochemical detection of malaria parasite products are available and under evaluation.
Bench aids for Malaria

25. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Life cycle
Raed Z. Ahmed, Medical Parasitology Lab.,2012

26. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Plasmodium spp.
Four species of Plasmodium are the causative agent of malaria, these are:
P. vivax, P. malariae, P. falciparum, and P. ovale.
Intermediate host: Human.
Definitive host: Anopheles mosquitoes.
Plasmodium spp. have 4 stages:
Ring form (young trophozoite.)
Late ( old ) trophozoite
Schizonts
Gametocyte.
Infective stage: Sporozoites.
Diagnosis:
Thick and stained thin blood film to detect parasites.
Raed Z. Ahmed, Medical Parasitology Lab.,2012

27. Raed Z. Ahmed, Medical Parasitology Lab.,2012

28. Raed Z. Ahmed, Medical Parasitology Lab.,2012

29. Raed Z. Ahmed, Medical Parasitology Lab.,2012

30. Raed Z. Ahmed, Medical Parasitology Lab.,2012

31. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Ring form
P. vivax
P. ovale
P. malariae
P. falciparum
Raed Z. Ahmed, Medical Parasitology Lab.,2012

32. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Trophozoite form
P. vivax
P. ovale
P. malariae
P. falciparum
Raed Z. Ahmed, Medical Parasitology Lab.,2012

33. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Schizonts form
P. vivax
P. ovale
P. malariae
P. falciparum
Raed Z. Ahmed, Medical Parasitology Lab.,2012

34. Raed Z. Ahmed, Medical Parasitology Lab.,2012
Gametocyte form
P. vivax
P. ovale
P. malariae
P. falciparum
Raed Z. Ahmed, Medical Parasitology Lab.,2012

35. Species Differentiation On Thin Films
Species Differentiation On Thin Films
Feature
P. falciparum
P. vivax
P. ovale
P. malariae
Enlarged infected RBC - +
Infected RBC shape
round
round, distorted
oval, fimbriated
Stippling infected RBC
Maurer’s clefts
Schuffner's spots
Schuffner's dots
none
Trophozoite shape
small ring, applique
large ring, amoeboid
large ring, compact
small ring, compact
Chromatin dot
often double
single
large
Mature schizont
rare, merozoites
12-24 merozoites
4-12 merozoites
( scattered )
6-12 merozoites
( rosette )
Gametocyte
crescent shape
large, round
compact, round
Raed Z. Ahmed, Medical Parasitology Lab.,2012