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Saijuntha W, Sithithaworn P, Wangboon C, Andrews RH, Petney TN. Liver Flukes: Clonorchis and Opisthorchis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1454:239-284. [PMID: 39008268 DOI: 10.1007/978-3-031-60121-7_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Clonorchis sinensis, Opisthorchis viverrini and O. felineus are liver flukes of human and animal pathogens occurring across much of Europe and Asia. Nevertheless, they are often underestimated compared to other, better known neglected diseases in spite of the fact that many millions of people are infected and hundreds of millions are at risk. This is possibly because of the chronic nature of the infection and disease and that it takes several decades prior to a life-threatening pathology to develop. Several studies in the past decade have provided more information on the molecular biology of the liver flukes which clearly lead to better understanding of parasite biology, systematics and population genetics. Clonorchiasis and opisthorchiasis are characterized by a chronic infection that induces hepatobiliary inflammation, especially periductal fibrosis, which can be detected by ultrasonography. These chronic inflammations eventually lead to cholangiocarcinoma (CCA), a usually fatal bile duct cancer that develops in some infected individuals. In Thailand alone, opisthorchiasis-associated CCA kills up to 20,000 people every year and is therefore of substantial public health importance. Its socioeconomic impacts on impoverished families and communities are considerable. To reduce hepatobiliary morbidity and CCA, the primary intervention measures focus on control and elimination of the liver fluke. Accurate diagnosis of liver fluke infections in both human and other mammalian, snail and fish intermediate hosts is important for achieving these goals. While the short-term goal of liver fluke control can be achieved by praziquantel chemotherapy, a comprehensive health education package targeting school children is believed to be more beneficial for a long-term goal/solution. It is recommended that transdisciplinary research or multisectoral control approach including one health and/or eco health intervention strategy should be applied to combat the liver flukes and hence contribute to reduction of CCA in endemic areas.
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Affiliation(s)
| | - Paiboon Sithithaworn
- Department of Parasitology and Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
| | - Chompunoot Wangboon
- School of Preclinical Sciences, Institute of Science, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Ross H Andrews
- CASCAP, Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Trevor N Petney
- CASCAP, Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Paleontology and Evolution, State Museum of Natural History, Karlsruhe, Germany
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2
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Esteban JG, Muñoz-Antolí C, Toledo R, Ash LR. Diagnosis of Human Trematode Infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1454:541-582. [PMID: 39008275 DOI: 10.1007/978-3-031-60121-7_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Digenetic trematodes form a major group of human parasites, affecting a large number of humans, especially in endemic foci. Over 100 species have been reported infecting humans, including blood, lung, liver and intestinal parasites. Traditionally, trematode infections have been diagnosed by parasitological methods based on the detection and the identification of eggs in different clinical samples. However, this is complicated due to the morphological similarity between eggs of different trematode species and other factors such as lack of sensitivity or ectopic locations of the parasites. Moreover, the problem is currently aggravated by migratory flows, international travel, international trade of foods and changes in alimentary habits. Although efforts have been made for the development of immunological and molecular techniques, the detection of eggs through parasitological techniques remains as the gold standard for the diagnosis of trematodiases. In the present chapter, we review the current status of knowledge on diagnostic techniques used when examining feces, urine, and sputum and also analyze the most relevant characteristics used to identify eggs with a quick key for the identification of eggs.
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Affiliation(s)
- J Guillermo Esteban
- Área de Parasitología, Departamento de Farmacia, Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain.
