Parasites causing Anemia

1. Parasites Causing Anemia
Undersupervision Of :
Dr. Azza El-Ghareeb , Assistant Professor
And Head Of Medical Parasitology
Department , Faculty Of Medicine ,
October 6 University

3. P. falciparum Malaria Normochromic
Hemolysis,
Hypersplenism
Parasite Disease Type of anemia Mechanism
L. donovani Leishmaniasis Normochromic
Spleen and bone marrow
involvement
T. gambiense Sleeping
sickness
Normochromic Haemolysis, removal of
immune sensitized RBCs,
Reduced bone marrow
activity
A. duodenale
N. americanus
Hookworm Hypochromic
microcytic
Haemorrhage
T. trichiura Trichuriasis Normochromic Haemorrhage
S. haematobium Schistosomiasis Normochromic Haemorrhage
The Parasites Causing Anemia

4. 1-Plasmodium falciparum
Malaria is caused by a parasite
called Plasmodium, which is
transmitted via the bites of
infected mosquitoes.
In the human body, the
parasites multiply in the liver,
and then infect red blood cells.
Usually, people get malaria by
being bitten by an infective
female Anopheles mosquito.Only Anopheles mosquitoes
can transmit malaria and they
must have been infected
through a previous blood meal
taken on an infected person.
About 1 week later, when the
mosquito takes its next blood
meal, these parasites mix with
the mosquito’s saliva and are
injected into the person being
bitten.
When a mosquito bites an
infected person, a small
amount of blood is taken in
which contains microscopic
malaria parasites
Malaria can also be
transmitted through blood
transfusion, organ transplant,
or the shared use of needles
or syringes contaminated with
blood.

5. Malaria Symptoms
• Symptoms of malaria may include fever, chills, vomiting, diarrhoea, cough,
stomach, pain and muscular aches and weakness.
• If infected with the malaria parasite, Plasmodium results in the most severe
form of malaria and if left untreated, it can cause serous illnesses. Like
seizures, mental confusion, kidney failure, coma and death.

6. How can malaria
be treated :
Malaria is treated with a
class of drugs called
antimalarial. Antimalarial
drugs are designed to
attack the parasites that
cause malaria,
preventing them from
spreading while also
killing them off so they
cant continue causing
infection.
How can malaria be
prevented :
Be aware of the places that
are malaria risk zones, the
main symptoms and how
long it takes for symptoms to
start.
If prescribed, take anti-
malarial medicines strictly as
directed. Anti malarial
medicines are not 100%
Immediately see a doctor and
seek treatment if a fever
develops after entering a
malaria-risk zone, and for up
to 3 months after leaving the
area

7. 2- Leishmania donovani

8. Clinical Manifestation
• Variable - Incubation 3-100+ weeks
• Lowgrade fever
• Hepato-splenomegaly
• Bone marrow hyperplasia
• Anemia, Leucopenia & Cachexia
• Hypergammaglobulinnemia
• Epistaxis , Proteinuria, Hematuria
• Most severe form of the disease, may
be fatal if left untreated
• Usually associated with fever, weight
loss, and an enlarged spleen and liver
• Anemia (low RBC), leukopenia (low
WBC), and thrombocytopenia (low
platelets) are common
• Lymphadenopathy may be present
• Visceral disease from the Middle East
is usually milder with less specific
findings than visceral leishmaniasis
from other areas of the world
Cutaneous
Leishmaniasis

9. • Suppress the reservoir: dogs, rats,
gerbils, other small mammals and
rodents
• Suppress the vector: Sandfly
• Critical to preventing disease
in stationary troop
populations
• Prevent sandfly bites: Personal
Protective Measures
• Most important at night
• Sleeves down
• Insect repellent w/ DEET
• Permethrin treated uniforms
• Permethrin treated bed nets
Prevention
• Antimony (Pentostam®,
Sodium stibogluconate) is
the drug of choice
• Given under an
experimental protocol at
Walter Reed Army
Medical Center
(WRAMC)
• 20 days of intravenous
therapy
• Available at WRAMC for
all branches of the
military
• Requires patient to
come to WRAMC
Treatment

10. 3-Trypansome gambiense
Testes
Fly

11. Symptoms
The symptoms begin within 1 to 4 weeks.
• Fever
• Personality changes
• Disturbance of sleep patterns
• Troubles with walking and talking
• Aching muscles and joints
• Slurred speech
• Seizures
• Rashes
• Swelling around the eyes and hands
• Headaches
• Fatigue
• Prolonged sleep
• Death shortly happens a few months
after the invasion of the central nervous system.

