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ប្រភេទសត្វល្អិតក្នុងខ្លួនមនុស្ស

 


សត្វល្អិតក្នុងពោះវៀនប្រភេទ Fasciolopsis Buski ឬ ហៅម្យ៉ាងទៀតថា "សត្វល្អិតយក្ស"

 
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Fasciolopsis Buski - Intestinal Flukes

 


សត្វល្អិតក្នុងសួត

 
សត្វល្អិតក្នុងសួត (Paragoninus Westermani) ឆ្លងច្រើននៅអាស៊ីអាគ្នេយ៍ ដោយសារចូលចិត្តអាហារសមុទ្រឆៅ ក្តាម មឹក រឺ ត្រីឆៅដែលមានផ្ទុកមេរោគ Paragoninus Westermani។ មនុស្សអាចផ្ទុកវា ២០ ឆ្នាំ។
ចំណាំ៖ ទោះបីជាពេលខ្លះយើងចំអិនបានឆ្អិនល្អ ក៏នៅតែអាចឆ្លង បើចុងភៅ រឺ អ្នករៀបចំអាហារ ប្រឡូក ប៉ូកប៉ាកជាមួយនឹង ចាន ស្លាបព្រា កាំបិត ជ្រុញ រឺ តុរៀបចំអាហារក្នុងផ្ទះបាយ។ ៨០% នៃក្តាមទឹកសាបនៅអាស៊ីមានផ្ទុក Paragoninus Westermani វដ្តនៃការឆ្លងសត្វល្អិតក្នុងសួត (Paragoninus Westermani)
  • ព្រូនខ្លះរុកពីពោះវៀនតូចទៅដល់ខួរក្បាល រឺ សរីរាង្គផ្សេងៗទៀត។
    ប៉ុន្តែក្នុងខួរក្បាលសត្វល្អិត មិនលូតលាស់ កើតកូនកើតចៅទេ។
    បើរុកទៅខួរឆ្អឹងខ្នង មនុស្សអាចពិការ។
    បើរុកទៅបេះដូង មនុស្សអាចស្លាប់។
  • សត្វល្អិតក្នុងសួតៈ អាចបណ្តាលឲ្យឈឺ និងក្អកខ្លាំង អាចមានឈាម រឺក្តៅខ្លួន។
    វិធីរុករកៈ
    ពិនិត្យកំហាក និងលាមករុករកពងសត្វល្អិត។
    អាចធ្វើថតសួត។
    វិធីព្យាបាលៈ
    ប្រើថ្នាំ
 
 

Paragonimus Westermani - Lung Fluke

Human lung fluke, Paragonimus westermani, infects 22 million people in Africa, Asia and South and Central America. Southeast Asia in particular is affected because raw seafood is very popular there. Humans get infected with the disease, paragonimiasis, by eating raw crabs or fish that are carrying the parasite. Even properly cooked sushi can cause infection, if the cook or waiter is careless when preparing the food. In Asia about 80 % of freshwater crabs are infected with the lung fluke.

Life cycle of a lung fluke begins, when the female lays eggs that are carried out from the human lungs in the sputum by the motion of microvilli. Then the eggs are taken through the gastrointestinal tract and out of the body. If the feces get in contact with water, then after two weeks larvae called miracidia hatch and start to grow. A miracidium finds a snail and penetrates its skin. In 3–5 months miracidium develops further and produces another larval form called cercaria. The cercaria crawls out of the snail to find fresh water crayfish (a lobster-like creature) or crabs. It finds its way to the muscles of the crab and starts forming a cyst. Within two months it transforms into metacercaria which is the resting form of cercaria. If a human eats this infected crab raw, the metacercaria cyst gets into the stomach. Once inside the beginning of the small intestine, duodenum, the metacercaria excysts and penetrates the intestinal wall. It continues through abdominal wall and diaphragm into the lungs where it forms a capsule and develops into an adult. Male and female lung worms reproduce and the cycle starts again.

Sometimes lung fluke larvae accidentally travel to the brain or other organs and reproduce there. But because the secretion of the eggs from the brain is blocked the life cycle will not happen. If the worm goes to the spinal cord instead of the lungs, the host might become paralyzed. If it infects the heart, the host could die.

Lung flukes cause pain and severe coughing (there might be some blood, too). Paragonimiasis diagnosis is done by looking at sputum (slime from the lungs), to see if there are any lung fluke eggs. Feces can be examined, too. Alternatively X-rays and biopsies can be taken. Paragonimiasis is usually treated with a drug called praziquantel.

