I

WHO 2006
Hookworm 2oo4 2oo5 zooS
(Ancylostoma A.lumbricoides A.lumbricoides A.lumbricoides
Trichuris
Ascaris duodenale & 2r,70/o n,5%o t7,80/o
trichiura
Iumbriciodes Necator
795 juta americanus) T.trichiura: t7,z%o T.trichiura: 20, zo/o T.trichiura: 24, zo/o
r miliar orang oran9
T4oj uta Hookworfft: 5,to/o HookworuTt: t,6o/o Hoolcworfft: t,oo/o
orang
Distri busi frekuensi kecacingan Cacing pita

yang ditularkan melalui tanah (Taenia saginata

dan Taenia
solium)

Cacing tambang
(Ancylostomo
duodenale dan
Necator
americanus)
Cacing gelang
caci ng (A lumbricoides)

Cacing kremi
(enterobius
vermikularis)

Ascaris lumbricoides Diqgnosis

Gejqlo Klinis
o Alhoriqsis Pemerihsqqn Feces
o lritqsi ohibot lorvq ' Metode Kqto-Kotz
o Pqru (loefler sindrom) '
.
Metote Kqto
o Gl ( muql, muntoh, Smeqr feces

sohit perut, diqre,

mqlqbsorbsi)
. Dopot menimbulhon
obstruhsi usus
Abendqzole
o Dosis 2oo mg (single dose)
Mebendqzole
o Dosis 5OO mg
o 2xlOO mg selqm 3 hqri
Pyrontel Pomoqt
. Dosis 10 mg/hgbb/hr (single
dose)

I Enterobiqsis relqtif tidqh berbohqyq

I Pruritus lohql€ lritosi di sehitqr qnus, perineum
dqn vqginq oleh cqcing betinq grovid yqng
bermigrosi he dqerqh qnus don vqginq.
Luhq gqruh di sehitor qnus podo wqhtu mqlqm
hqri hinggq penderitq tergqnggu tidurnyo dqn
menjqdi lemqh.
Cqcing dewosq mudo dopot bergerqh he usus
hqlus bqgiqn prohsimql sompoi he lqmbung,
t esofqgus dqn hidung sehinggq menyebqbhqn
o3o gqngguqn.
Apendisitis, sqlpingitis, endometriosis, vqginitis
 l;

Gejqlq Klinis don Diqgnosis f

I

7
I
{ I
J

menemuhon telur don cocing '{

ofot anol swabyqng ditempelhqn di sehitor \*
onus podo wqktu pogi hqri sebelum onoh
Diagnosis buong oir besor don mencuci pontot.
Grohom 's Scotch Adhesive Tope Technique
Cellulose Tope Technique

Mebendozole (1OO mg PO) diulong dolom 2

minggu. Dosis tunggol olbendozole (4oo mg PO
diulong dolom 2 minggu otou dosis tunggol
pirontel pomoote (ll mg/hgBB PO mohsimol t g
Pengobatan drug of choice).
I

Penggontion pohoion yong sering, boju tidur,

don seproi menurunhon hontqminosi telur don
menurunhon resiho terjodi outoinfehsi I
Cqcing tqmbong CAnqtlostomo ,

duodenaledqn Necotor americqnul

A
A ^6.
Geiqlq nehqtoriqsis dqn
qnhilostomiqsis
Stqdium lqrvq
Bilq bonyoh lqruq filqriform
sehqligut menembus hulit,
mqho teriqdi perubqhqn hulit
yqng disebut ground itch.
Stqdium dewqsq
Geiqlq tergqntung pqdq (q)
spesiel dqn jumlqh cqcing
dqn (b) heqdqqn gizi
penderitq (Fe dqn protein).
r Tiqp cqcing N.omericanus
menyebqbhqn hehilongqn
dorqh sebqnyqh o,oo5 - o,l cc
sehori, sedonghqn A.duodenale
O,OB - O,34 cc. Biqsonlrq teriodi
qnemiq hipohrom mihrositer. Di
sqmping itu iugq terdqpqt
eosinofiliq.
Mqculopopulor ledons u ground itch" or "deur
itch"ltching, edemo,
The lung, during lorvol migrqtion
Bronchftis
Pneumonltis
The smqll intestine, the hqbitqt of the odult
worrn
Abdominol poin,Steqtorrheo,Diqrrheq
qnd mucus
telur dolqm tiniq segqr.
r Direct fecol smeqr
o onlV for heqvy infectlons
o Kqto Technique
r Increqses detection rqte
o Kqto Kqtz Method
r Quorrtitqtive diognosls
r Zinc Sulfqte Centrifugqtion
o Formqlin Ether Concentrqtion
o Horodq-Mori
o Mebendqzole
r
(loo mg x 2 perorol selamo 3 hori)
Pirqntel pomocte (ttmg/hgBB seholi sehqri rdqmq 3 hqri, dosis mqkrimql I g)
o Terqpi preporct besi orql tidqh selolu dibutuhhqn untuh mengqtqsi defisiensi besi
with blood
 Anterior three-fifths long and
o Whipworm o

