7252019 Intestinal Helminthiasis and Filariasis_SGT
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Dr Kyaw Min
Assoc Prof Clinical Tropical Medicine amp Public Health
HOD ComMedM DTMampH MCTM MPH PhD PH
ACTM $TMampH
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Intestinal helminths
List intestinal helminths
Describe life cycle clinical manifestationand management (Inv+Tt+prevention) of
each intestinal helminthiasis
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Filariasis
1 ention the prevalence of filariasis in
alaysia and globally Discss epidemiology of filariasis
according to chain of transmission
Discss prevention and control of filariasis
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$ematodes (ondamporms)
Tisse $ematode Infections Intestinal $ematode Infections
Trichinellaspiralis others
Toocara anis
ncylostoma brailiense
scariasis
oo-amporm (d $a)
trongyloidiasis
nterobiasis
Filariasis
0nchocerciasis
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LargeI
Trichuris (amphipamporm) oral hemorrhagic colitis
Enterobius (pinamporm) oral perianal itch mallI
Ascaris (rond amporm) oral small intestine obstrction
Strongyloides (thread amporm) perctaneos and
atoinfection dodenitis ctaneos larva crrenshyperinfection in immnocompromised
Ancylostoma Necator (hoo-amporms) perctaneosiron deficiency anemia
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Trematodes (Flatamporms)
2lood Fl-e (chistosomiasis) Liver fl-e
Intestinal
1 mansoni
3aponicm
me-ongi
4 intercalatm
5rinary
1 haematobim
1 0pisthochiasis
lonorchiasis
Fascioliasis
Lng Fl-es
1 6aragonims
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estodes (Tapeamporms)
Tinea olim ysticercosi
T aginata
chinococcosis
Diphylobothriasis
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Intestinal nematodesIntestinal nematodes
Larvae pass
throgh lngs
Larvae penetrate
throgh intact s-in
strongyloides
hoo-amporm
ggs ingested
trichiris
enterobis
Larvae enter
bloodstreamascaris
dlt amporms in the
the intestine
ggs
Larvae hatch
from eggs
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Intestinal $ematodescariasis
Ascaris lumbricoides The largest intestinal nematodes
Fecally contaminated soil
ampalloamped eggs hatch in intestine to lngs brea- into alveoli
ascending bronchial tree
sampalloamp
I
matre
6rodce p to47777 eggsd
F8 asymptomaticLngs8 cogh sbsternal discomfortdyspnoea bld9tinged sptm
osinophiliaosinophilic pnemonitis (Lfflersyn)eavy infections8 pain small boampelobst perforation volvls biliary
obstrction colic and pancreatitis
T8 single dose of lbendaole 477 mg
ebendaole lt77 mgIvermectin 1lt7977 =g-g6yrantel pamoate 11mg-g p to 1gm
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A pair of female and male worms of A lumbricoidesNotice the vulvar waist(arrow)of the female worm and thecoiled end of the male worm
7252019 Intestinal Helminthiasis and Filariasis_SGT
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Life cycle Adult worms intestine
(nembryonated
e))s stool
mbryonated e))s
in +- wees in soil
infectie form
0n)estion of
e))s$habditiform
lara hatches
Penetrate
intestine reach
lier
$i)ht heart lun)
respiratory
passa)e
Throat swallow
small intestine
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parasite lab by lampafa menaampi
ncylostoma dodenalencylostoma dodenale
$habditiform
lara
Adult
))
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parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
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parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
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parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
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parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
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parasite lab by lampafa menaampi
Life cycle of hookworm
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parasite lab
by lampafa menaampi
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1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
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amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
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oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
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Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
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trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
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nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
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ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
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Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
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Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
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osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
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Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
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Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
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4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
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Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