| | - Carla Muñoz-Antolí
- Área de Parasitología, Departamento de Farmacia, Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain
| | - Rafael Toledo
- Área de Parasitología, Departamento de Farmacia, Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain
| | - Lawrence R Ash
- Infectious & Tropical Diseases, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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Wang YC, Law A, Namsanor J, Sithithaworn P. Examining ecosystem (dis-)services on liver fluke infection in rural Northeast Thailand. Infect Dis Poverty 2023; 12:38. [PMID: 37076937 PMCID: PMC10114451 DOI: 10.1186/s40249-023-01079-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/09/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND The direct reliance of humans on and their interactions with freshwater ecosystems in the Lower Mekong Basin have given rise to parasitic infections, which is particularly prevalent in Northeast Thailand where raw fish consumption is practiced. This study examined the interactions between environments, ecosystem (dis-)services, human raw fish consumption habits, and raw fish dish sharing on liver fluke infection risk. METHOD Water fecal contents and the first intermediate snail host were sampled between June and September of 2019. One hundred twenty questionnaires were surveyed in two villages of different environmental surroundings, one next to a river and the other located inland, in Northeast Thailand. Multivariate regression analyses using linear mixed effect models assessed the influence of social, behavioral and perceptual factors on raw fish consumption frequency, willingness to avoid consumption and liver fluke infection status. Social network analysis compared the degree of raw fish dish sharing between the villages and assessed the probable influence of connections to fish procurement locations and sharing activities on liver fluke infection risk. RESULTS High abundance of the first intermediate snail host and presence of fecal contamination in water could endanger both villages to ecosystem disservices of parasitic transmission. The river-side village relied more on provisioning ecosystem services than the inland village (29.7% vs. 16.1% of villages) to consume raw fish as their main source of protein. Males in both villages (64.5 and 40.4 days/year for the respective villages) are also likely to consume koi pla and pla som, higher risk fish dishes, more frequently than females (4.1 and 4.3 days/year for the respective villages). The consumption habits of both villages were driven mostly by deriving cultural ecosystem services. Participation in raw fish dish sharing activities significantly reduced the odds of an individual being willing to avoid the consumption (Odds ratio = 0.19). Network analysis suggested that river-side villagers had a more direct raw fish dish sharing interaction and they procured fish from multiple locations; these characteristics might potentially account for more liver fluke infected households in the village. CONCLUSION Villagers' raw fish consumption is driven by deriving cultural ecosystem services, and the geographic settings of the villages potentially affect villagers' fish procurement locations and infection risk. The findings underscore the linkages between villagers and their surrounding ecosystem environments as pertinent determinants for foodborne parasitic disease risk.
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Affiliation(s)
- Yi-Chen Wang
- Department of Geography, National University of Singapore, 1 Arts link, Block AS2, 117568, Singapore, Singapore.
| | - Andrea Law
- Department of Geography, National University of Singapore, 1 Arts link, Block AS2, 117568, Singapore, Singapore
| | - Jutamas Namsanor
- Department of Geography, National University of Singapore, 1 Arts link, Block AS2, 117568, Singapore, Singapore
| | - Paiboon Sithithaworn
- Department of Parasitology and Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, 123 Mittraphap Rd, Mueang Khon Kaen District, 40002, Khon Kaen, Thailand
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Crellen T, Haswell M, Sithithaworn P, Sayasone S, Odermatt P, Lamberton PHL, Spencer SEF, Déirdre Hollingsworth T. Diagnosis of helminths depends on worm fecundity and the distribution of parasites within hosts. Proc Biol Sci 2023; 290:20222204. [PMID: 36651047 PMCID: PMC9845982 DOI: 10.1098/rspb.2022.2204] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/16/2022] [Indexed: 01/19/2023] Open
Abstract
Helminth transmission and morbidity are dependent on the number of mature parasites within a host; however, observing adult worms is impossible for many natural infections. An outstanding challenge is therefore relating routine diagnostics, such as faecal egg counts, to the underlying worm burden. This relationship is complicated by density-dependent fecundity (egg output per worm reduces due to crowding at high burdens) and the skewed distribution of parasites (majority of helminths aggregated in a small fraction of hosts). We address these questions for the carcinogenic liver fluke Opisthorchis viverrini, which infects approximately 10 million people across Southeast Asia, by analysing five epidemiological surveys (n = 641) where adult flukes were recovered. Using a mechanistic model, we show that parasite fecundity varies between populations, with surveys from Thailand and Laos demonstrating distinct patterns of egg output and density-dependence. As the probability of observing faecal eggs increases with the number of mature parasites within a host, we quantify diagnostic sensitivity as a function of the worm burden and find that greater than 50% of cases are misdiagnosed as false negative in communities close to elimination. Finally, we demonstrate that the relationship between observed prevalence from routine diagnostics and true prevalence is nonlinear and strongly influenced by parasite aggregation.