12. Medicines used to treat this disorder
include:
Eflornithine (for T. b. gambiense only)
Melarsoprol
Pentamidine (for T. b. gambiense only)
Suramin (Antrypol)
Some patients may receive combination
therapy
Treatment
Pentamidine injections protect against T.
b. gambiense. But not against T. b.
rhodesiense . Because this medicine is
toxic, using it for prevention is not
recommended.
Insect control measures can help prevent
the spread of sleeping sickness in high-
risk areas.
Prevention
Tsetse Fly Trap

13. 4- Ancylostoma duodenale & Necator americanus
(Hook worm)
A .
Duodenale
N.
Americanus

14. Pathogensis & Clinical Features
When filariform larva enters the skin, they
cause severe local itching
Erythematous papular rash may develop
Scratching and secondary bacterial infection
may follow
This condition is called Ground itch, occurs
when large number of larvae penetrate the
skin, more common with necator
Larvae sometimes cause creeping eruption-
more common in animal hookworms
When larvae enters the alveoli, they may
cause minute local haemorrhages.
Clinical pneumonitis develops only in
massive infections
Important manifestations of
ancylostomiasis is in the intestine
Worms attach to gut mucosa by their
buccal capsules
Suck a portion of intestinal villi, utilise gut
epithelial cells and plasma for their food
The worm sucks in blood, which passes
out undigested through its intestines
Adult ancylostome can suck about 0.2ml
blood and necator sucks 0.03ml per day
The worms frequently leave one site and
attaches to another site

15. In hookworm disease, intestinal
absorption of iron is normal so oral
administration of iron can correct anemia
Hookworm infection cause intestinal
syndrome resembling peptic ulcer- with
epigastric pain, dyspepsia and vomiting.
Reddish or black stool, diarrhoea may be
seen in acute stage
Anaemia leads to lassitude and dullness,
hypoprotenemia etc
Severe hookworm anemia leads to cardiac
failure

16. Treatment
• MEBENDAZOLE
• PYRANTEL PAMOATE
• THIABENDAZOLE is less effective
• BEPHENIUM HYDROXYNAPHTHOATE
is active against Ancylostoma but not
against Necator
The best way to avoid hookworm
infection is not to walk barefoot in areas
where hookworm is common and where
there may be human fecal contamination
of the soil. Also, avoid other skin contact
with such soil and avoid ingesting it.
Infection can also be prevented by not
defecating outdoors and by effective
sewage disposal systems.
Prevention & Control

17. 5- Schistosoma haematobium

18. Infection occurs when skin comes in contact with contaminated
freshwater in which certain types of snails that carry the parasite are
living. Freshwater becomes contaminated by Schistosoma eggs when
infected people urinate or defecate in the water. The eggs hatch, and if
the appropriate species of snails are present in the water, the parasites
infect, develop and multiply inside the snails. The parasite leaves the
snail and enters the water where it can survive for about 48
hours. Schistosomaparasites can penetrate the skin of persons who
come in contact with contaminated freshwater, typically when wading,
swimming, bathing, or washing. Over several weeks, the parasites
migrate through host tissue and develop into adult worms inside the
blood vessels of the body. Once mature, the worms mate and females
produce eggs. Some of these eggs travel to the bladder or intestine and
are passed into the urine or stool.
Symptoms of schistosomiasis are caused not by the worms themselves
but by the body’s reaction to the eggs. Eggs shed by the adult worms
that do not pass out of the body can become lodged in the intestine or
bladder, causing inflammation or scarring. Children who are repeatedly
infected can develop anemia, malnutrition, and learning difficulties.
After years of infection, the parasite can also damage the liver,
intestine, spleen, lungs, and bladder.
Clinical Picture

19. The drug of choice for treating all species of
schistosomes is praziquantel. Cure rates of 65-
90% have been described after a single
treatment with praziquantel. In individuals
not cured, the drug causes egg excretion to be
reduced by 90%.[55] Praziquantel affects the
membrane permeability of the parasite,
which causes vacuolation of the tegument. It
paralyses the worm and exposes it to attack
by the host immune system. However, as
praziquantel is ineffective on developing
schistosomula, it may not abort early
infection.
Treatment Prevention
• Avoid swimming or wading in
freshwater
• Drink safe water. Although
schistosomiasis is not transmitted
by swallowing contaminated
water, if your mouth or lips come
in contact with water containing
the parasites, you could become
infected.
• Water used for bathing should be
brought to a rolling boil for 1
minute to kill any cercariae

20. 6-Trichuris trichiura

21. Light infestations (<100 worms) are
frequently asymptomatic.
Heavy infestations may have bloody
diarrhea.
Long-standing blood loss may lead to iron-
deficiency anemia.
Rectal prolapse is possible in severe cases.
Vitamin A deficiency may also result due to
infection.
Mechanical damage to the mucosa may
occur as well as toxic or inflammatory
damage to the intestines of the host.
Finger clubbing
Clinical manifestations
Trichuris Egg

22. TREATMENT
Mebendazole (Vermox)
Causes worm death by selectively and
irreversibly blocking glucose uptake and
other nutrients in the susceptible adult
intestine where helminths dwell.
Administer a second course if patient is
not cured within 3-4 wk.
Albendazole (Albenza)
Decreases whipworm ATP production,
causing energy depletion,
immobilization, and death.
Avoid ingesting soil that
may be contaminated with
human feces
Wash your hands with
soap and warm water
before handling food.
Teach children the
importance of washing
hands to prevent infection.
Wash, peel, or cook all raw
vegetables and fruits
before eating
Prevention

23. THANK
YOU