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Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
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ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
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ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
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brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
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mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
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epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
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nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
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Pistia plants
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estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
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T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
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Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
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man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
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man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
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man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
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Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
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Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
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Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
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Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
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Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
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Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
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D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
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Intestinal helminths
List intestinal helminths
Describe life cycle clinical manifestationand management (Inv+Tt+prevention) of
each intestinal helminthiasis
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Filariasis
1 ention the prevalence of filariasis in
alaysia and globally Discss epidemiology of filariasis
according to chain of transmission
Discss prevention and control of filariasis
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$ematodes (ondamporms)
Tisse $ematode Infections Intestinal $ematode Infections
Trichinellaspiralis others
Toocara anis
ncylostoma brailiense
scariasis
oo-amporm (d $a)
trongyloidiasis
nterobiasis
Filariasis
0nchocerciasis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 573
LargeI
Trichuris (amphipamporm) oral hemorrhagic colitis
Enterobius (pinamporm) oral perianal itch mallI
Ascaris (rond amporm) oral small intestine obstrction
Strongyloides (thread amporm) perctaneos and
atoinfection dodenitis ctaneos larva crrenshyperinfection in immnocompromised
Ancylostoma Necator (hoo-amporms) perctaneosiron deficiency anemia
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 673
Trematodes (Flatamporms)
2lood Fl-e (chistosomiasis) Liver fl-e
Intestinal
1 mansoni
3aponicm
me-ongi
4 intercalatm
5rinary
1 haematobim
1 0pisthochiasis
lonorchiasis
Fascioliasis
Lng Fl-es
1 6aragonims
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 773
estodes (Tapeamporms)
Tinea olim ysticercosi
T aginata
chinococcosis
Diphylobothriasis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 873
Intestinal nematodesIntestinal nematodes
Larvae pass
throgh lngs
Larvae penetrate
throgh intact s-in
strongyloides
hoo-amporm
ggs ingested
trichiris
enterobis
Larvae enter
bloodstreamascaris
dlt amporms in the
the intestine
ggs
Larvae hatch
from eggs
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 973
Intestinal $ematodescariasis
Ascaris lumbricoides The largest intestinal nematodes
Fecally contaminated soil
ampalloamped eggs hatch in intestine to lngs brea- into alveoli
ascending bronchial tree
sampalloamp
I
matre
6rodce p to47777 eggsd
F8 asymptomaticLngs8 cogh sbsternal discomfortdyspnoea bld9tinged sptm
osinophiliaosinophilic pnemonitis (Lfflersyn)eavy infections8 pain small boampelobst perforation volvls biliary
obstrction colic and pancreatitis
T8 single dose of lbendaole 477 mg
ebendaole lt77 mgIvermectin 1lt7977 =g-g6yrantel pamoate 11mg-g p to 1gm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1073
A pair of female and male worms of A lumbricoidesNotice the vulvar waist(arrow)of the female worm and thecoiled end of the male worm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1173
Life cycle Adult worms intestine
(nembryonated
e))s stool
mbryonated e))s
in +- wees in soil
infectie form
0n)estion of
e))s$habditiform
lara hatches
Penetrate
intestine reach
lier
$i)ht heart lun)
respiratory
passa)e
Throat swallow
small intestine
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1573
parasite lab by lampafa menaampi
ncylostoma dodenalencylostoma dodenale
$habditiform
lara
Adult
))
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1673
parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