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Affiliation(s)
- Thomas Crellen
- School of Biodiversity One Health and Veterinary Medicine, Graham Kerr Building, University of Glasgow, 82 Hillhead Street, Glasgow G12 8QQ, UK
- Wellcome Centre for Integrative Parasitology, Sir Graeme Davies Building, University of Glasgow, 120 University Place, Glasgow G12 8TA, UK
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7LF, UK
| | - Melissa Haswell
- Office of the Deputy Vice Chancellor, Indigenous Strategy and Services and School of Geosciences, John Woolley Building, University of Sydney, Sydney, New South Wales 2050, Australia
- School of Public Health and Social Work, Kelvin Grove Campus, Queensland University of Technology, Brisbane City, Queensland 4000, Australia
| | - Paiboon Sithithaworn
- Department of Parasitology, Khon Kaen University, 123 Thanon Mittraphap, Khon Kaen 40002, Thailand
| | - Somphou Sayasone
- Lao Tropical and Public Health Institute, Samsenthai Road, Sisattanak district, Vientiane, Lao PDR
| | - Peter Odermatt
- Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil 4123, Switzerland
- University of Basel, Petersplatz 1, Basel 4001, Switzerland
| | - Poppy H. L. Lamberton
- School of Biodiversity One Health and Veterinary Medicine, Graham Kerr Building, University of Glasgow, 82 Hillhead Street, Glasgow G12 8QQ, UK
- Wellcome Centre for Integrative Parasitology, Sir Graeme Davies Building, University of Glasgow, 120 University Place, Glasgow G12 8TA, UK
| | | | - T. Déirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7LF, UK
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Khuntikeo N, Thinkhamrop B, Crellen T, Eamudomkarn C, Petney TN, Andrews RH, Sithithaworn P. Epidemiology and Control of Opisthorchis viverrini Infection: Implications for Cholangiocarcinoma Prevention. Recent Results Cancer Res 2023; 219:27-52. [PMID: 37660330 DOI: 10.1007/978-3-031-35166-2_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
It is known that Opisthorchis viverrini (OV) is the most significant risk factor for the development of cholangiocarcinoma (CCA); hence, it is also known as carcinogenic parasite. Effective control and elimination of OV infection should significantly reduce O. viverrini-related CCA. This chapter includes details of the three recently developed innovative tools, namely the Isan cohort database software, an OV-RDT for screening of O. viverrini, and an ultrasound telecommunication system. Past and current control programs, i.e., education, medication, and sanitation were discussed and stressed the need for a comprehensive control program which encompasses primary, secondary, and tertiary patient care programs for confirmation and management of suspected CCA cases. The approach of mathematical modeling for control of OV and CCA was also briefly described. Additionally, we highlighted the current progress toward control of OV and CCA in Thailand and potential for expansion into nearby countries in Southeast Asia.
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Affiliation(s)
- Narong Khuntikeo
- Department of Surgery, Faculty of Medicine, Khon Kaen University and Cholangiocarcinoma Research Institute, Khon Kaen, Thailand
| | - Bandit Thinkhamrop
- Faculty of Public Health, Khon Kaen University and Cholangiocarcinoma Research Institute, Khon Kaen, Thailand
| | - Thomas Crellen
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, G12 8QQ, Glasgow, United Kingdom
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, OX3 7LF, London, UK
| | - Chatanun Eamudomkarn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Trevor N Petney
- Evolution and Paleontology, State Museum of Natural History Karlsruhe, Erbprinzenstrasse 13, 76133, Karlsruhe, Germany
| | - Ross H Andrews
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, UK
| | - Paiboon Sithithaworn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University and Cholangiocarcinoma Research Institute, Khon Kaen, Thailand.
