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Summary Parasitology

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A snapshot of the summary - Parasitology

  • 1 Lectures

  • 1.1 Introduction

  • What are facultative and obligate hosts?
    Fucultative is when the parasite may exist in an free living stage, ibligate is when the parasite cannot survive without its host.
  • 1.2 Diagnostic challenges

  • How do protozoa replicate?
    Through schizogony/sporogony or binary fission
  • What does ASSURED stand for?
    Affordaple, sensitive, specific, user-friendly, rapid&robust, equipment free, deliverable
  • What are limitations of ASSURED?
    It is focused on test& treat and remote areas, but in other settings other requirements may be as important (eg reproducibitity for research, counting for helminths, large throughput)
  • What are cons of microscopy?
    Less sensitive (3 samples of 3 days), species distinction may be difficult, time consuming, requires training, observer dependent, multiple procedures with one sample
  • How can entamoeba histolytica, giardia lamblia and cryptosporidium parvum be diagnosed? And what are the pro's and cons?
    1. Microscopy
    Pro: available, affordable, mostly specific
    Con: more samples, staining procedures

    2. Antibody detection
    Pro: fast, sensitive
    Con: invasive

    3. Antigen detection (like pregnancy test)
    Pro: fast, sensitive, less training required, reproducible
    Con: Only crypto+giardia, relatively expensive, miss other parasites

    4. PCR, NAAT
    Pro: fast, sensitive, specific, multiplex, high throughput, quality control options, reproducible
    Con: need molecular set-up laboratory
  • How can malaria be diagnosed and what are pros and cons?
    1. Microscopy (thick smear with lysed blood, thin smear with fixed and stained blood)
    + Sensitive (thick), species differentiation (thin), quantification, fast

    - detection limit, observer&procedure dependent, not fast enough, labourous

    2. Antibody detection (serology)
    - it takes time to develop antibodies so you might be dead

    3. Antigen detection (RDT's used in many areas, fingerprick stick)
    + fast, species differentiation for vivax and falciparum, no training, sensitive when high parasite loed, widely available, inexpensive
    - less sensitive for non-falciparum, no counting, deletions in target antigen reported

    4 PCR
    + sensitive, specific, quantify, large throughput
    - costly, not so fast, availability (now changing)
  • How is schistosoma diagnosed and what are pros and cons?
    1. Microscopy (reference test, look at eggs as other half stuck in tissue, kato-kats to look at intensity eggs per mg/ml)
    + specific, quantification, available, affordable
    - low sensitivity, fluctuation of egg secretion

    2. Serology/antibodies (chronic so you stay positive)
    + specific, sensitive, no cross-reactivity with other helminths
    - no intensity of infection, not for evaluation of treatment


    3. Antigen detection 
    + non-invasive
    - POC-CCA only mansoni and 20 mins reading, UCP-LF CAA laboratory based
  • What are 3 requirements for a new diagnostic tool for schistosoma?
    1. Highly field applicable and user friendly
    2. Highly sensitive: case detection for monitoring intervention
    3. Detecting active infection (worm load)
  • What are CCA and CAA?
    These are circulating antigens excreted from the parasite gut. They can be found in blood and urine and they are unique for schistosoma.
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