ANTHELMINTICS

1. ANTHELMINTICS Presented by:- BhavanaZalavadiya ChiragPrajapati Dr.PoonamPatil KavitaVankore M.Sc. CRM (2009-11) (PRIST UNIVERSITY)

2. Contents • What are the Helminths? • Classification • Disease caused by them • Anthelmintic drugs • Anthelmintic herbs • Recent trials • School deworming programs • Surgeries

3. Helminths • Helminths (from the Greek Helmins, meaning worm). • Parasitic worms or helminths are a division of eukaryotic parasites that, unlike external parasites such as lice and fleas, live inside their host.They are worm-like organisms that live and feed off living hosts, receiving nourishment and protection while disrupting their hosts' nutrient absorption, causing weakness and disease.

4. It has been estimated that about Half of country’s population suffers from helminthiasis, and number is on increase. • It is not only limited to tropical & subtropical countries, but is also endemic in many regions because of poor sanitation, poor family hygiene, malnutrition, and crowded living condition.

5. Classification There are 3 classes of Helminths: • Nematodes (roundworms) • Trematodes (flukes) • Cestodes (tapeworms)

6. Causes • Low priority linked to poverty: unsafe water, poor sanitation, substandard housing, poor education. • Common in low income countries. Deaths Infections STDs excluding HIV STDs excluding HIV Diarrhoeal diseases Diarrhoeal diseases HIV/Aids HIV/Aids Childhood & vaccine preventable diseases Childhood & vaccine preventable diseases TB TB Other infectious and parasitic diseases Malaria Other infectious and parasitic diseases Malaria African trypanosomiasis, Chagas disease, schistosomiasis, leishmaniasis, lymphatic filariasis, onchocerciasis, leprosy, dengue, japanese encephalitis, trachoma, STH

7. DISEASES CAUSED BY HELMINTHS

9. ANTHELMINTIC DRUGS • Public health fights to reduce helminth infections in the US may be traced as far back as 1910, when the Rockefeller Foundation began the fight against hookworm – the so-called “germ of laziness” – in the American South • Are drugs used to eradicate parasitic worms from the human body. • Most anthelmintics in use today are active against specific parasites, and some are toxic. Hence,the worms must be identified before treatment is started,usualy by finding the ova, parasite or larvae in the faeces, urine, blood, sputum or tissue of the host.

10. ANTHELMINTHIC DRUGS • May act by causing : 1- paralysis of the worm. 2- damaging the worm leading to partial digestion or rejection by immune mechanisms. 3- interfere with the metabolism of the worm.

11. ANTHELMINTHIC DRUGS

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14. Anti-HelminthicAyurvedic Herbs: • These medicinal plants damage the worms in the intestine. They either cause the death of worms or make them unconscious. So some purgatives are used along with these herbs. • These are of two types. • Specific Antihelminthic Herbs: Some herbs act specifically on particular type of worm. e.g. Chauhar, Palashbeeja, Vidanga for pin worm; Pomegranate bark, Puga for thread worm. • General Antihelminthic Herbs: These herbs affect all the worms. These usually possess bitter, pungent and astringent taste and are with hot active principle

15. Contd … • GmelinaarboreaRoxb • Latex of Calotropisprocera: Latex possesses wormicidal activity and thus, may be useful as an anthelmintic. • Baliospermummontanum :Roots of B. montanum were evaluated for their anthelmintic activity against Pheretimaposthuma and Ascardiagalli as test worms. • Streblusasper Lour :Antifilarial • Cleome viscosa (wild mustard) • Garlic: It is also used as anthelminthic.

16. Preventive measures • The infective larvae develop and survive in an environment of damp dirt, particularly sandy and loamy soil. The main lines of precaution are those dictated by sanitary science: • Do not defecate in places other than latrines, toilets etc. • Deworm pet dogs — canine and feline hookworms rarely develop to adulthood in humans but their invasive larvae can cause an itchy rash called cutaneous larva migrans • Handwashing before food handling . • Avoiding ingestion of soil by thorough washing of food that may have been contaminated with egg-containing soil are other preventive measures. • Improvement of Sewage and Sanitation systems, as well as improved facilities for feces disposal

17. Recent trials • Efficacy of Vaccine Sh28GST in Association With Praziquantel (PZQ) for Prevention of Clinical Recurrences of SchistosomaHaematobium Pathology (Bilhvax) Sponsor: Institut National de la Santé Et de la RechercheMédicale, France • Phase 1 Trial of Na-ASP-2 Hookworm Vaccine in Previously Infected Brazilian Adults Sponsor: Albert B. Sabin Vaccine Institute • Antihelminthic Therapy Combined With Antimony in the Treatment of CutaneousLeishmaniasis Sponsor: Hospital Universitário Professor Edgard Santos

18. School deworming programs These programs have a number of advantages. On the one hand, they allow health policymakers to take advantage of existing infrastructure and institutions for the dispensation of medical treatment; students already plan to attend school on a somewhat regular basis, and teachers can easily distribute the medication to their students without receiving any medical training.

19. Surgeries • There are various surgeries to remove worms from the body like colonoscopy , heart surgery, brain surgery, etc. • See videos.