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6
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Abbas I, Al-Araby M, Elmishmishy B, El-Alfy ES. Gastrointestinal parasites of cats in Egypt: high prevalence high zoonotic risk. BMC Vet Res 2022; 18:420. [PMID: 36447265 PMCID: PMC9706847 DOI: 10.1186/s12917-022-03520-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/16/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Several gastrointestinal parasites that infect cats pose potential health threats for humans and animals. The present study is the first to report gastrointestinal (GIT) parasites in feces of stray cats from Gharbia governorate, Egypt. Findings were combined with those published in the earlier surveys from various Egyptian governorates, and various meta-analyses were conducted to underline the parasitic zoonoses from cats in Egypt. RESULTS Out of 143 samples tested in Gharbia, 75 (52.4%) were found infected with 13 different parasites. Co-infections were observed in 49.3% of positives. Several parasites were detected, e.g., Toxocara cati (30.0%), Toxascaris leonina (22.4%), hookworms (8.4%), taeniids (4.2%), Strongyloides spp. (2.1%), Physaloptera spp. (2.1%), Alaria spp. (1.4%) and Dipylidium caninum (0.7%). Opisthorchis-like eggs were found in a single sample being the first report from cats in Africa. Oocysts of 4 coccidian parasites were identified, and a few Toxoplasma gondii-like oocysts were detected in 2 samples (1.4%). Results of the meta-analysis illustrated that occurrence of T. gondii oocysts in feces of cats from Egypt may have been overestimated in earlier studies; 1432 cats have been tested and displayed a 5 times higher pooled prevalence (11.9%) than the published global pooled prevalence for T. gondii oocysts in cats. This overestimation might have occurred because some small-sized oocysts that belong to other coccidian parasites were mis-identified as T. gondii. Toxocara cati had a high pooled prevalence (22.5%) in cats from Egypt, which is even greater than the published pooled prevalence in cats globally; however, several reports from Egypt have neglected the role of T. cati in human toxocarosis. Dipylidium caninum displayed also a high prevalence (26.7%). CONCLUSION Several zoonotic parasite species have been found in stray cats from Egypt, raising concerns about the risks to the Egyptian human population as well as environmental contamination. Prompt surveillance supervised by the government and accompanied by data dissemination will be helpful for developing effective control strategies.
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Affiliation(s)
- Ibrahim Abbas
- grid.10251.370000000103426662Parasitology Department, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516 Egypt
| | - Moustafa Al-Araby
- grid.10251.370000000103426662Parasitology Department, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516 Egypt
| | - Bassem Elmishmishy
- grid.10251.370000000103426662Parasitology Department, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516 Egypt
| | - El-Sayed El-Alfy
- grid.10251.370000000103426662Parasitology Department, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516 Egypt
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7
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Esteban JG, Muñoz-Antoli C, Toledo R, Ash LR. Diagnosis of Human Trematode Infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1154:437-471. [PMID: 31297770 DOI: 10.1007/978-3-030-18616-6_14] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Digenetic trematodes form a major group of human parasites, affecting a large number of humans, especially in endemic foci. Over 100 species have been reported infecting humans, including blood, lung, liver, and intestinal parasites. Traditionally, trematode infections have been diagnosed by parasitological methods based on the detection and the identification of eggs in different clinical samples. However, this is complicated due to the morphological similarity between eggs of different trematode species and other factors such as lack of sensitivity or ectopic locations of the parasites. Moreover, the problem is currently aggravated by migratory flows, international travel, international trade of foods, and changes in alimentary habits. Although efforts have been made for the development of immunological and molecular techniques, the detection of eggs through parasitological techniques remains as the gold standard for the diagnosis of trematodiases. In this chapter, we review the current status of knowledge on diagnostic techniques used when examining feces, urine, and sputum and also analyze the most relevant characteristics used to identify eggs with a quick key for the identification of eggs.
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Affiliation(s)
- J Guillermo Esteban
- Área de Parasitología, Departamento de Farmacia y Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain.
