TAPEWORM OR CESTODES
BY SR.REGINA MULENGA
TAPEWORM OR CESTODES
• Is the infection of the digestive tract by adult
parasitic flatworms called cestodes or
tapeworms.
• Live tapeworm larvae (coenuri) are sometimes
ingested by consuming undercooked food.
• Once inside the digestive tract, a larva can
grow into a very large adult tapeworm.
Definition
• Additionally, many Tapeworm larvae cause
symptoms in an intermediate host.
• For example, cysticercosis is a disease of humans
involving larval tapeworms in the human body.
Occurrence
• Most occurrences are found in
areas which lack adequate
sanitation and include South-east
Asia and East Africa.
Mode of transmission
• Ingestion of eggs - Tapeworm eggs are
generally ingested through food, water or soil
contaminated with human or animal (host)
faeces.
• For example, if a pig is infected with a
tapeworm, it may pass eggs or segments
(proglottids) of the adult tapeworm through
its faeces into soil.
Mode of transmission cont.
• Ingestion of larvae cysts in meat or muscle
tissue - Tapeworm infection can also be caused
by eating raw or undercooked meat from an
animal or a fish that has the larval form of the
tapeworm cysts in its muscle tissue.
• Once ingested, the larvae then develop into
adult tapeworms in the intestines.
• Adult tapeworms can measure up to 50 feet
(15 m) long and can survive as long as 20 years.
Types of cestodes
• Among the most common tapeworms in humans
are
• Pork tapeworm (Tinea solium),
• Beef tapeworm (Tinea saginata) = can grow up to
(12m); other species may grow to over (30m)
• Fish Tape worm (Diphylobothrium latum)
• Infections involving beef and pork tapeworms are
also called taeniasis.
Anatomy of cestodes
• Scolex ("head") attaches to the intestine of
the definitive host.
• In some species, the scolex is dominated by
bothria (tentacles), which are sometimes
called "sucking grooves", and function like
suction cups.
• Once docked to the host intestinal wall, the
tape worm begins to grow a long tail.
Scolex
Anatomy cont: Proglottids
• The body is composed of successive segments (proglottids).
• The sum of the proglottids is called a strobila, which is thin,
and resembles a strip of tape.
• From this is derived the common name "tapeworm".
• Like some other flatworms, cestodes use flame cells
(protonephridia), located in the proglottids, for excretion.
Mature proglottids are released from the tapeworm's
posterior end and leave the host in faeces.
• Because each proglottid contains the male and female
reproductive structures, they can reproduce independently.
Life cycle.
• The life cycle of tapeworms is simple in the
sense that there are no asexual phases.
• Many tapeworms have a two-phase life cycle
with two types of host.
• The adult Taenia saginata lives in the gut of a
primate such as a human.
• Proglottids leave the body through the anus
and fall onto the ground, where they may be
eaten with grass by animals such as cows.
Life cycle cont.
• In the cow's body, the juvenile form migrates and
establishes as a cyst in body tissues such as
muscles, rather than the gut.
• They cause more damage to this host than the
intestinal form to its host.
• The parasite completes its life cycle when the
grass-eater is eaten by a compatible carnivore—
possibly a human with a preference for raw meat—
in whose gut the adult Taenia establishes itself.
Clinical manifestations
• Some people experience upper abdominal
discomfort, diarrhoea, and loss of appetite.
• Pallor may develop in people with tapeworm.
• Infection is generally recognized when the
infected person passes segments of proglottids
in the stool (looks like white worms), especially
if a segment is moving.
Clinical manifestations cont.
• Rarely, worms may cause obstruction of the
intestine.
• And very rarely, T. solium larvae can migrate to
the brain causing severe headaches, seizures
and other neurological problems.
• This condition is called neurocysticercosis.
• It can take years of development before the
patient has those symptoms of the brain.
Diagnosis
• Stool for routine microscopy, eggs
can be identified.
• History of passing segments.
• Skull x-ray, will demonstrate
calcification in cysticercosis.
Treatment
• Tapeworms are treated with medications taken by
mouth, usually in a single dose.
• The drug of choice for tapeworm infections is
niclosamide.
• Praziquantel and albendazole can also be used.
Preventive measures
• Use of latrines by communities.
• Adequately cooking of meat.
• Discourage usage of night soil.
• De-worm cows and freezing meat at -20oc for 12
hours.
• Meat inspection.