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Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
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Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
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D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
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Filariasis
1 ention the prevalence of filariasis in
alaysia and globally Discss epidemiology of filariasis
according to chain of transmission
Discss prevention and control of filariasis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 473
$ematodes (ondamporms)
Tisse $ematode Infections Intestinal $ematode Infections
Trichinellaspiralis others
Toocara anis
ncylostoma brailiense
scariasis
oo-amporm (d $a)
trongyloidiasis
nterobiasis
Filariasis
0nchocerciasis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 573
LargeI
Trichuris (amphipamporm) oral hemorrhagic colitis
Enterobius (pinamporm) oral perianal itch mallI
Ascaris (rond amporm) oral small intestine obstrction
Strongyloides (thread amporm) perctaneos and
atoinfection dodenitis ctaneos larva crrenshyperinfection in immnocompromised
Ancylostoma Necator (hoo-amporms) perctaneosiron deficiency anemia
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 673
Trematodes (Flatamporms)
2lood Fl-e (chistosomiasis) Liver fl-e
Intestinal
1 mansoni
3aponicm
me-ongi
4 intercalatm
5rinary
1 haematobim
1 0pisthochiasis
lonorchiasis
Fascioliasis
Lng Fl-es
1 6aragonims
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 773
estodes (Tapeamporms)
Tinea olim ysticercosi
T aginata
chinococcosis
Diphylobothriasis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 873
Intestinal nematodesIntestinal nematodes
Larvae pass
throgh lngs
Larvae penetrate
throgh intact s-in
strongyloides
hoo-amporm
ggs ingested
trichiris
enterobis
Larvae enter
bloodstreamascaris
dlt amporms in the
the intestine
ggs
Larvae hatch
from eggs
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 973
Intestinal $ematodescariasis
Ascaris lumbricoides The largest intestinal nematodes
Fecally contaminated soil
ampalloamped eggs hatch in intestine to lngs brea- into alveoli
ascending bronchial tree
sampalloamp
I
matre
6rodce p to47777 eggsd
F8 asymptomaticLngs8 cogh sbsternal discomfortdyspnoea bld9tinged sptm
osinophiliaosinophilic pnemonitis (Lfflersyn)eavy infections8 pain small boampelobst perforation volvls biliary
obstrction colic and pancreatitis
T8 single dose of lbendaole 477 mg
ebendaole lt77 mgIvermectin 1lt7977 =g-g6yrantel pamoate 11mg-g p to 1gm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1073
A pair of female and male worms of A lumbricoidesNotice the vulvar waist(arrow)of the female worm and thecoiled end of the male worm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1173
Life cycle Adult worms intestine
(nembryonated
e))s stool
mbryonated e))s
in +- wees in soil
infectie form
0n)estion of
e))s$habditiform
lara hatches
Penetrate
intestine reach
lier
$i)ht heart lun)
respiratory
passa)e
Throat swallow
small intestine
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1573
parasite lab by lampafa menaampi
ncylostoma dodenalencylostoma dodenale
$habditiform
lara
Adult
))
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1673
parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
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Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
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D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 473
$ematodes (ondamporms)
Tisse $ematode Infections Intestinal $ematode Infections
Trichinellaspiralis others
Toocara anis
ncylostoma brailiense
scariasis
oo-amporm (d $a)
trongyloidiasis
nterobiasis
Filariasis
0nchocerciasis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 573
LargeI
Trichuris (amphipamporm) oral hemorrhagic colitis
Enterobius (pinamporm) oral perianal itch mallI
Ascaris (rond amporm) oral small intestine obstrction
Strongyloides (thread amporm) perctaneos and
atoinfection dodenitis ctaneos larva crrenshyperinfection in immnocompromised
Ancylostoma Necator (hoo-amporms) perctaneosiron deficiency anemia
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 673
Trematodes (Flatamporms)
2lood Fl-e (chistosomiasis) Liver fl-e
Intestinal
1 mansoni
3aponicm
me-ongi
4 intercalatm
5rinary
1 haematobim
1 0pisthochiasis
lonorchiasis
Fascioliasis
Lng Fl-es
1 6aragonims
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 773
estodes (Tapeamporms)
Tinea olim ysticercosi
T aginata
chinococcosis
Diphylobothriasis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 873
Intestinal nematodesIntestinal nematodes
Larvae pass
throgh lngs
Larvae penetrate
throgh intact s-in
strongyloides
hoo-amporm
ggs ingested
trichiris
enterobis
Larvae enter
bloodstreamascaris
dlt amporms in the
the intestine
ggs
Larvae hatch
from eggs
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 973
Intestinal $ematodescariasis
Ascaris lumbricoides The largest intestinal nematodes
Fecally contaminated soil
ampalloamped eggs hatch in intestine to lngs brea- into alveoli
ascending bronchial tree
sampalloamp
I
matre
6rodce p to47777 eggsd
F8 asymptomaticLngs8 cogh sbsternal discomfortdyspnoea bld9tinged sptm
osinophiliaosinophilic pnemonitis (Lfflersyn)eavy infections8 pain small boampelobst perforation volvls biliary
obstrction colic and pancreatitis
T8 single dose of lbendaole 477 mg
ebendaole lt77 mgIvermectin 1lt7977 =g-g6yrantel pamoate 11mg-g p to 1gm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1073