Salting food does not kill the parasite, cooking and freezing will. After ingestion it takes about three months for the lung fluke to start laying eggs. The host might stay infected up to 20 years.

Paragonimus westermani life cycle

Paragonimus westermani body parts 

adult lung flukeParagonimus westermani (adult) Paragonimus westermani egg (egg)

Adult lung flukes are 4–6 mm wide, 3–5 mm thick and 7–12 mm long. They are red-brown looking almost like a coffee bean. They hold on to tissue with two suckers. The oral sucker is in the front and just before the center of its lower body is the ventral sucker.

In addition to humans, Paragonimus westermani infects other carnivores such as felids (cats etc.), canids (dogs etc.), rodents (rats etc.), weasels and pigs.

 


 

Fasciola Hepatica - Liver Fluke


 

 


 

Schistosoma - Blood Flukes

 
 

Wuchereria Bancrofti - Lymphatic Filariasis - Elephantiasis

 

Lymphatic filariasis is a parasitic disease caused by thread-like worms called Wuchereria bancrofti. The parasite is carried from person to person by mosquitoes. 120 million people are infected in subtropical and tropical Asia (mostly in India), Africa, the Pacific and the Americas (mostly in Brazil, Haiti, Guyana and the Dominican Republic). Lymphatic filariasis is the leading cause of permanent disability worldwide. Out of the 120 million more than 30 % are severely incapacitated by the disease. Over one billion people in over 80 countries are at risk of getting infected.

The life cycle of Wuchereria bancrofti starts, when a male and a female mate inside lymphatic vessels of an infected human. The female releases thousands of microfilariae (prelarval eggs) into the bloodstream. When the host is awake, the microfilariae tend to stay in deep blood vessels. During the sleep they travel near the surface in peripheral blood vessels. This behaviour enables them to get ingested by the night biting mosquito. When ingested by the mosquito, the microfilariae migrate through the wall of the proventriculus and cardiac portion of the midgut eventually reaching the thoracic muscles. Within 1–2 weeks they mature into first-stage larvae and eventually into infective third-stage larvae which migrate through the hemocoel to the mosquito's prosbocis. When the mosquito bites another person, the larvae are injected into the human skin. They migrate to the lymph vessels and mature into adults within six months. Adult females can live up to seven years.

Wuchereria bancrofti life cycle

Repeated mosquito bites during several months are usually needed to develop lymphatic filariasis. In some cases lymphedema (swollen tissue caused by obstruction of the lymph fluid) may develop within six months and elephantiasis within a year. Citizens of tropical and subtropical areas have the biggest risk whereas tourists have a very low risk.

Wuchereria bancrofti infection is usually asymptomatic. Some people can develop lymphedema, swelling, which is prevalent in the legs, but sometimes also in the arms, genitalia and breasts. The swelling and decreased flow of the lymph fluid will expose the body to skin and lymph system infections. Over time the disease causes thickening and hardening of the skin, a condition called elephantiasis which can be fatal. Filarial infection might also cause pulmonary tropical eosinophilia syndrome, which is mostly found in patients living in Asia. Pulmonary tropical eosinophilia syndrome can cause: cough, shortness of breath, and wheezing. In addition to eosinophilia there might be high levels of IgE (Immunoglobulin E) and antifilarial antibodies.

Diagnosis for lymphatic filariasis is traditionally done from a blood sample by microscopic examination. The sample has to be taken during the night to ensure the microfilariae are present in the bloodstream. The blood can also be studied to check for the presence of antibodies (antifilarial IgG4) that the human body develops to fight against antigens excreted by adult female Wuchereria bancrofti worms. A new method of a highly sensitive "card test" has been developed to detect antigens without laboratory equipment using finger-prick blood droplets taken anytime of the day. Molecular diagnosis by polymerase chain reaction (PCR) is possible, too.

Treatment for infected patients is usually done using a drug called diethylcarbamazine (DEC). The medicine kills the microfilariae in the bloodstream and sometimes adult worms in the lymph vessels. It has some side effects which include: dizziness, fever, headache, nausea and muscle and joint pain. DEC should only be used, if Wuchereria bancrofti has been identified. This is because most people with lymphedema are not infected with parasites. DEC can worsen Onchocerciasis (an eye disease caused byOnchocerca volvulus) and can cause encephalopathy (brain disease) and death in people who are infected with Loa loa. Another drug, ivermectin, can also be used, although it only kills microfilariae. In some cases lymphedema can be prevented from getting worse by exercising the swollen leg or arm to improve the lymph flow. The swollen skin is vulnerable to bacterial infections because immune defences cannot work properly due to the impaired flow of fluids. That is why the skin must be kept clean.

