Parasitology

• Introduction
Parasitology is the study of parasites
• parasite is an organism which is unable to complete its
development and reproduction processes without the
aid of another partner and may cause a disease.
• Host-An organism which harbours the parasite.
• Parasitism is therefore a relationship in which a parasite
benefits and the host provides the benefits.
• commensalism is a relationship in which neither partner
is harmed.
• When a parasite lives within its host eg. malaria parasites,
it is referred to as endoparasite and it causes an infection.
• When a parasite lives on the outer surface or in the
superficial tissues of its host e.g.. Flea, it is called an
ectoparasite and is said to cause an infestation.
• Zoonosis is a parasitic infection in which the normal host
is an animal but can produce diseases in humans. 
• A vector is an agent, usually an insect that transmits an
infection from one host to another.
• A mechanical vector is a vector which assists in transfer
of parasitic forms between hosts but is not essential in
the life cycle of a parasite eg. A fly that transfers amoebic
cysts from infected faeces to food that is eaten by
humans.
 LIFE CYCLE OF PARASITES
• In preventing the spread of parasitic diseases
and in selecting and evaluating control
interventions, It is important to know the life
cycles of parasites, the hosts and vectors, and
the human and environmental factors that are
involved.
• Life cycles also provide information on the
tissue infected and the parasitic forms that can
be found in specimens from patients.
• Direct life cycle- when a parasite requires only one species
of host in which to complete its development. Important
parasites in humans that have a direct life cycle include:
E. histolytica
G. lamblia
A. lumbricoides
E. Vermicularis