A pair of female and male worms of A lumbricoidesNotice the vulvar waist(arrow)of the female worm and thecoiled end of the male worm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1173
Life cycle Adult worms intestine
(nembryonated
e))s stool
mbryonated e))s
in +- wees in soil
infectie form
0n)estion of
e))s$habditiform
lara hatches
Penetrate
intestine reach
lier
$i)ht heart lun)
respiratory
passa)e
Throat swallow
small intestine
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1573
parasite lab by lampafa menaampi
ncylostoma dodenalencylostoma dodenale
$habditiform
lara
Adult
))
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1673
parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 573
LargeI
Trichuris (amphipamporm) oral hemorrhagic colitis
Enterobius (pinamporm) oral perianal itch mallI
Ascaris (rond amporm) oral small intestine obstrction
Strongyloides (thread amporm) perctaneos and
atoinfection dodenitis ctaneos larva crrenshyperinfection in immnocompromised
Ancylostoma Necator (hoo-amporms) perctaneosiron deficiency anemia
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 673
Trematodes (Flatamporms)
2lood Fl-e (chistosomiasis) Liver fl-e
Intestinal
1 mansoni
3aponicm
me-ongi
4 intercalatm
5rinary
1 haematobim
1 0pisthochiasis
lonorchiasis
Fascioliasis
Lng Fl-es
1 6aragonims
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 773
estodes (Tapeamporms)
Tinea olim ysticercosi
T aginata
chinococcosis
Diphylobothriasis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 873
Intestinal nematodesIntestinal nematodes
Larvae pass
throgh lngs
Larvae penetrate
throgh intact s-in
strongyloides
hoo-amporm
ggs ingested
trichiris
enterobis
Larvae enter
bloodstreamascaris
dlt amporms in the
the intestine
ggs
Larvae hatch
from eggs
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 973
Intestinal $ematodescariasis
Ascaris lumbricoides The largest intestinal nematodes
Fecally contaminated soil
ampalloamped eggs hatch in intestine to lngs brea- into alveoli
ascending bronchial tree
sampalloamp
I
matre
6rodce p to47777 eggsd
F8 asymptomaticLngs8 cogh sbsternal discomfortdyspnoea bld9tinged sptm
osinophiliaosinophilic pnemonitis (Lfflersyn)eavy infections8 pain small boampelobst perforation volvls biliary
obstrction colic and pancreatitis
T8 single dose of lbendaole 477 mg
ebendaole lt77 mgIvermectin 1lt7977 =g-g6yrantel pamoate 11mg-g p to 1gm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1073
A pair of female and male worms of A lumbricoidesNotice the vulvar waist(arrow)of the female worm and thecoiled end of the male worm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1173
Life cycle Adult worms intestine
(nembryonated
e))s stool
mbryonated e))s
in +- wees in soil
infectie form
0n)estion of
e))s$habditiform
lara hatches
Penetrate
intestine reach
lier
$i)ht heart lun)
respiratory
passa)e
Throat swallow
small intestine
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1573
parasite lab by lampafa menaampi
ncylostoma dodenalencylostoma dodenale
$habditiform
lara
Adult
))
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1673
parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
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Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
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ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
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D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 673
Trematodes (Flatamporms)
2lood Fl-e (chistosomiasis) Liver fl-e
Intestinal
1 mansoni
3aponicm
me-ongi
4 intercalatm
5rinary
1 haematobim
1 0pisthochiasis
lonorchiasis
Fascioliasis
Lng Fl-es
1 6aragonims
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 773
estodes (Tapeamporms)
Tinea olim ysticercosi
T aginata
chinococcosis
Diphylobothriasis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 873
Intestinal nematodesIntestinal nematodes
Larvae pass
throgh lngs
Larvae penetrate
throgh intact s-in
strongyloides
hoo-amporm
ggs ingested
trichiris
enterobis
Larvae enter
bloodstreamascaris
dlt amporms in the
the intestine
ggs
Larvae hatch
from eggs
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 973
Intestinal $ematodescariasis
Ascaris lumbricoides The largest intestinal nematodes
Fecally contaminated soil
ampalloamped eggs hatch in intestine to lngs brea- into alveoli
ascending bronchial tree
sampalloamp
I
matre
6rodce p to47777 eggsd
F8 asymptomaticLngs8 cogh sbsternal discomfortdyspnoea bld9tinged sptm
osinophiliaosinophilic pnemonitis (Lfflersyn)eavy infections8 pain small boampelobst perforation volvls biliary
obstrction colic and pancreatitis
T8 single dose of lbendaole 477 mg
ebendaole lt77 mgIvermectin 1lt7977 =g-g6yrantel pamoate 11mg-g p to 1gm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1073
A pair of female and male worms of A lumbricoidesNotice the vulvar waist(arrow)of the female worm and thecoiled end of the male worm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1173
Life cycle Adult worms intestine
(nembryonated
e))s stool
mbryonated e))s
in +- wees in soil
infectie form
0n)estion of
e))s$habditiform
lara hatches
Penetrate
intestine reach
lier
$i)ht heart lun)
respiratory
passa)e
Throat swallow
small intestine
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1573
parasite lab by lampafa menaampi
ncylostoma dodenalencylostoma dodenale
$habditiform
lara
Adult
))
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1673
parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
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Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
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trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
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ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
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D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 773
estodes (Tapeamporms)
Tinea olim ysticercosi
T aginata
chinococcosis
Diphylobothriasis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 873
Intestinal nematodesIntestinal nematodes
Larvae pass
throgh lngs
Larvae penetrate
throgh intact s-in
strongyloides
hoo-amporm
ggs ingested
trichiris
enterobis
Larvae enter
bloodstreamascaris
dlt amporms in the
the intestine
ggs
Larvae hatch
from eggs
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 973
Intestinal $ematodescariasis
Ascaris lumbricoides The largest intestinal nematodes
Fecally contaminated soil
ampalloamped eggs hatch in intestine to lngs brea- into alveoli
ascending bronchial tree
sampalloamp
I
matre
6rodce p to47777 eggsd
F8 asymptomaticLngs8 cogh sbsternal discomfortdyspnoea bld9tinged sptm
osinophiliaosinophilic pnemonitis (Lfflersyn)eavy infections8 pain small boampelobst perforation volvls biliary
obstrction colic and pancreatitis
T8 single dose of lbendaole 477 mg
ebendaole lt77 mgIvermectin 1lt7977 =g-g6yrantel pamoate 11mg-g p to 1gm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1073
A pair of female and male worms of A lumbricoidesNotice the vulvar waist(arrow)of the female worm and thecoiled end of the male worm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1173
Life cycle Adult worms intestine
(nembryonated
e))s stool
mbryonated e))s
in +- wees in soil
infectie form
0n)estion of
e))s$habditiform
lara hatches
Penetrate
intestine reach
lier
$i)ht heart lun)
respiratory
passa)e
Throat swallow
small intestine
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1573
parasite lab by lampafa menaampi
ncylostoma dodenalencylostoma dodenale
$habditiform
lara
Adult
))
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1673
parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
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D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 873
Intestinal nematodesIntestinal nematodes
Larvae pass
throgh lngs
Larvae penetrate
throgh intact s-in
strongyloides
hoo-amporm
ggs ingested
trichiris
enterobis
Larvae enter
bloodstreamascaris
dlt amporms in the
the intestine
ggs
Larvae hatch
from eggs
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 973
Intestinal $ematodescariasis
Ascaris lumbricoides The largest intestinal nematodes
Fecally contaminated soil
ampalloamped eggs hatch in intestine to lngs brea- into alveoli
ascending bronchial tree
sampalloamp
I
matre
6rodce p to47777 eggsd
F8 asymptomaticLngs8 cogh sbsternal discomfortdyspnoea bld9tinged sptm
osinophiliaosinophilic pnemonitis (Lfflersyn)eavy infections8 pain small boampelobst perforation volvls biliary
obstrction colic and pancreatitis
T8 single dose of lbendaole 477 mg
ebendaole lt77 mgIvermectin 1lt7977 =g-g6yrantel pamoate 11mg-g p to 1gm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1073
A pair of female and male worms of A lumbricoidesNotice the vulvar waist(arrow)of the female worm and thecoiled end of the male worm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1173
Life cycle Adult worms intestine
(nembryonated
e))s stool
mbryonated e))s
in +- wees in soil
infectie form
0n)estion of
e))s$habditiform
lara hatches
Penetrate
intestine reach
lier
$i)ht heart lun)
respiratory
passa)e
Throat swallow
small intestine
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1573
parasite lab by lampafa menaampi
ncylostoma dodenalencylostoma dodenale
$habditiform
lara
Adult
))
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1673
parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 973
Intestinal $ematodescariasis
Ascaris lumbricoides The largest intestinal nematodes
Fecally contaminated soil
ampalloamped eggs hatch in intestine to lngs brea- into alveoli
ascending bronchial tree
sampalloamp
I
matre
6rodce p to47777 eggsd
F8 asymptomaticLngs8 cogh sbsternal discomfortdyspnoea bld9tinged sptm
osinophiliaosinophilic pnemonitis (Lfflersyn)eavy infections8 pain small boampelobst perforation volvls biliary
obstrction colic and pancreatitis
T8 single dose of lbendaole 477 mg
ebendaole lt77 mgIvermectin 1lt7977 =g-g6yrantel pamoate 11mg-g p to 1gm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1073
A pair of female and male worms of A lumbricoidesNotice the vulvar waist(arrow)of the female worm and thecoiled end of the male worm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1173
Life cycle Adult worms intestine
(nembryonated
e))s stool
mbryonated e))s
in +- wees in soil
infectie form
0n)estion of
e))s$habditiform
lara hatches
Penetrate
intestine reach
lier
$i)ht heart lun)
respiratory
passa)e
Throat swallow
small intestine
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1573
parasite lab by lampafa menaampi
ncylostoma dodenalencylostoma dodenale
$habditiform
lara
Adult
))
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1673
parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1073
A pair of female and male worms of A lumbricoidesNotice the vulvar waist(arrow)of the female worm and thecoiled end of the male worm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1173
