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Gis2-K11 2024 (Nka&ds)

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Darrell Parapat
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13 views17 pages

Gis2-K11 2024 (Nka&ds)

Uploaded by

Darrell Parapat
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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INTESTINAL

CESTODES

PARASITOLOGY DEPT.
Medical Faculty, USU
NKA/DS 2024
What already known about this
subject
◦ Species of human cestodes
◦ Life cycle of human cestodes
◦ Morphology of each cestodes
Specific Learning Objective

◦ Explaining and comparing the pathogenesis


and pathophysiology of intestinal cestodes.
◦ Explaining the parasitologic examinations and
preventions of the infestations of intestinal
cestodes.
Intestinal Cestodes

◦ Taenia solium, T saginata, and T asiatica


◦ Diphyllobothrium spp.
◦ Hymenolepis spp.
Taeniasis in Indonesia
◦ Taenia solium in Papua, T saginata in Bali and North Sumatera, T
asiatica in North Sumatera. (Wandra, Depary, et al,
2006, DOI: 10.1016/j.parint.2005.11.024)

◦ Incidence has been decreasing in Samosir within the past


decade (Wandra, Darlan, Yulfi, et al, 2019, DOI:
https://doi.org/10.1016/j.actatropica.2019.105250), yet recent unpublished
survey has revealed cases in different district, i.e., Kabupaten
Simalungun. (Panggabean, 2020, unpublished)

6
Intestinal taeniasis
◦ Infestation of taeniid tapeworms (Taenia saginata, T solium, T asiatica)
in host intestine.
◦ When humans eat insufficiently cooked cysticercus-infected meat, all
but the scolex is digested.
◦ The invaginated scolex & neck evaginate in response to bile salts →
attaches to the intestinal wall to begin growing a chain of proglottid.
◦ Despite its length, taeniasis is usually asymptomatic.
◦ Tapeworm lifespan: 2-5 years
◦ Differentiation of Taenia species is important due to different clinical
and epidemiological consequences.
Review on Life Cycle
Pathogenesis

▪ Humans will be infected by Taenia sp. when they swallow


cysticercus larvae.
▪ Infected eggs/proglottids T. solium cause cysticercosis
▪ Larvae that have entered will settle in the jejunum and
develop into adult worms there.
▪ Larvae take about 2-3 months to become adult worms.
Pathogenesis

▪ Adult worms have suckers in the scolex so that they can


attach to the mucosa of the digestive tract.
▪ These suckers function to take nutrients from the blood
vessels
▪ The Taenia solium hooks in the scolex attach to the
intestinal wall becomes stronger.
▪ Gastrointestinal bleeding due to taeniasis infection can
occur and the individual can experience anemia.
Diagnosis
o Stool examination/anal
swab: detects eggs, motile
proglottids in feces
o QDP (Questionaire
Demonstration Proglottid)
o Taenia specific
coproantigen detection in
stool: ELISA
o Antibody detection in
serum: ELISA, CFT,
Immunoblot
o Molecular method: PCR
o NCC: CT scan, MRI
Prevention
• Identification and treatment of taeniasis cases
• Health education, including hygiene and food
safety
• Avoid consuming raw or unproperly cooked meat
• Improved sanitation
• Improved pig husbandry
• Improved meat inspection.
Taeniasis asiatica

• Etiology: T asiatica
• Intermediate host: pig (not cow)
• Cysticerci are located primarily in liver
(not in muscle)
• Both the cysticerci and the adult worm
are smaller (with 300–1,000 proglottids)
Taeniasis asiatica

• Found mainly in Taiwan and other


Asian countries like Korea, China,
Vietnam, Malaysia, Thailand and
Indonesia (North Sumatera)
• Clinical features and diagnosis are
similar to that of T saginata.
Hymenolepiasis
◦ Agents: Hymenolepis nana and Hymenolepis diminuta.
◦ H nana is most common, whilst H diminuta is rarely in humans.
◦ H nana does not require intermediate host. Autoinfection in gut
is possible.
◦ Other host: rodent.
◦ Transmission can occur thru grain fleas or beetles.
◦ Symptoms may vary from abdominal discomfort to diarrhea.
◦ In children, large burden can lead to malabsorption and
malnutrition.
Mega, et al, 2013, https://doi.org/10.1016/B978-1-4160-4390-4.00126-0
Summary
◦ Taeniasis is caused by three taeniids species.
◦ T solium exclusively causes cysticercosis (NCC or non NCC).
◦ It is important to differentiate the taeniid tapeworm due to
different clinical and epidemiological consequences.
◦ The most common tapeworm infection in human: Hymenolepis
nana.
Thank You

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