According to some new studies Wolbachia bacteria are in symbiosis with Wuchereria bancrofti. The bacteria live inside the worm. If the bacteria are killed with antibiotics,Wuchereria bancrofti dies, too.

To prevent new infections, avoid infective mosquitoes between dusk and dawn (the time when they mostly feed). A mosquito net can be applied all around your bed. Mosquito repellent applied on your skin or the use of long trousers and sleeves might keep the mosquitoes away. Mass treatments are given to whole communities in some endemic countries. Programs to eliminate lymphatic filariasis in more than forty countries are decreasing the risk of infection.

An Adult female Wuchereria bancrofti is about 80–100 mm long and 0.24–0.30 mm in diameter, whereas a male is about 40 mm long and 0.1 mm in diameter.

 

A microfilaria is about 240–300 µm (micrometers) long and 7.5–10 µm thick. It is sheathed and has nocturnal periodicity, except the South Pacific microfilaria which does not have marked periodicity. It has a gently curved body, and a tail that is tapered to a point. The nuclear column (the cells that constitute its body) is loosely packed. The cells can be seen individually under a microscope and do not extend to the tip of the tail.

mosquitoA mosquito is the intermediate host and carrier. The most common   vectors/carriers are:

  • in Africa: Anopheles species
  • in the Americas: Culex quinquefasciatus
  • in the Pacific and in Asia: Mansonia and Aedesspecies.

Also check out the Wuchereria bancrofti pictures and videos.

Wuchereria bancrofti Quiz

To reveal the answer you need to click the correct option.

What is the life cycle route inside mosquitoes?

+ A) L1 larva --> L3 larva
+ B) L1 larva --> L3 larva --> Microfilaria
+ C) Microfilaria --> L1 larva --> L3 larva

What is the life cycle route inside humans?

+ A) L3 larva --> Adult --> Microfilaria
+ B) L1 larva --> L3 larva --> Adult --> Microfilaria
+ C) Microfilaria --> L1 larva --> L3 larva --> Adult --> Microfilaria

What is elephantiasis characterized by?

+ A) Thickening and hardening of the skin
+ B) Increased body size due to masses of worms all over the body, especially in the nose
+ C) Eosinophilia, heart failure and breathing difficulty

What causes elephantiasis?

+ A) Decrease of blood flow due to worms inside blood vessels
+ B) Blockage of lymph fluid due to worms inside lymph vessels
+ C) Masses of microfilaria in skin tissue

 

សត្វល្អិតក្នុងពោះវៀនប្រភេទ Giardia

គេហៅឈ្មោះវាបាន ៣ យ៉ាងៈ

  • Giardia intestinalis
  • Giardia lamblia
  • Giardia duodenalis
វាជាសត្វល្អិតដែលមានកោសិកាតែមួយ មានព្រុយ បណ្តាលឲ្យរលាកពោះវៀនតូច (វាបង្ករជំងឺឈ្មោះ Giardia )។ វាភ្ជាប់ខ្លួនវានឹងកោសិកាពោះវៀនតូច ហើយស្រូបយកអាហាររបស់យើង។ វាអាចឆ្លងទៅ បក្សី, គោ, ក្របី, ចៀម, ឆ្កែឆ្មា វារស់នៅពេញពិភពលោកភាគច្រើន ប្រទេសមានអាកាសធាតុក្តៅ និង មិនមានអនាម័យ។ វាអាចឆ្លងតាមរយៈការរួមភេទតាមរន្ធគូថ រឺ តាមមាត់។ ពេលឆ្លងពងគីស Giardia មនុស្ស 50% មិនមានរោគសញ្ញាទេ។ ប៉ុន្តែជាទូទៅ មានរោគសញ្ញាដូចតទៅៈ
  • ហើមពោះ
  • ក្លិនដង្ហើមស្អុយ ភោមស្អុយខ្លាំង
  • ខ្វះជាតិទឹក
  • រាគ
  • អស់កំលាំង
  • មិនឃ្លានអាហារ
  • ចង់ក្អួត
  • ឈឺពោះ រឺ ចុកពោះ
  • ខ្សោយកំលាំង
  • ស្រកទំងន់
  • ក្មេងមិនធំលូតលាស់ល្អ
  • មិនមានកំលាំង
  • មិនចង់ញុំាអាហារ
  • មិនចង់រៀន
  • រៀនមិនចាំ
Giardia intestinalis