Life cycle Adult worms intestine
(nembryonated
e))s stool
mbryonated e))s
in +- wees in soil
infectie form
0n)estion of
e))s$habditiform
lara hatches
Penetrate
intestine reach
lier
$i)ht heart lun)
respiratory
passa)e
Throat swallow
small intestine
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1573
parasite lab by lampafa menaampi
ncylostoma dodenalencylostoma dodenale
$habditiform
lara
Adult
))
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1673
parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1173
Life cycle Adult worms intestine
(nembryonated
e))s stool
mbryonated e))s
in +- wees in soil
infectie form
0n)estion of
e))s$habditiform
lara hatches
Penetrate
intestine reach
lier
$i)ht heart lun)
respiratory
passa)e
Throat swallow
small intestine
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1573
parasite lab by lampafa menaampi
ncylostoma dodenalencylostoma dodenale
$habditiform
lara
Adult
))
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1673
parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1573
parasite lab by lampafa menaampi
ncylostoma dodenalencylostoma dodenale
$habditiform
lara
Adult
))
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1673
parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1573
parasite lab by lampafa menaampi
ncylostoma dodenalencylostoma dodenale
$habditiform
lara
Adult
))
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1673
parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1573
parasite lab by lampafa menaampi
ncylostoma dodenalencylostoma dodenale
$habditiform
lara
Adult
))
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1673
parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1573
parasite lab by lampafa menaampi
ncylostoma dodenalencylostoma dodenale
$habditiform
lara
Adult
))
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1673
parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1673
parasite lab
by lampafa menaampi
2 Eggs 60times40 microm in size oval in
shape shell is thin and colorlessContent is 2-8cells
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1773
parasite lab by lampafa menaampi
Ancylostoma dodenale ecatoramericans -- hman hoo$orms
mall nematodes amp-(cm)
ead is sli+htly endamphoo) and the moth
carries characteristic teethampAncylostoma) or platesampecator note that theseare not real teeth tcticlar ormations o theccal capsle)
he posterior end o themale $orm is elaoratedinto a coplatory rsa
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1873
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of
Ancylostoma duodenale note the presence of for gtteethgt tampo
on each side
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 1973
parasite lab by lampafa menaampi
canning electron micrograph of the moth capsle of $ecatoramericans another species of hman hoo-amporm $ote the
presence of tampo ctting gtteeth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2073
parasite lab by lampafa menaampi
Life cycle of hookworm
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2173
parasite lab
by lampafa menaampi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2273
1atho+enesis and Clinical
aniestations 3arval mi+ration
amp) ermatitis no$n as 5+ronditch5 or 5stool poison5he larvaepenetratin+ the sin case aller+icreaction petechiae 0r paple $ithitchin+ and rnin+ sensation
cratchin+ leads to secondary inection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2373
amp2) pnemonitis ampaller+ic reaction)3oeer7s syndrome co+hasthma lo$ ever lood-tin+ed
sptm or hemoptysis chest-paininammation shado$s in ln+snder 9-ray hese maniestations
+o on aot 2 $ees
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2473
oo-amporm
Ancylostoma duodenaleNecator americanus
Infectious larvae penetrate the skin
Lngs via the blood stream invade alveoli sampalloamp I matre into
adlt attach to the mcosa sc- blood and intestinal flid
F8 most asymptomatichronic8 Iron defi + hypoproteinemia ampea-ness shortnessof breath
T8lbedaole 477mg onceebendaole lt77mg once6yrantel pamoate 11mg-g od for d $tritional spportIron replacementD8 stool eamination
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2573
Then as adlts they attach by moth to
small intestinal mcosa and sc- blood
($ecator 77 mlday Ancylostoma 71lt
mlday)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2773
trongyloidiasis
Strongyloides stercoralis Unlike others can replicate in thehuman host
toinfection most common amongimmnocompromised hosts
Life cycle
F8 mild ctaneos andor abdmanifestation sch as rticaria prritserythematos erption along the corseof larva migration abd pain nasea D+ampt loss colitis enteritis malabsorption
Disseminated disease8$ peritonem liver -idney2acteremia can develop amphen entericflora enter the bldstream A9ve sepsispnemonia or meningitis can
complicate the disease
D8 osiniphilia rhabditiform larvae instoolLI
T8Ivermectin (77=g-g daily for D) ismore effective thanlbendaole (477 mg daily for D)Disseminated case8 Ivermectin B lt9C D
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2873
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 2973
nterobiasis
nterobius vermicularis pinworm
dlt amporms migrate noctrnally ot
into the perianal region releasing
immatre eggs infective ampithin hors
toinfection reslts from perianal
scratching moth
6erson to person spread occrs
F8 prrits ani D8 celllose acetate tapeggs are flattened on one side
T80ne dose of