• Indirect life cycle- when two or more species of hosts are

required. Examples of parasites that have indirect life
cycle include:
Plasmodium species
Trypanosoma species
FACTORS THAT CONTRIBUTE TO THE SPREAD
AND INCREASE OF PARASITIC INFECTIONS
• Inadequate sanitation and unhygienic living conditions leading
to faecal contamination of the environment.
• Lack of health education.
• Insufficient water and contaminated water supplies.
• Failure to control vectors due to ineffective interventions,
• Insecticides resistance.
• Poverty, malnutrition and for some parasites increased
susceptibility due to co-existing HIV infection.
• Failure of drugs to treat parasitic infections effectively.
• Climatic factors.
• Population migrations causing poor health, loss of natural
immunity, exposure to new infections.
 PROTOZOAN
• Single –celled organisms that multiply in human hosts.They are
classified into;
i) AMOEBAE –Entamoeba histolytica.
ii) FLAGELLATES –
– Giardia lamblia,
– Trichomonas vaginalis,
– Trypanosoma species
– Leishmania species.
iii) CILIATES -Balantidium coli.
iv) COCCIDIA -(grouped into two)
a) Blood and tissue coccidia – Plasmodium species and Toxoplasma
gondii.
b) Intestinal coccidia – Isospora belli
Some terms used in protozoology;
• Flagella-These are long delicate slender-like
filaments used for locomotion.
• Cilia-These are fine thread-like structures
covering the entire body of the organism and
are used for locomotion.
• Cyst-Some protozoans encyst during
unfavourable conditions in order to survive.At
this stage,they form structures that are
resistant to temperature changes, some
chemicals.
• Trophozoite-This is the vegetative form of most
protozoans and they are able to feed,move and
reproduce.
• Asexual reproduction- Its reproduction where
by there is no sexual union but reproduction is
through either simple binary fission (Individual
cell divide into two daughter organism e.g.
Amoebae) or Multiple binary fission(one
individual cell divides to more than two
daughter organisms e.g. Plasmodium species)
• Sexual reproduction- where there is sexual
union (e.g.Balantidium coli).
 EXAMINATION OF STOOL
There are direct and concentration techniques that are used in
examination of faeces for parasites.
Direct techniques, there are three(3) methods that can be used
1. Direct saline unstained smear
•Examine the stool sample carefully, find any blood stain or mucous.
•Take a small portion of the stool using an applicator stick and place it
onto a slide.
•Thoroughly emulsify the sample with one or two drops of normal
saline.
•Apply a coverslip on the preparation and examine microscopically
using power 10x objective and then identify further using 40x
objective.
2. Direct 2% Eosin stained smear.
3. Direct iodine stained smear.
 i) AMOEBAE
1. ENTAMOEBA HISTOLYTICA
Geographical distribution – Endemic in tropical and
subtropical Africa,Asia,Mexico and China.Distribution
is more related to inadequate environmental sanitation
and poor personal hygiene than to climate.
Transmission – By the faecal- oral route with infective
cysts being ingested in food,water or from hands
contaminated with faeces.
Habitat – Small intestines,large intestines and sometimes
the liver.
 LIFE CYCLE:
• Man acquire infection through ingestion of infective cysts in
contaminated food, water or hands.
• The cyst will excyst in the large intestine forming trophozoites
(nuclei divide to form trophozoites)
• Trophozoites multiply in the intestines and attack the intestinal
mucosa.
• The trophozoites may be carried together with faeces in the
bowels or gain access to the blood circulation and be taken to the
liver.
• If they are carried together with faeces in the bowels,they encyst
and form single nucleated cysts which then develop into infective
cyst(four nuclei)
• Also in diarrhoea cases, trophozoites can sometimes be passed in
faeces.
• The faeces will contaminate the environment and the lifecycle will
continue.
 LABORATORY DIAGNOSIS
• Examination of formed or semiformed faeces
for cyst stage.
• The parasite may be detected in aspirated
material of liver abscess.
Cyst of E.histolytica
Trophozoite of E.histolytica
• signs and symptoms
• Most people are asymptomatic
– loose stools,
– mild abdominal cramping,
– frequent, watery, and/or bloody stools with severe
abdominal cramping (termed amoebic dysentery)
may occur,
– flatulence,
– appetite loss, and
– fatigue
– Jaundice and anaemia in patients with multiple and
large abscesses
PREVENTION AND CONTROL:
• Preventing faecal contamination of the environment
by using latrines.
• Hand washing after defaecation and before eating.
• Covering food and water to prevent contamination
from flies which can act as carriers.
• Not eating green salads or other uncooked foods
which may contain cysts,usually as a result of
fertilization with untreated human faeces.
• Boiling drinking water(E. histolytica cysts are killed at
550c)
• Health education of food handlers.
 Differences between Amoebic and bacilliary dysentry
Amoebic Dysentry Bacilliary dysentry
-Gradual onset(slow) -Acute onset(sudden)
-No significant fever or -Fever and usually vomiting.
vomiting.
-Offensive odour in stool -No offensive odour in stool.
-Blood and mucous are -Often waterly and bloody
present in faeces . faeces.
-Acid pH. -Alkaline Ph.
-Few pus cells in stool -Many pus cells in stool.
-Motile amoeba containing -No motile amoeba,only
Rbc’s in stool. Motile bacteria.
 ii) FLAGELLATES
1. GIARDIA LAMBLIA
• Disease - Giardiasis
• Transmission – Faecal-oral route.
• Habitat – Small intestines.
LIFE CYCLE:
• Man acquire infection through ingestion of infective
cysts in contaminated food,drinks or hands.
• In the small intestines,excystation takes place and
trophozoites(flagellates) are formed.
• The trophozoites multiply by binary fission and attach
themselves on the mucosa.
• When the conditions become unfavourable,they
detach and are carried down the intestinal track
during which they encyst and the cysts are passed in
faeces.Also you can get trophozoites in fresh
diarrhoeic faeces.

• LABORATORY DIAGNOSIS (Stool analysis)

Cyst of gardia lambia
Trophozoite of gardia lambia
CLINICAL FEATURES AND PATHOLOGY:
• Abdominal pains,severe
diarrhoea,flatulence,vomiting,weight loss and
malabsorption .
• Impairment of growth in children.

