Protozoa and the Illnesses They Cause

Protozoa are single-celled organisms classified as eukaryotes (organisms whose cells have a defined nucleus). Other eukaryotes include:

• Humans
• Other animals
• Plants
• Algae
• Helminths (parasitic worms)
• Fungi

Protozoa are everywhere. They can live independently as free-living organisms in the environment, often in the soil, water, or moss. They can also be resting cysts, which lets them survive through dry times.

In addition, some protozoa are parasites. Others live in symbiosis with other organisms, relying on the other for survival.

This article explains the role of protozoa in infectious disease and how protozoan diseases are treated.

What Are Protozoa?

Protozoa are broken down into different classes:

• Sporozoa (intracellular parasites)
• Flagellates (with tail-like structures that flap around to move them)
• Amoeba (which move using temporary cell body projections called pseudopods)
• Ciliates (which move by beating multiple hair-like structures called cilia)

Infections caused by protozoa can spread through ingesting cysts (the dormant life stage), sexual transmission, or through insect vectors (insects that transmit diseases through bites or stings).

Protozoa cause some common and some uncommon infections. Some of these infections cause illness in millions of people each year; other diseases are rare.

Protozoan Diseases

Common infectious diseases caused by protozoans include:

• Malaria
• Giardia
• Toxoplasmosis

These infections arise in very different parts of the body. For example, malaria infections start in the blood, giardia begins in the gut, and toxoplasmosis can infect lymph nodes, the eye, and the brain.

Less common protozoan diseases include African trypanosomiasis and amoebic dysentery.

African Trypanosomiasis

African trypanosomiasis, also called "sleeping sickness," is caused by Trypanosoma brucei gambiense (98% of cases) and Trypanosoma brucei rhodesiense (2%). Tsetse fly bites spread both.

The flies that spread sleeping sickness live in at least 36 countries. The disease causes serious neurologic effects, and the treatment is complex. In poorer, resource-limited areas, it's hard to identify and treat.

Most cases occur in the Democratic Republic of the Congo, where people are working to reduce the spread of the disease and its burden—and possibly even drive these protozoa into extinction.

Amoebic Dysentery

Amoebic dysentery is due to Entamoeba histolytica, which causes diarrhea and gastrointestinal upset. It can also travel through the walls of the intestines and go into the bloodstream and other organs, like the liver, where it can create liver abscesses.

Detecting Infections

Unlike other pathogens, cultures do not identify protozoa. However, sometimes you can see them under a microscope inside red blood cells (as in malaria) or in the stool (as in giardia and E. histolytica).

In addition, rapid blood tests for antibodies or antigens and PCR tests can detect their genetic material.

Toxoplasmosis

Healthcare providers can identify toxoplasmosis in several different ways depending on where it's causing an infection, including:

• Antibody blood tests
• PCR tests
• Special stains of tissue
• Direct isolation of the pathogen

Giardia

Giardia can be found through a stool antigen test and by looking at stool under a microscope. It may take multiple stool samples (maybe three) to diagnose this.

Entamoeba Histolytica 

E. histolytica can also be identified from stool samples. It may also be identified under a microscope, through a PCR test, antigen test, or an antibody test of the blood.

Human African Trypanosomiasis

Diagnosing human African trypanosomiasis involves blood tests, fluid tests, or a biopsy from a lymph node (or a chancre wound). 

Trypanosoma Brucei Rhodesiense

T. b. rhodesiense parasites can usually be found in the blood of infected people. 

Trypanosoma Brucei Gambiense

T. b. gambiense has a lower burden of protozoa in the blood, so blood microscopy is usually unable to identify it. However, microscopic examination of a lymph node biopsy is more likely to identify the infection. 

Treatment

Treatment options depend on what protozoa are infecting you. Some are a lot more successful than others.

For example, malaria is a common illness worldwide that has straightforward treatment. However, the treatment depends on the type of malaria (Plasmodium falciparum, Plasmodium knowlesi, Plasmodium malariae, Plasmodium ovale, and Plasmodium vivax).

Treatment also depends on whether the protozoa are drug-resistant. P. falciparum especially has grown resistant to some essential drugs over the last few decades.

Summary

Protozoa are single-celled organisms that can sometimes cause diseases. Common protozoan diseases include malaria, giardia, and toxoplasmosis. Diagnosing protozoan illness may involve blood tests, stool tests, or biopsies, depending on which protozoa a healthcare provider suspects. Treatment varies based on the cause.