| | - Carla Muñoz-Antoli
- Área de Parasitología, Departamento de Farmacia y Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
| | - Rafael Toledo
- Área de Parasitología, Departamento de Farmacia y Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
| | - Lawrence R Ash
- Infectious and Tropical Diseases, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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8
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Khieu V, Fürst T, Miyamoto K, Yong TS, Chai JY, Huy R, Muth S, Odermatt P. Is Opisthorchis viverrini Emerging in Cambodia? ADVANCES IN PARASITOLOGY 2019; 103:31-73. [PMID: 30878058 DOI: 10.1016/bs.apar.2019.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Opisthorchis viverrini infection is widely prevalent in Southeast Asia. In Cambodia information on this helminth infection is scare. Recent reports suggest that O. viverrini is an emerging public health problem. We aimed to synthesize all information in relation to the infection, epidemiology, and morbidity of O. viverrini in Cambodia; from published as well as thus far unpublished sources. First reports on O. viverrini date back to 1995. In 2006 an O. viverrini initiative was launched by the national helminth control program. Since then O. viverrini has been reported in all - except two - provinces. Villages with high prevalences (>20%) were found in provinces from Preah Vihear to Takeo. The infection has a highly focal distribution. In many villages no infections were detected. O. viverrini infection was also reported in cats, dogs and intermediate hosts. No report on morbidity associated with O. viverrini was found. The current evidence suggests that O. viverrini infection remains underreported in Cambodia. It is likely that the transmission will further increase in the future with potentially serious consequences for human health.
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Affiliation(s)
- Virak Khieu
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | - Thomas Fürst
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; School of Public Health, Imperial College London, London, United Kingdom
| | - Kazuko Miyamoto
- School of Nursing, Faculty of Medicine & Center for International Education and Exchange, Yamanashi University, Yamanashi, Japan
| | - Tai-Soon Yong
- Department of Environmental Biology, Institute of Tropical Medicine, and Arthropods of Medical Importance Resource Bank, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong-Yil Chai
- Institute of Parasitic Diseases, Korea Association of Health Promotion, Seoul, Republic of Korea; Department of Parasitology and Tropical Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Rekol Huy
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | - Sinuon Muth
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | - Peter Odermatt
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
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9
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Saijuntha W, Sithithaworn P, Kiatsopit N, Andrews RH, Petney TN. Liver Flukes: Clonorchis and Opisthorchis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1154:139-180. [PMID: 31297762 DOI: 10.1007/978-3-030-18616-6_6] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Clonorchis sinensis, Opisthorchis viverrini, and O. felineus are liver flukes of human and animal pathogens occurring across much of Europe and Asia. Nevertheless, they are often underestimated compared to other, better known neglected diseases in spite of the fact that many millions of people are infected and hundreds of millions are at risk. This is possibly because of the chronic nature of the infection and disease and that it takes several decades prior to a life-threatening pathology to develop. Several studies in the past decade have provided more information on the molecular biology of the liver flukes which clearly lead to better understanding of parasite biology, systematics, and population genetics. Clonorchiasis and opisthorchiasis are characterized by a chronic infection that induces hepatobiliary inflammation, especially periductal fibrosis, which can be detected by ultrasonography. These chronic inflammations eventually lead to cholangiocarcinoma (CCA), a usually fatal bile duct cancer that develops in some infected individuals. In Thailand alone, opisthorchiasis-associated CCA kills up to 20,000 people every year and is therefore of substantial public health importance. Its socioeconomic impacts on impoverished families and communities are considerable. To reduce hepatobiliary morbidity and CCA, the primary intervention measures focus on control and elimination of the liver fluke. Accurate diagnosis of liver fluke infections in both human and other mammalian, snail and fish intermediate hosts, are important for achieving these goals. While the short-term goal of liver fluke control can be achieved by praziquantel chemotherapy, a comprehensive health education package targeting school children is believed to be more beneficial for a long-term goal/solution. It is recommended that a transdisciplinary research or multisectoral control approach including one health and/or eco health intervention strategy should be applied to combat the liver flukes, and hence contribute to reduction of cholangiocarcinoma in endemic areas.
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Affiliation(s)
- Weerachai Saijuntha
- Walai Rukhavej Botanical Research Institute, Mahasarakham University, Maha Sarakham, Thailand
| | - Paiboon Sithithaworn
- Department of Parasitology, Faculty of Medicine, Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.
