H.nana

after i saw an eggs during sool examination then thinking to make powerpoint about

1. Hymenolepis nana by : Akram A. Ismael YÜZÜNCÜ YIL ÜNİVERSİTESİ

2. What is Hymenolepis nana is the most common human cestode , belongs to a large family known as Hymenolepididae . Hymenolepis nana previously known as vampiroleis nana. Hymenolepis nana  is the most common tapeworm in humans. It is also known as the dwarf tapeworm due to its particularly small size (nana meaning dwarf). Definitive host of H.nana includes human, mice and rats, It is the only cestode that does not require an intermediate host to develop into its infective stage, intermediate host some time optional ( various species of beetles and fleas may serve as intermediate hosts )

3. Geographical distribution Hymenolepis nana can be found throughout the world, but is usually most common in temperate zones . Hymenolepis nana can be found wherever humans and rodents live. They have been found in almost all types of terrestrial biomes It is most often seen in children in countries in which sanitation and hygiene are inadequate

4. Hymenolepiasis is the term when a human is infected with either H. diminuta or H. Nana Hymenolepis nana Hymenolepis diminuta

5. Morphology of H.nana Adult worm are only 10-45 mm long and 0.5-1 mm wide Neck is long and slender Whole H. nana adult worm with various stages of proglottid development stained for visibility

6. Morphology of H.nana Scolex is small, 0.3 mm in diameter, globular (rounded), cup-like. Scolex situated at the anterior end, has four suckers and retractile rostellum with a single row of 20–30 hooks. Genital pores are unilateral (side of the segment) Each mature segment contains three testes

7. Morphology of H.nana They have 100-200 segments that are wider then they are long Gravid (mature, full of eggs) proglottids are 0.2–0.3 mm long and 0.8–0.9 mm wide. Proglottid is filled with eggs, Each proglottid has both male and female reproductive organs making Hymenolepis nana hermaphroditic. A proglottid copulates with itself or with other segments of the same individual or nearby H.nana . Proglottids usually disintegrate in the gastrointestinal tract and are rarely present in the feces.

8. Morphology of H.nana H. nana egg is colourless , almost transparent, round to oval , 30–50 µm in diameter, has polar filaments. When shed in stool they are immediately infective and survive up to 10 days in the external environment, they are embryonated and have a 6-hooked oncospheres inside the shells. Shell consists of two distinct membranes. On inner membrane there are two small “knobs” or poles from which 4–8 filaments arise and spread out between the two membranes.

9. Morphology of H.nana

10. Life cycle of H.nana Eggs of the tapeworm H. nana are infective when passed with the stool, but cannot survive more than about 10 days outside the body.

11. Life cycle of H.nana When eggs are ingested (in contaminated food or water or from hands contaminated with feces), the oncospheres contained in the eggs are released.

12. Life cycle of H.nana The oncospheres penetrate the intestinal villi and develop into cysticercoid (encysted) larvae. Upon rupture of the villus, the cysticercoids return to the intestinal lumen, attach to the intestinal mucosa and develop into adults that reside in the ileal part of the small intestine and produce gravid proglottids .

13. Life cycle of H.nana Eggs, when released in the small intestine, are passed in the stool.

14. Life cycle of H.nana * An alternate mode of infection occurs, known as internal autoinfection, where the eggs release their oncospheres , which then penetrate the villi continuing the infective cycle without leaving the host's body.

15. Life cycle of H.nana The life span of adult worms is four to six weeks, but internal autoinfection can permit an infection to last for years.

16. How we get infection with H.nana and what is symptomes By accidentally ingesting tapeworm eggs. by ingesting fecally contaminated foods and water by touching your mouth with contaminated fingers by ingesting contaminated soil. Once you are infected, the dwarf tapeworm may cause auto infection where the tapeworm may reproduce inside the body and continue the infection . Symptoms are: -Those who have symptoms may experience nausea, weakness, loss of appetite, diarrhea, and abdominal pain . headache , itchy bottom, or have difficulty sleeping . - H . nana can be deadly in children or people with a weak immune system -Dehydration can result from prolonged diarrhea . - Sometimes infection is misdiagnosed as a pinworm infection .

17. Diagnosis - Examination of the stool for eggs confirms the diagnosis. - Seeing tapeworm in intestine. Image by Akram from yüzüncü yıl hastanesi

18. Treatment Treatment: Praziquantel , adults and children, 25mg/kg in a single-dose therapy. Alternatives : Niclosamide : adults, 2 gm in a single dose for 7 days; children 11-34 kg, 1 gm in a single dose on day then 500 mg per day orally for 6 days; children > 34 kg, 1.5 gm in a single dose on day then 1 gm per day orally for 6 days. Nitazoxanide : adults, 500 mg orally twice daily for 3 days; children aged 12-47 months, 100 mg orally twice daily for 3 days; children 4-11 years, 200 mg orally twice daily for 3 days. -Expect ful l recovery following treatment

19. Prevention -Good hygiene -Elimination of rats and mice -A well-balanced diet to promote resistance to infection -Public health and sanitation programs