PREVENTION AND CONTROL:

• Improving environmental sanitation and personal
hygiene to prevent food,water and hands becoming
contaminated with faeces containing infective cysts.
• Treating infected individuals and health education.
 2. TRICHOMONAS VAGINALIS
Disease – Trichomoniasis(Vaginitis and urethritis)
Habitat - Genito urinary tract especially vagina in
females and prostate glands and urethra in
males.
Transmission – Sexual contact.
• It can also rarely be transmitted through;
• Sharing of clothes especially underpants and
towels.
LIFE CYCLE:
• It has no cystic stage.
• Man get infected with the trophozoite and on
reaching the appropriate site,it multiply by
binary fission.
• The trophozoites inhibite areas having a slightly
acidic media and in females,they stay mostly in
high vagina areas where they cause irritation.
• In males,they invade prostate gland and
urethra.
LABORATORY DIAGNOSIS
• Lab tests are performed on a sample of
vaginal fluid or urethral fluid to look for the
disease-causing parasite. Also Urine Analysis
signs and symptoms
• Intense itching in females(vaginitis)
• Leucorrhoea(whitish,creamy,frothy discharge with a
foul smell)
• Urethritis in male.
• The discharge is more often after periods(yellowish-
green frothy discharge)
• Temporary sterility in men because the trophozoites
feed on spermatozoa.
 
PREVENTION AND CONTROL:
• Health education on hygiene and change of behaviour.
• Screening and treating infected individuals.
 hemoflagellates
3. Trypanosomes
4. LEISHMANIA

3. Trypanosomes
 
Disease
i) African trypanosomiasis

ii) American trypanosomiasis / chagas disease

 
 i) African trypanosomiasis
Habitat – Blood, lymph glands, brain, c.s.f and
heart muscles.
Transmission
– African trypanosomiasis is transmitted through
bite from an infected tsetse fly when it is
sucking blood trypomastigotes.
– Trypanosomiasis can also be transmitted by
blood transfusion (fresh blood)
LIFECYCLE:
• Metacyclic trypomastigotes are inoculated through the skin
when an infected tsetse fly takes a blood meal.
• They develop into long slender trypomastigotes which
multiply at the site of inoculation and later in the
blood,lymphatic system and tissue fluid.
• They are carried to the heart and various organs of the body
and in the later stages of infection they invade the CNS.
• Trypomastigotes are ingested by a tsetse fly when it sucks
blood and in the midgut of the fly,the parasites develop and
multiply. 
• After 2-3 weeks,the trypomastigotes migrate to the salivary
glands of the tsetse fly where they become
epimastigotes,multiply and develop into infective metacyclic
trypomastigotes.
LABORATORY DIAGNOSIS
• T. b. parasites can easily be found in blood,
lymph node aspirate,
• They can also be found in lymph node fluid or
in fluid or biopsy chancre.
tryponosoma
 CLINICAL FEATURES AND PATHOLOGY:
• African trypanosomiasis is a wasting disease which is
usually fatal unless treated.
• A painful swelling called a chancre develops and can be
seen at the site of inoculation of the trypomastigotes. It
contains multiplying trypomastigotes and it disappears
after 10 days.
• In early stages of infection, there is fever with shivering,
sweating and an increased pulse rate.There is a
persistent headache and usually pains in the neck,
shoulders and calves.
• As the disease progresses,the spleen becomes enlarged,
there is oedema of the eyelids and face, sleeplessness,
aimless scratching of the skin and often a transient rash.
• In men, impotence may occur and in women, abortion or
amenorrhoea.
• There is a rapid fall in Hb, reduction in platelets numbers
and a significant rapid rise in the ESR.
• In late stages of infections,the trypanosomes invade the
CNS dullness,apathy,excessive sleeping and incontinence.
• There is usually rapid weight loss,continuing irregular
fever,oedema of the limbs and inability to walk without
help.If untreated,coma develops and finally death.

PREVENTION AND CONTROL:

• Detecting and treating infected individuals at an early
stage.
• Vector control by use of chemicals.
 ii) AMERICAN TRYPANOSOMIASIS /CHAGAS DISEASE

Habitat - Blood
Transimission – Through contact with the faeces of
an infected blood-sucking triatomine bug. Also
through blood transfusion and transplacental
transmission occurs with a fetus being infected
from an asymptomatic mother.
• LABORATORY DIAGNOSIS
Examination of a wet blood preparation or stain
blood flim
 CLINICAL FEATURES AND PATHOLOGY:
• In acute chagas disease, trypomastigotes can be found circulating
in the blood. They then multiply intracellularly as amastogotes
and spread throughout the body. There is fever, malaise, an
increased pulse rate and enlargement of lymph glands, liver and
spleen. Lymphocytosis is also common.
• Acute disease is most common in young children and an acute
attack can cause serious damage to the heart or result in other
complication which may lead to death.
• If a person survives an acute attack, chronic chagas disease may
develop with signs of cardiac muscle damage including a weak
and irregular heart beat, enlargement of the heart and oedema.
Severe damage to heart muscle leads to heart failure. Chagas
disease is one cause of cardiac death in young adults.
PREVENTION AND CONTROL:
• Spraying of bug-infested houses, furniture,
sheds, latrines with insecticides.
• vector control.
• Health education to the community.
 4. LEISHMANIA
The following are the principal Leishmania
species that cause the different clinical forms of
leishmaniasis.