| | - Nadda Kiatsopit
- Department of Parasitology, Faculty of Medicine, Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
| | - Ross H Andrews
- CASCAP, Faculty of Medicine, Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.,Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Trevor N Petney
- CASCAP, Faculty of Medicine, Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.,Department of Paleontology and Evolution, State Museum of Natural History, Karlsruhe, Germany
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10
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Khuntikeo N, Titapun A, Loilome W, Yongvanit P, Thinkhamrop B, Chamadol N, Boonmars T, Nethanomsak T, Andrews RH, Petney TN, Sithithaworn P. Current Perspectives on Opisthorchiasis Control and Cholangiocarcinoma Detection in Southeast Asia. Front Med (Lausanne) 2018; 5:117. [PMID: 29765958 PMCID: PMC5938629 DOI: 10.3389/fmed.2018.00117] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 04/06/2018] [Indexed: 02/06/2023] Open
Abstract
Similar to bile duct cancer or cholangiocarcinoma (CCA) in the western world, opisthorchiasis-associated CCA in Southeast Asia is an aggressive cancer with high mortality rates. It is known to cause a significant health burden in the opisthorchiasis region in Thailand and possibly throughout mainland Southeast. To reduce this health burden, a comprehensive prevention and control program for opisthorchiasis, as well as CCA, is required. In this review, our aim is to provide a brief update of the current situation regarding the natural history of opisthorchiasis and health burden of CCA in Southeast Asia. A comprehensive approach to tackling these issues being implemented in Thailand under the “Cholangiocarcinoma Screening and Care Program” is described. This comprehensive program consists of a three stage prevention and patient care program. The primary prevention component involves opisthorchiasis screening using a new and sensitive urine assay. The secondary prevention component involves screening for CCA and periductal fibrosis, with suspected CCA patients following the protocol for confirmation and appropriate treatment. Due to the eco-epidemiology of opisthorchiasis-induced CCA, the anticipated impacts and outcomes of the program include short-, medium-, and the long-term goals for the reduction of CCA incidence. To achieve long-term sustainable impacts, concerted efforts to raise social awareness and participating action by general public, non-government organizations, and government agencies are necessary. The strategic plans developed for this program can be expanded for use in other endemic areas as well as being a model for use in other chronic diseases.
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Affiliation(s)
- Narong Khuntikeo
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.,Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Attapol Titapun
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.,Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Watcharin Loilome
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.,Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Puangrat Yongvanit
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.,Cholangiocarcinoma Foundation, Khon Kaen University, Khon Kaen, Thailand
| | - Bandit Thinkhamrop
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.,Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Nittaya Chamadol
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.,Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Thidarat Boonmars
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.,Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Teerachai Nethanomsak
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.,Curriculum and Instruction Program, Faculty of Education, Khon Kaen University, Khon Kaen, Thailand
| | - Ross H Andrews
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.,Faculty of Medicine, St Mary's Campus, Imperial College, London, United Kingdom
| | - Trevor N Petney
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.,Department of Ecology and Parasitology, Institute of Zoology, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Paiboon Sithithaworn
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand.,Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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11
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Phan TV, Bui NT, Nguyen VH, Murrell D. Comparative Risk of Liver and Intestinal Fluke Infection from Either Wild-Caught or Cultured Fish in Vietnam. Vector Borne Zoonotic Dis 2016; 16:790-796. [DOI: 10.1089/vbz.2016.1997] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Thi Van Phan
- Research Institute for Aquaculture No. 1, Bac Ninh, Vietnam
| | - Ngoc Thanh Bui
- Research Institute for Aquaculture No. 1, Bac Ninh, Vietnam
| | - Van Ha Nguyen
- Institute of Ecology and Biological Resources, Vietnam Academy of Science and Technology, Ha Noi, Vietnam
| | - Darwin Murrell
- Department of Preventive Medicine and Biometrics, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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12
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Sithithaworn P, Yongvanit P, Duenngai K, Kiatsopit N, Pairojkul C. Roles of liver fluke infection as risk factor for cholangiocarcinoma. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2014; 21:301-8. [DOI: 10.1002/jhbp.62] [Citation(s) in RCA: 146] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Paiboon Sithithaworn
