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Taeniasis

Professor à Regency Institute of Nursing
29 Jan 2021
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Taeniasis

  1. TAENIASIS Mrs. Namita Batra Guin Associate Professor Dept. of Community Health Nursing
  2. • Zoonotic disease • Two parasites: T. solium and T. saginata. • Classified as cyclo-zoonoses. • T. saginata – highly endemic in south of Sahara, Eastern mediterranean and parts of USSR. India comes under moderate prevalence. • T.solium- endemic in many countries of Latin America, Africa and Asia. Endemic in India.
  3. Epidemiological determinants • T.saginata and T.solium pass their life cycle in 2 hosts. • Adult parasites lives in man’s small intestine. Larval stage of T. saginata is found in cattles while that of T.solium in pigs. • Can lead to muscular, ocular and cerebral cysticercosis.
  4. Epidemiological determinants • Mode of transmission: – Through ingestion of larvae in undercooked beef. – Through ingestion of food, water and vegetables contaminated with eggs. – Reinfection by transport of eggs from bowel to stomach. (very rare) Incubation period: 8 to 14 weeks
  5. Clinical features • Vast cases they do not lead to clinical illhealth. • Abdominal discomfort, anorexia and chronic ingestion. • May occasionally cause appendicitis or cholangitis. • Most serious risk of T. solium infection is cysticercosis.
  6. HUMAN CYSTICERCOSIS • Human infection is caused by the ingestion of eggs. • The eggs disintegrate and infective stages leave the intestine via hepatic portal system and are dispersed throughout the body. • Cysticerci that develop in nervous system is a serious threat to individual and community. • Variety of pathological changes lead to epilepsy, intracranial hypertensive syndrome, psychiatric diseases and death
  7. Control measures • Treatment of infected persons. • Meat inspection • Health education • Adequate sewage treatment and disposal • Surgical removal of symptom producing cysts • Hand washing • Improvement of living conditions. • Treatment of sewage used for farming
  8. TREATMENT • Praziquantel – 10mg/kg body wt. cure rate is 99%. Minimal side effects. • Niclosamide- single dose of 4 tablets i.e. 2gm. Given empty stomach in morning. • Give moderate purgative 2-3hrs to eliminate segments and eggs from bowels to avoid possibility of cyticercosis. (in case of T.solium)
  9. TREATMENT FOR CYSTICERCOSIS • Should be individualized. Based on no. of cysts. • Albendazole and praziquantel. • 400mg albendazole twice daily with fatty meal. • Duration of treatment may vary. • Can be repeated. • Praziquantel – thrice daily 50mg/kg/day for 15days.
  10. HYDATID DISEASE
  11. • Zoonoses- group of cestodes infections • Disease is caused by metacystode stage (infective larva) of canine intestinal tapeworm Echinococcus. • Adult worms are found in dogs and other carnovores. • Found in sheep raising countries- Australia, New –zealand etc. • Highest prevalence is seen in India in Andhra Pradesh and Tamil Nadu.
  12. EPIDEMIOLOGICAL DETERMINANTS • Agent factors: echinococcus species. No. of proglottids varies from 2 to 6 . • E. granulosus: maintained in domestic cycle. • E.multilocularis: restricted to Northern hemisphere. • E.oligarthus: occurring in Central and South America and suspected to cause disease in man. • E. vogeli: causes polycystic hydatidosis
  13. LIFE CYCLE • Adult tapeworm lives in intestine of dogs for 2 to 4 yrs. • Eggs are voided in feces which contaminate soil and drinking water. • Sheep,goats, cattles get infected after feeding on infected vegetations. • Eggs hatch in intestine and larvae penetrate intestinal lining and migrate to other organs • They lodge themselves into liver, lungs and brain and develop into hydatid cysts
  14. LIFE CYCLE • Cycle is completed when dog ingest the hydatid cysts. • Dogs began to pass eggs in 7 weeks after the ingestion. • Man doesn’t harbor the adult worm.
  15. MODE OF TRANSMISSION • By ingestion of eggs of Echinococcus with food vegetables or water contaminated with feces of infected dogs. • Infection may occur while playing or handling with dog. • By inhalation of the dusts contaminated by the infected eggs. • Disease is not transmissible from person to person.
  16. CLINICAL FEATURES Incubation period varies from months to years depending upon number and location of cysts. • Cysts grow slowly from 5 to 20 years before they are diagnosed. • Cysts are filled with watery fluid and contain large number of tapeworm heads. • Cysts of smaller size are generally asymptomatic. • Large cysts causes pressure symptoms (jaundice in liver cysts). • In vital organs they may cause sever symptoms and death
  17. CLINICAL FEATURES • It has been estimated that 70% of the cysts become located in the right lobe of the liver, and rest in lungs, brain, peritoneum, long bones and kidney.
  18. DIAGNOSIS • Clinical : based on history of residence in endemic area. Close association with dogs • X-ray: location of the cyst is confirmed • Serological test: ELISA, immunofluoroscent test. • Intradermal (Casoni) test is still widely used because of its simplicity to perform. But this often lacks specificity.
  19. Treatment • No specific treatment, except surgical removal of cysts. • Mebendazole can also be given. Tests are still on.
  20. Treatment • Preventing dogs from gaining access to raw meat at slaughter houses- proper meat inspection and destruction of infected viscera. • Control of Dogs: elimination of stray dogs, dog registration system, surveillance of dogs based on periodic stool examination. • Single dose of praziquantel -5mg/kg will remove adult worms from dogs. • Health education: particularly to butchers, dog owners, animal breeders and shepherds etc.
  21. THANK YOU
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