MLS 412: MEDICAL PARASITOLOGY
AND ENTOMOLOGY
SCHISTOSOMIASIS
By
MLS B. I. Shuaib
Department of Medical Laboratory Science
Faculty of Applied Health Sciences
Edo State University, Uzairue Edo State
INTENDED LEARNING OUTCOMES
At the end of this class, students should be able to
• List the medically important species of Schistosomes and areas of
endemicity
• Describe the life cycle of schistosomes of medical importance
• List the symptoms and clinical features of schistosomissis
• Highlight methods for diagnosis and control of schistosomiasis
INTRODUCTION
• Schistosomiasis is also known as Bilharziasis
• Disease is caused by flatworms called Schistosomes
• Schistosomes may affect the intestine or urinary tract
• It is a water borne disease affecting millions in Asia, Africa
and Latin America
INTRODUCTION
Main species include
• Schistosoma japanicum invade the intestine (endemic in Asia)
• Schistosoma heamatobuim parasitize the urinary tract
(endemic in Africa, along Nike river in Egypt)
• Schistosoma mansoni invade the intestine and liver (endemic
in Africa)
Others are
• Schistosoma mekongi
• Schistosoma intacalatum
INTRODUCTION
• Disease is spread by contact with fresh water contaminated
with the parasite
• Children in developing countries are mostly at risk of
contracting disease
• Other high risk group include farmers, fishermen
• People with STD are also at risk
SPECIAL FEATURES OF
SCHISTOSOMES
EGGS OF SCHISTOSOMES
SCHISTOSOMES (MALE AND FEMALE)
LIFE CYCLE
• Host defecates or urinates into water bodies releasing ova
• Ova hatches into miraciduim when in contact with water
• Miraciduim swims and infect tissue of intermediate host (snail)
• These divide by asexual means giving rise to sporocyts
• Upon full maturation, sporocytes are released from snails as
cercaria
CERCARIA
LIFE CYCLE CON’T……….
• Free moving cercaria infects host when he comes in contact
with water
• In the host they shed their biforked tails and become
schistosomula
• These migrate through venous circulation to liver, heart
• They mature in the liver, and exit it through the portal vein
LIFE CYCLE CON’T……….
• Male and female worms copulate with female becoming gravid
inhabiting varied locations depending on species
• S japanicum and S. mansoni invades the superior and inferoir
mesentric veins draining into the small and large intestines
respectively
• S heamatobuim invades the venus plexus of the bladder
• Eggs are eliminated through the feaces or urine depending on the
specie
• In the bladder, the eggs causes inflammation
LIFE CYCLE CON’T……….
• Host responds through delayed hypersensitivity reaction to
destroy eggs
• Resolution of inflammation leads to scar formation and blood
loss
LIFE CYCLE
HOSTS
• Host for S. japanicum include cattle, dogs, cats, rodents, pigs, horses, and
goats,
• Dogs are hosts for S. mekongi.
• Intermediate Hosts for Schistosomes
• S. mansoni - Snails of the genus Biomphalaria
• S. japonicum - Snails of the genus Oncomelania
• S. haematobium, S. intercalatum, S. guineensis. - Snails of the genus Bulinus
• S. mekongi - Neotricula aperta is intermediate host
CLINICAL FEATURES OF
SCHISTOSOMIASIS
SCHISTOSOMES
CLINICAL PRESENTATIONS
• Katayama fever or snail fever (associated with S. japanicum)
• Cercariae dermatitis (Swimmers itch)
• Lymphadenopathy
• Splenomegaly
• Heamaturia usually microscopic, but can be macroscopic in
severe infection)
• Hyperplasia and inflammation of bladder
• Carcinoma of the bladder in severe cases
• Intestinal bilazhiariasis (dysentary)
• Abdominal pain
DIAGNOSIS
• Finding parasite eggs in urine or stool by microscopy
• Concentration method helps to detect eggs
• S. heamatobuim egg has a terminal spine similar to S.
intacalatum egg
• S hematobuim differs from S. intacalatum in that it is negative
with Zeihl Nelson stain
S . HEAMATOBUIM
S. MANSONI
S. JAPANICUM
DIAGNOSIS
• Rectal Biosy
• Serological diagnosis: Detecting schistosamal antigens and
antibodies
• Imaging: Useful in detecting hepato-spleenomegaly
DIAGNOSIS
CONTROL AND PREVENTION
• Prompt diagnosis and treatment of infected people
• Provision of safe water to reduce exposure
• Health education
• Control of intermediate host
SNAIL CONTROL (MOLLUSCIDE SPRAY)
THANKS FOR LISTENING