ជំងឺរាគរូសអាចបណ្តាលឲ្យស្លាប់ បើយើងមិនញុំាទឹកគ្រប់គ្រាន់ ខ្វះជាតិអំបិល និង ស្ករ។ បាត់បង់វីតាមីន B12 ដោយមិនដឹងខ្លួន ព្រោះវីតាមីន B12 មិនអាចជ្រាបបានដោយសារមេ Giardia ធ្វើឲ្យខូច រឺ រលាកកោសិកាពោះវៀនតូច។ មេ Giardia intestinalis មានរូបរាងដូចផ្លែសារី និងមានប្រវែង 10-20mm ព្រុយច្រើន មានរាងជាស៊ីមេទ្រី និងមានបន្ទះសំរាប់ភ្ជាប់ស្រូបយកអាហារ ពងវាមានរាងពងក្រពើប្រវែង 8-19mm។ ពងមិនទាន់ករកូនមាន ស្នូល2 រឺឯពងដែលករកូនអាចឆ្លងបានស្នូល mature 4។

វិធីរុករកៈ   - យកលាមកមកពិនិត្យមើលក្នុងមីក្រូទស្សន៍ រកពងគីសរបស់វា។ ពេលខ្លះចាំបាច់យកលាមក ៣ដងមកពិនិត្យ ព្រោះពេលខ្លះមិនមាន ពងគីស រឺ មេ Giardia ក្នុងលាមក
វិធីព្យាបាលៈ        - Metronidazole     -  Nitazoxanide    - Tinidazole   - Paromomycin   - Quinacrine   - Furazolidone
- ក្រោយពេលព្យាបាលរួចគួរផ្សំបំពេញ វីតាមីន B12
- ត្រូវពិគ្រោះយោបល់ជាមួយ វេជ្ជបណ្ឌិតឲ្យបានត្រឹមត្រូវ!

Giardia Intestinalis

Giardia intestinalis (also known as Giardia lamblia or Giardia duodenalis) is a protozoan flagellate causing giardiasis in the small intestine. It attaches to the mucosa and absorbs nutrients that it gets from the intestinal wall. In addition to humans, Giardia intestinalis infects birds, cows, sheep, deer, dogs and cats. Giardiasis is found worldwide mostly in warm climates.

Giardia intestinalis lives as active trophozoites in the small intestine. Some trophozoites encyst into cysts which are released in a bowel movement. The feces might contaminate soil, water, food or surfaces such as bathroom sinks. The cyst has a protective shell and it can survive in the environment for many weeks (in cold water many months). You become infected after accidentally swallowing the microscopic cysts. Each cyst releases two trophozoites in the small intestine. They remain in the lumen where they can feed freely or attached to the mucosa by a ventral sucking disk. After eating enough, they go through another transformation and multiply by binary fission. The trophozoites encyst as they move towards the colon. Cysts are found more often in firm stool whereas both trophozoites and cysts are present in loose stool. Because the cysts become infective almost instantly after being passed out, the disease can be transmitted during anal-oral-sexual intercourse.

Giardia intestinalis life cycle

Common giardiasis symptoms include:

  • bloating
  • bad breath and farts
  • dehydration
  • diarrhea or greasy floating stools
  • fatigue
  • loss of appetite
  • nausea
  • stomach ache
  • weakness
  • weight loss.

Diarrhea can be fatal, if you do not drink enough water with salt and glucose. Another not so recognizable effect is the lack of B12-vitamin. This is due to the impaired absorption (malabsorption) in the damaged intestinal wall. 50 % of giardiasis cases are asymptomatic. Symptoms begin usually within two weeks after becoming infected. In healthy individuals the sickness normally persists up to three weeks, but sometimes longer.

Giardia intestinalis

Giardia intestinalis trophozoites are pear-shaped and 10–20 µm long. Other characteristics include: flagella, median bodies, sucking disks and two big nuclei. Giardia intestinalis cysts are oval to ellipsoid and 8–19 µm long. Immature cysts have two nuclei, whereas mature cysts have four.

Your health care provider makes the giardiasis diagnosis by examining stool samples under a microscope. Common microscopical techniques include: wet mount with iodine, trichrome or immunofluorescent antibody staining and/or enzyme immunoassays. Several stool samples are usually needed on different days because cysts and trophozoites are not always present in the feces. Trophozoites can also be found from duodenal fluid or from biopsies taken during endoscopy.

Giardiasis treatment is accomplished with antimicrobial drugs such as: metronidazole, nitazoxanide (good for treating children), tinidazole, paromomycin, quinacrine and furazolidone.