ebendaole 177 mg or lbendaole 477 mg or6yrantel pamoate 11mg-g ma 1 gm
ame T repeated after amp-sosehold members shold also be
treated
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3073
ey to the diagnosis of Intestinal $ematodes
Intestinal
NematodesIntestinal
Nematodes
Larvae in Stool
S stercoralis
Larvae in Stool
S stercoralisEggs in stoolEggs in stool
Eggs on
Perianal SkinEggs on
Perianal Skin
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colored
(Bile Stained)
A lumbricoides
T trichiura
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
Colorless
(Non Bile Stained)
A duodenale
N americanus
E vermicularis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3173
Trichenellosis
Trichenella spiralis $ other
Ingest meat (sly por-)contains cysts ampith T
larvae
Dring 1st amp- larvae
invade small boampel
mcosa nd rd amp-s
matre into adlts
amphich release neamp larva
migrate to striated
mscle via circlationand encyst
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3273
Trichenellosis
ampeek (iarrhea abd pain constipation N) )
Eee- reaction ampith fever hypereosinophilia periorbital andfacial edema ge in con3nctiva retina and nail beds
mp rashes headache cogh dyspnea dysphagiaDeath are sly de to myocarditis ampith arrhythmais orF
Eee- 9 yositis myalgias mscle edema ampea-ness(esply8etraoclar mscle biceps diaphragm) ymptoms pea- at ampee-s
splinter hemorrha)e
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3373
osinophilia in + - (rugs are ineffective againstmuscle larvae
Ig and mscle enymes level
specific b titres by ampee-s
ebendaole
779477 mg tid days then˟
477 mg tid G914 days then˟
lbendaole477 mg bid G914 days˟
ay be active against enteric parasites
Definite D is by detection of larvaob biopsyighest at near insertions of tendon
Alcocorticoids (1mg-g daily for ltdays) may redce severe myositisand myocarditis
6revention8 coo-ing por- ntil it is no longer pin- or freeing it at 1ltH for
ampee-s -ills larvae and prevents infection
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3473
Filarial infections
(well in S tissue and lymphatics + - million people are infected
Disease tends to be more intense andacte in neamply eposed persons than in
natives of endemic areas
dlt amporm live for yearsicrofilariae live for 9 months
Echereria bancrofti (noctrnally periodic)2rgia malayi2 Timori
dlt amporms case inflammatorydamage to the lymphatics
1ematodes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3773
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3873
Agent 0actors
Sno 6arasite osJito Disease
1 Wbancrofti ule1 L0
Bmalayi 2ansonia L0
Btimori Anopheles3
2ansoniaL0
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 3973
4ost 0actors
an K $atral ost
ge K ll age ( months) a8 797 years
e K igher in men
igration K leading to etension of
infection to non9endemic areas
Immnity K may develop after long year of
eposre
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4073
Social $ nvironmental 0actors
ssociated ampith 5rbaniation 6overty
Indstrialiation Illiteracy and 6oorsanitation
limate8 is an important factor amphich
inflences81 The breeding of mosJito
Longevity (0ptimm temperatre 7977 midity C7)
The development of parasite in the vector
4 anitation Toampn planning eampage Drainage
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4173
Filarial and related infections
05Asymptomatic microfilaremia4ydroceleA(L acute adenolymphangitis feverlymphatic inflammation transientlocal edema
(15 2icrofilariae can be found inblood hydrocele fluid
67 w8 and 8m
osinophilia and 9 Ig
E 2 particlarly affects genitallymphatics
T8D diethycarbamaine mg-g dailyfor 1 D
lbendaole 477 mg bid for 1 D (lesseffective)
DL may progress to lymphaticobstrction and elephantiasis ampith braampny edema
1ematodes
http233wwwncbinlmnih)o3pubmed3454-5-4
l
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4273
ector ontrolMector control involves anti larval measres antiadlt measres personal prophylais n
integrated method sing all the vector controlmeasres alone ampill bring abot sstained vectorcontrol
I nti larval measres8
1 hemical control
a osJito larvicidal oil
b 6yrosene oil
c 0rgano phosphoros componds sch asTemephos Fenthion
emoval of pistia plants
inor environmental measres
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4373
ector ontrol
II Anti adult measures5
nti adlt measres as indoor residal spaysing DDT and Dieldrin 6yrethrm as
a space spray is also folloamped
III 6ersonal 6rophyla1is5 edction of man mosJito contact by sing
mosJito nets screening of hoses etc
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4473
brgian filariasis vectors mainly ansonia
bonneae and ansonia dives
pirimiphos9methyl residal spraying
Mansonia species breed in sampampy areas
ampater hyacinth
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4573
mass drg administration (D)
sally bite indoors at night and rest on ampallsamphile they digest host9blood and develop
their eggs
impact on night9biting and indoor resting poplations of C quninquefasciatus Aedes
and Mansonia mosJitoes
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4673
epanded polystyrene beads into septic tan-s and
pit latrines can prodce a drastic redction in
Culex mosJito poplations
This mechanically prevents gravid mosJitoes
from laying eggs or larvae and ppae from
breathing Long lasting insecticide impregnated nets
(LLI$s)8
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4773
nvironmental sanitation involving cleaning p of
drains