whip-like
Posterior two-fifths is thick
Soi I transmitted heminth
a
o and fleshy
o Inhabit the large intestine
o Often observed occuring a Inseil into the intestinal wall
of the cecum in a pin-fashion
together with Ascaris o Male
Iumbricoides due to similarities .
.
30-45 mm
Goiled posterior end
in transmission and mode of .
.
Single spicule
Retractile sheath
distribution Female
. 35-50 mm
o Holomyarian . Bluntly rounded posterior
end
o Somatic muscles are small and . Gan produce over 60
closely packed in narrow zones million ggs in an average
life span of 2 years

Ova Pathogenesis & Glinical

o Passed out
together with
Manifestations
feces trichuriasis
Embroyanation Petechial hemorrhages
in the soil (2-3 predisposing to amebic dysentery
weeks)
Protuberant Over 5,OOO eggs lg of stool:
bipolar mucus symptomatic
plugs Over 2O,OOO eggs/g : severe
Football in shape diarrhea or dysenteric syndrome
Diagnosis o Epidemiology
o Direct fecal
smear o Distributed in warm. Moist areas of
o Kato Thick
smear
the world
o Kato K.atz . 2oo/o - 30o/o prevalence in
o Goncentration temperate countries
Techniques o 600/o r 85"h in tropical countries
-ZnSOe
- Formalin o Ghildren 5 to {5 years of age are
Ether frequently infected
Trichuris trich
o Treatment
o Mebendazole
o Drug of choice
o 5OO mg single dose in light infections
o 2 - 3 days of consecutive treatment for
moderate and heany infections
o Gontraindicated during early pregnancy and in
hypersensitivity
o Albendazole
o 4OO mg single dose
o Gontraindicated during pregnancy
 Wuchereria bancrofti

o Pathogenesis
BLOOD and TISSUE o causes chronic
NEMATODES disfiguring
disease
presenting as
lymphedema,
elephantiasis,
hydrocoele

Wuchereria bancrofti Wuchereria bancrofti

Adults worms Microfilaria

il
o GreahVr white , o Appear as minute
long filariform in snake-like
shape organisms among
the red blood cells
Male 27O um -29O um
o 2-4cmin enclosed in a sheath
length that is longer than
the microfilaria
Female Gentral axis shows
o 8-{Ocmin dark-staning nuclei
length T
Wuchereria bancrofti Brugia malayi

Hm S g

o Adult worms
o Nlale
o 13 -23 mm
o Female
.43-55mm
o Indistinguishable
from adult female
W bancrofti

Brugia malayi
Wuchereria bancrofti Brugia malayi
o Microfilarta Mean length 290 um 222 um
o 177 -23O um Gephalic space: 1=1 2=1
o Enlosed in a breadth
Sheath in Giemsa unstained pink
sheath with
nuclei Regularly spaced; lrregularly spaced
angular separately situated and overlapping
curvatures and tail Single row that does Single row that
secondary kinks
o 2 terminal nuclei t Terminal nuclei
not reach the tailts
end
None
reaches the tailts end

2 nuclei
at the tip of the Appearance in blood Smoothly curved kinky
tail o film
I
 Wuchereria bancrofti
Brugia malayi Brugia malayi

f,losquito Stages
Epidemiology
o More than { billion people in over 8O countries are at
o::l:' risk
. Over 12O million peole are affected
/ o 43 million are seriously affected
. In the Philippines:
. Gamarines Norte
. Gamarines Sur
. Albay
. Sorsogon
. Mindoro
. Palawan
. Romblon
. Mountain Province
. All provincrs of Mindanao

Wuchereria bancrofti
ncrofti Brugia malayi

Diagnosis
Epidemiology . Microscopic finding of
characteristic
o Wuchereria bancrofti microfilariae in wet F
smears or thick blood
o Anopheles minimus van flavirostris . =-"ars
(principal vector for malaria) ; rural
o Gulex: urban ,l
to the peripheral
o ledes poecilus (abaca and banana
plants)
circulation
. Detection of circulating t
filarial antigens
o Brugia . Ultrasonography may
malayi demonstrate live worms
in the lymphatics
o Mansonia bonnae
Wuchereria bancrofti Wuchereria bancrofti
Brugia malayi Brugia malayi

Prevention an Gontrol o Treatment

. WHO has targeted elimination of o Diethylcarba mazine (DEG)
filariasis by 2O2O o Drug of choice
o DEG medicated table or cooking o 6 mg/kg body weight for 12 days

salt o Divided doses after meals

o Elimination of microfilariae in the o lvermectin

blood o 2OOto 4OO ug/kg body weight in a
o Personal protective measures single ral dose

Wuchereria bancrofti
Brugia malayi