a) Visceral leishmaniasis (VL)

b) Cutaneous leishmaniasis (CL)
c) Diffuse cutaneous leishmaniasis (DCL)
d) Mucocutaneous leishmaniasis (MCL)

Transmission – Transmitted by the bite of an infected

female sandfly
 LIFE CYCLE:

• Promastigotes are inoculated in the skin of man when a

female sandfly takes a blood meal.
• The promastogotes are taken up by macrophages and
develop into intracellural forms called amastigotes.They
multiply,rupture from the macrophages and infect new cells.
• In visceral leishmaniasis,the amastigotes multiply in the
macrophages of the spleen, liver, bone marrow, lymph
glands, mucosa of the small intestines and other tissues of
reticuloendothelial system. Blood monocytes are also
infected.
• In cutaneous leishmaniasis,the parasite multiply in
skin macrophages(histiocytes)
• The lifecycle is continued when intracellular and
free amastigotes are ingested by a female sandfly.
• After about 72 hours,the amastogotes become
flagellated promastigotes in the midgut of the
sandfly.They multiply and fill the lumen of the gut.
• After 14-18 days (depending on species)the
promastigotes move forward to the head and
mouth-parts of the sandfly.
 LABORATORY DIAGNOSIS

Finding amastigotes in:-

• Material aspirated from the spleen, bone
marrow, or enlarged lymph nodes,
• Nasal secretions
• Can be seen in groups inside the blood
leishmania
 CLINICAL FEATURES AND PATHOLOGY:
i) VISCERAL LEISHMANIASIS (VL)
• This is the most severe form of leishmaniasis.The disease is
more chronic with young adults and children being more
commonly infected.
• In chronic VL, there is irregular fever, splenomegaly,
hepatomegaly and lymphadenopathy, loss of weight with
wasting, diarrhoea, low white cell and platelets counts and
anaemia.
• In acute VL, there is splenomegaly, high undulating fever,
chills, profuse sweating, rapid weight loss, fatigue, anaemia
and leucopenia.
 PREVENTION AND CONTROL
• Early detection and treatment of infected
individuals.
• Personal protections from sandfly bite by
using insects repellants, use of insecticides
etc.
 iii) CILIATES
1. BALANTIDIUM COLI
• This is a parasite of pigs(natural host) but man
become infected accidentally.It is the only
ciliate that can parasitize humans.
• Disease – Balantidiosis. 
• Transmission – By ingesting infective cyst in
food,water or hands that are contaminated
with pig faeces.
LIFE CYCLE:
• Man acquire infection through ingestion of infective
cyst in food,water or contaminated hands.
• In the large intestine,cysts excysts and become
trophozoites which multiply through binary fission.
• When conditions become unfavourable,the
trophozoites encyst and the cysts are passed out in
faeces.

LABORATORY DIAGNOSIS
• Stool Analysis
B.coli cyst in saline
B.coli trophozoite in saline preparation
CLINICAL FEATURES AND PATHOLOGY:

Balantidial dysentry when the ciliates invade the

wall of large intestines causing inflamation and
ulceration with blood and mucus in faeces.
PREVENTION AND CONTROL:
• Avoid eating food which could be contaminated
with pig faeces.
• Improving personal hygiene and protecting
water supplies from faecal contamination.
 iv) COCCIDIA
a) Blood and tissue coccidia
1.PLASMODIUM SPECIES
There are four major species that are of medical importance that cause
malaria and are;
• Plasmodium falciparam.
• Plasmodium vivax.
• Plasmodium ovale.
• Plasmodium malariae