Larval control sing bio9 larvicides sch as Bacillus
shaericus can effectively be sed to significantly
redce poplations of C quinquefasciatus in rbanand peri9rban areas
emoval of certain aJatic vegetation from
potential breeding sites of ansonia species is also
a feasible option of redcing the vector in clearlydefined settings
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4873
Pistia plants
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 4973
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5173
estodes Tapeamporms
Taenia saginata
mans are definitive
host
D8
tool eamination (eggs proglottids)
osinophilia Ig
Inhabits 5pper 3e3nm T86raiJantel a single doseof 17mg-g
6erianal discomfort mildabd pain change inappetite ampea-ness ampt
loss
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5373
T solim and cysticercosis
por- tapeampormmans are definitivehost
ysticercosis5
N ysticerci can be fond
anyamphere in the body mostoften in brain s-etal mscle tisse or eye
N eires de toinflammation srronding
cysticerci in brainhydrcephals headache $+M+ diiness ataiaconfsion
Intestinal8 epigastricdiscomfort nasea sensationof hnger ampt loss diarrhea orasymptomatic
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5673
Tampo different forms in hmans8
9 man taeniases
9 man cysticercosis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5773
man infection 9 taeniasis
The scole attaches to the mcosa and beginsforming segments (proglotids)
fter tampo months of infection gravid proglotids begin to detach from the distal end 9 ecreted in thefeces
ach segment contains 7777 eggs
Eorm cases only minor inflammation to theintestine (mild symptoms 9 abdominal paindistension diarrhea and nasea 9 or none at all)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5873
man infection 9 cysticercosis
Faecal9oral contamination ampith T solim eggs fromtapeamporm carriers
The invasive oncosphere (embryos) in the eggs areliberated by the action of gastric acid and cross the
boampel ampall
They establish at small terminal vessels (mscles
brain eye) amphere they groamp to abot the sie of 1cm in 9 months
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 5973
man cysticercosis
scle 9 small palpable movable nodles 9 chestsand arms 9 mild or no symptoms
0phthalmic cysticercosis 9 intraoclar cysts floatingfreely in the vitreos hmor 9 decreased visalacity
$erocysticercosis 9 most symptoms are becase of
the inflammatory reaction associated ampith cystdegeneration (that may ta-e years to happen) 9epilepsy hydrocephals encephalitis meningitis
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6073
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6173
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6273
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6373
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6473
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6573
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6673
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6773
Diagnosis 9 taeniasis
Misaliation of Taenia eggs are the only
diagnosis ntil recently 9 has poor sensitivity
and difficlt to differentiate from taenia saginata
2est diagnosis 9 coproantigen detection LI
(detect taenia specific molecles in the feces 9Olt sensitivity and OO specificity)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6873
Diagnosis 9 cysticercosis
Depends on the targeted organ8 $ 9 F immnology neroimaging (the
scole can be seen)
scle 9 imaging b
ye 9 imaging (ltrasond)
(serological eam 9 LI)
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 6973
Treatment 9 taeniasis
Taeniasis 9 relatively easy for intestinal
disease 9 60 drgs 9 niclosamide and
praiJantel
niclosamide is the choice as it is not
absorbedP hoampever it is an epensive drg
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7073
Treatment 9 cysticercosis
$erocysticercosis is the main problem
The problem of the cyst is the inflammatory
reaction
5se of parasiticide (praiJantel or albendaole) 9
debatable 9 aim is to redce inflammation and scar
tisse palliative treatment to control inflammation 9
corticosteroids antihistamines
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7173
Diagnostic riteria for man
ysticercosis1 bsolte criteria
a Demonstration of cysticerci by histologic or microscopiceamination of biopsy material
b Misaliation of parasite in the eye by fndoscopyc $eroradiologic demonstration of cystic lesions containing
a characteristic scole
a3or criteria
a $eroradiologic lesions sggestive of nerocysticercosis
b Demonstration of b to cysticerci by LI
c esoltion of I cystic lesions spontaneosly or after Tampith albendaole or praiJantel
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7273
Diagnostic riteria (ont) inor criteria
a Lesions compatible ampith nerocysticercosis detected byneroimaging stdies
b linical manifestation sggestive of nerocysticercosis
c Demonstration of b to cysticerci or g in F by LI
d vidence of cysticercosis otside the $ (eg igar9shaped soft tisse calcification)
4 pidemiologic criteriaa esidence in endemic area
b FreJent travel to a endemic area
c osehold contact ampith an individal infected ampith T
solim
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi
7252019 Intestinal Helminthiasis and Filariasis_SGT
httpslidepdfcomreaderfullintestinal-helminthiasis-and-filariasissgt 7373
D is comfirmed by
0ne absolte criteria or
ma3or + 1 minor + 1 pi
probable D
Q 1 ma3or + minor
Q 1 ma3or + 1 minor + 1 pi
Q minor + 1 pi