 


Entamoeba Histolytica - Amoebiasis

Entamoeba histolytica is a protozoan parasite responsible for a disease called amoebiasis. It occurs usually in the large intestine and causes internal inflammation as its name suggests (histo = tissue, lytic = destroying). 50 million people are infected worldwide, mostly in tropical countries in areas of poor sanitation. In industrialized countries most of the infected patients are immigrants, institutionalized people and those who have recently visited developing countries.

Inside humans Entamoeba histolytica lives and multiplies as a trophozoite. Trophozoites are oblong and about 15–20 µm in length. In order to infect other humans they encyst and exit the body. The life cycle of Entamoeba histolytica does not require any intermediate host. Mature cysts (spherical, 12–15 µm in diameter) are passed in the feces of an infected human. Another human can get infected by ingesting them in fecally contaminated water, food or hands. If the cysts survive the acidic stomach, they transform back into trophozoites in the small intestine. Trophozoites migrate to the large intestine where they live and multiply by binary fission. Both cysts and trophozoites are sometimes present in the feces. Cysts are usually found in firm stool, whereas trophozoites are found in loose stool. Only cysts can survive longer periods (up to many weeks outside the host) and infect other humans. If trophozoites are ingested, they are killed by the gastric acid of the stomach. Occasionally trophozoites might be transmitted during sexual intercourse.

Entamoeba histolytica life cycle

Most Entamoeba histolytica infections are asymptomatic and trophozoites remain in the intestinal lumen feeding on surrounding nutrients. About 10–20 % of the infections develop into amoebiasis which causes 70 000 deaths each year. Minor infections(luminal amoebiasis) can cause symptoms that include:

  • gas (flatulence)
  • intermittent constipation
  • loose stools
  • stomach ache
  • stomach cramping.

Severe infections inflame the mucosa of the large intestine causing amoebic dysentery. The parasites can also penetrate the intestinal wall and travel to organs such as the liver via bloodstream causing extraintestinal amoebiasis. Symptoms of these more severe infections include:

  • anemia
  • appendicitis (inflammation of the appendix)
  • bloody diarrhea
  • fatigue
  • fever
  • gas (flatulence)
  • genital and skin lesions
  • intermittent constipation
  • liver abscesses (can lead to death, if not treated)
  • malnutrition
  • painful defecation (passage of the stool)
  • peritonitis (inflammation of the peritoneum which is the thin membrane that lines the abdominal wall)
  • pleuropulmonary abscesses
  • stomach ache
  • stomach cramping
  • toxic megacolon (dilated colon)
  • weight loss.

To prevent spreading the infection to others, one should take care of personal hygiene. Always wash your hands with soap and water after using the toilet and before eating or preparing food. Amoebiasis is common in developing countries. Some good practices, when visiting areas of poor sanitation:

  • Wash your hands often.
  • Avoid eating raw food.
  • Avoid eating raw vegetables or fruit that you did not wash and peel yourself.
  • Avoid consuming milk or other dairy products that have not been pasteurized.
  • Drink only bottled or boiled water or carbonated (bubbly) drinks in cans or bottles.

Natural water can be made safe by filtering it through an "absolute 1 micron or less" filter and dissolving iodine tablets in the filtered water. "Absolute 1 micron" filters are found in outdoor/camping supply stores. Micron = micrometer = 0.001 mm.

Amoebiasis is diagnosed by your health care provider under a microscope by finding cysts and (rarely trophozoites) from a stool sample. The results are usually said to be negative, if Entamoeba histolytica is not found in three different stool samples. But it still does not necessarily mean that you are not infected because the microscopic parasite is hard to find and it might not be present the particular samples. A blood test might also be available but is only recommended, if your health care provider believes that the infection could have spread to other parts of the body. Trophozoites can be identified under a microscope from biopsy samples taken during colonoscopy or surgery.

Entamoeba histolytica should be differentiated from the non-pathogenic Entamoeba dispar. The two are morphologically identical and differentiation must be based on immunologic or isoenzymatic analysis or molecular methods. They can be distinguished under a microscope, if Entamoeba histolytica has ingested red blood cells. Entamoeba dispar is about 10 times more common. If either one is found, then you are usually treated.

If you are experiencing amoebiasis symptoms, you are treated with two antibiotics. The preferred drugs are metronidazole or tinidazole immediately followed with paromomycin, diloxanide furoate or iodoquinol. Asymptomatic intestinal amoebiasis is treated with paromomycin, diloxanide furoate or iodoquinol.

cysttrophozoites which have ingested red blood cellsentamoeba histolytica trophozoite 


 



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