Transmission
• By the bite of an infected female Anopheles mosquito.
• Also through blood transfusion with infected donor blood.
 GENERAL LIFE CYCLE:
• The lifecycle occurs in 2 phases i.e In the mosquito and in
man.
• The life cycle in mosquito is known as Sporogony whereas in
man is known as Schizogony.
• Schizogony is divided into exo-erythrocytic and erythrocytic
phases.
Sporogony cycle (sexual)
• The gametocytes are found in blood stream of man( male
and female)
• When female anopheles mosquito bites man,it applies
saliva which contains an anticoagulant and sucks mature
gametocytes
 CONT…
• On reaching the stomach,the male and female
gametes fuse to form zygotes which then develop into
oocysts.
• The oocysts will then develop into sporozoites(long
slender bodies with nuclei)These differ in numbers
and maybe upto 60,000 sporozoites.
• The sporozoites will move to the salivary glands of the
mosquito and are infective to humans.
• When the infected mosquito bites man, it will inject
these sporozoites in the blood stream.
 LABORATORY DIAGNOSIS

• The diagnosis of malaria is by:

• Detecting and identifying malaria parasites
microscopically in blood films..
• Using a malaria rapid diagnostic test (RDT) to
detect malaria antigen.
plasmodium
 CLINICAL FEATURES AND PATHOLOGY
• Typical malaria fever attack-It start with a cold stage in
which the patient shivers and feels cold,even though
his or her temperature is rising.A hot stage follows in
which the temperatures rises to its
maximum,headache is severe and there are back and
joint pains,vomiting and diarrhoea.
• Spleenomegaly occurs in all forms of malaria with
repeated attacks causing a greatly enlarged spleen.
• Anaemia due to destruction of red cells and jaundice
but are more common with falciparam malaria.
 PREVENTION AND CONTROL:

• Avoid mosquito bites by using nets,mosquito

repellants,screening windows,wearing protective
clothing.
• Using drugs to treat and prevent infection.
• Prevent mosquito from breeding by spraying
their breeding sites with chemicals and clearing
bushes.
• Health education.
 2. TOXOPLASMA GONDII
• Disease – Toxoplasmosis
• Transmission – By the ingestion of oocysts in food, water or hands
contaminated with faeces from an infected cat.
• Transmission can also occurs by transplacental transmission.
• Through blood transfusion.

• LIFECYCLE:
• Following ingestion of infective oocysts,the parasites become intracellural
and multiply in the lymph glands,l iver, muscle, CNS and other internal
organs.

LABORATORY DIAGNOSIS
• Most infections with T. gondii are diagnosed serologically.
CLINICAL FEATURES AND PATHOLOGY:
• Adult acquired infections are often asymptomatic but can
cause fever, a rash, enlargement of lymph glands with
lymphocytosis and occasionally inflammation of the
eye(ocular toxoplasmosis)
myocarditis,meningoencephalitis and atypical pneumonia.
• In some infected persons,the only clinical symptoms is
fever.
• In patients with HIV, serious and often fatal opportunistic
toxoplasma infection can occurs in those with abnormal
immune responses.
 PREVENTION AND CONTROL:
• Controlling straying domestic cats.
• Avoiding the contamination of hands, food
and water with cats faeces.
 b) Intestinal coccidia
1. ISOSPORA BELLI
• Human infection with I. belli is uncommon but the parasite is thought to
infect only humans. 
• Transmission – By ingesting oocysts in food, water or contaminated hands

LIFECYCLE:
• Man acquire infection after ingesting infective oocysts in food, water or
contaminated hands.
• Following ingestion, the parasite excyst and the sporozoites enter
epithelial cells of the small intestine where they develop and multiply by
schizogony.
• Oocysts are formed following sporogony and these are excreted in the
faeces.
• The oocysts are immature when passed. Maturation to the infective stage
takes place outside the body.
 LABORATORY DIAGNOSIS
• Diarrhoeal disease caused by I. belli is
diagnosed by finding oocysts in faecal
specimens.
ISOSPORA BELLI
• CLINICAL FEATURES AND PATHOLOGY:
• Infections with I. belli is rarely serious and
asymptomatic.
• Abdominal pains and a mucoid diarrhoea
associated with malabsorption.
• There is often an eosinophilia.

PREVENTION AND CONTROL:

• Personal hygiene.
• Adequate sanitation.