Peter Chiodini^1
1UK Health Security Agency (UKHSA) Malaria Reference Laboratory

Echinococcosis and taeniasis/cysticercosis are both neglected tropical diseases.  Whilst cysticercosis has received increased attention in the last two decades, especially with respect to therapeutics, drug treatment for cystic echinococcosis has hardly changed since the early 1980s when albendazole and praziquantel became available.  At the same time, with the advent of improved cross-sectional imaging, alveolar echinococcosis is increasingly recognised and its geographical range has extended westwards in Europe. This lecture focuses on these medically important cestodes, the challenges they pose and the prospects for their elimination.

Richard S. Bradbury¹

¹School of Public Health and Tropical Medicine, James Cook University, Townsville, QLD

Nematodes, or roundworms, are among the most common infections of humans in tropical regions of the world. It is estimated that between an estimated 642 million and 1.5 billion people are infected with Soil transmitted helminths alone. Most Pathologists are aware of the epidemiology, clinical significance, diagnosis and treatment of the common nematode infections, including giant roundworms, whipworms, hookworms, threadworms, and pinworms. 

However, recent advances in molecular epidemiology have identified several previously overlooked nematodes of humans in the tropics. Furthermore, previously “exotic” infections have been recognised as far more common than previously understood. This talk will discuss several such recent findings, including human infections with dog and gorilla hookworms, a widespread and multi-drug resistant species of whipworm in Africa, the expanding range and importance of Strongyloides fuelleborni infections in Africa and Asia and new understandings of Strongyloides fuelleborni in the Pacific. 

Despite their ubiquity as a cause of human infection, there are still many new things to be discovered and understood about the nematode infecting humans. This presentation will summarise the recent discoveries and advances in this field and will update attendees on the implications for our understanding of both the epidemiology, clinical presentation, diagnosis, and treatment of tropical nematode infections.

David Blair^1
1College of Science and Engineering, James Cook University, Australia

Trematodes are parasitic flatworms. All have a life cycle involving at least two hosts, one of them always being a mollusc. Humans are the definitive hosts for some species. Multiplication of adult worms does not occur within the human host: eggs must pass out of the body to the environment for the life cycle to continue.  There are two principal routes by which humans can be infected. Direct skin penetration by cercariae in freshwater allows schistosomes to enter the body. These worms mature in blood vessels of the intestine or bladder wall. Schistosomes that normally infect birds sometimes penetrate human skin but do not mature: this is “swimmers’ itch”.  The second route of infection is by ingestion of food containing infective metacercariae. These mature in different sites depending on species: liver (Fasciola, Opisthorchis and others with metacercariae on vegetation or in fish); lungs (with ectopic infections in other organs, Paragonimus species with metacercariae in freshwater crabs/crayfish); digestive tract (echinostomes, Fasciolopsis and others, with metacercaria on aquatic vegetation or various invertebrates). For an update on pathogenesis, see Chai and Jung. Pathogenesis of Trematode Infections (Blood, Liver and Lung Flukes). Molecular Medical Microbiology, 2024, 2965–3001.