- Department of Parasitology; Faculty of Medicine; Khon Kaen University; 123 Mitraparb Road Khon Kaen 40002 Thailand
- Liver Fluke and Cholangiocarcinoma Research Center; Faculty of Medicine; Khon Kaen University; Khon Kaen Thailand
| | - Puangrat Yongvanit
- Department of Biochemistry; Faculty of Medicine; Khon Kaen University; Khon Kaen Thailand
- Liver Fluke and Cholangiocarcinoma Research Center; Faculty of Medicine; Khon Kaen University; Khon Kaen Thailand
| | - Kunyarat Duenngai
- Department of Public Health; Faculty of Science and Technology; Phetchabun Rajabhat University; Phetchabun Thailand
- Liver Fluke and Cholangiocarcinoma Research Center; Faculty of Medicine; Khon Kaen University; Khon Kaen Thailand
| | - Nadda Kiatsopit
- Department of Parasitology; Faculty of Medicine; Khon Kaen University; 123 Mitraparb Road Khon Kaen 40002 Thailand
- Liver Fluke and Cholangiocarcinoma Research Center; Faculty of Medicine; Khon Kaen University; Khon Kaen Thailand
| | - Chawalit Pairojkul
- Department of Pathology; Faculty of Medicine; Khon Kaen University; Khon Kaen Thailand
- Liver Fluke and Cholangiocarcinoma Research Center; Faculty of Medicine; Khon Kaen University; Khon Kaen Thailand
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Abstract
PURPOSE OF REVIEW To highlight the gastrointestinal helminths in the context of renewed global commitment to control or eliminate neglected tropical diseases in the coming decade. RECENT FINDINGS Two key documents, namely the 2012 London Declaration for Neglected Tropical Diseases and the 2013 World Health Assembly resolution, emphasize the importance of mass drug administration (MDA) for controlling several key neglected tropical diseases. These documents, together with the Global Burden of Disease Study 2010, establish the major gastrointestinal helminth infections, including the soil-transmitted helminthiases - ascariasis, trichuriasis, hookworm, and strongyloidiasis - in addition to the intestinal and liver fluke infections, as some of the most important gastrointestinal infections of humankind. Current MDA approaches using single-dose albendazole or mebendazole are effective for ascariasis, less so for other soil-transmitted helminth infections. Expanded use of albendazole in combination with ivermectin would ensure improved drug efficacies against trichuriasis and strongyloidiasis. There is no effective elimination strategy for targeting hookworm and liver and intestinal fluke infections through current MDA approaches. SUMMARY The global community must expand current MDA efforts, while simultaneously developing additional drugs, diagnostics, and vaccines alongside better utilizing transmission dynamics and modeling, if it is to successfully meet the goals and targets established by policymakers.
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Wang YC. Examining landscape determinants of Opisthorchis viverrini transmission. ECOHEALTH 2012; 9:328-341. [PMID: 22890564 DOI: 10.1007/s10393-012-0789-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Revised: 07/19/2012] [Accepted: 07/24/2012] [Indexed: 06/01/2023]
Abstract
Liver fluke (Opisthorchis viverrini, O.v.) infection, along with its associated cholangiocarcinoma, is a major public health problem in Southeast Asia. Despite the vast amount of epidemiological research, human O.v. prevalence remains high and varies greatly across the region. This paper examines the landscape determinants that influence O.v. transmission in relation to the three hosts of its life cycle and identifies areas that require further research so as to advance the understanding of the spatial variation in disease risk. A critical agent functionally connects all sequential life cycle stages of O.v. is water. Seasonality and water quality appear to affect the habitats and population dynamics of the two intermediate hosts, Bithynia snails and cyprinid fish. Land use practice through the construction of irrigation ditches increases the connections between the hosts, thereby functionally facilitating the disease transmission. Multi-season sampling data of host infections and habitat characteristics are needed for integration with analyses of landscape connectivity and human behavior to allow better understanding of the interactions among the landscape determinants on the spatial-temporal dynamics of disease transmission.
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Affiliation(s)
- Yi-Chen Wang
- Department of Geography, National University of Singapore, Singapore, Singapore.
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15
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Toledo R, Esteban JG, Fried B. Current status of food-borne trematode infections. Eur J Clin Microbiol Infect Dis 2012; 31:1705-18. [PMID: 22228314 DOI: 10.1007/s10096-011-1515-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 12/07/2011] [Indexed: 02/01/2023]
Abstract
Food-borne trematodiases constitute an important group of the most neglected tropical diseases, not only in terms of research funding, but also in the public media. The Trematoda class contains a great number of species that infect humans and are recognized as the causative agents of disease. The biological cycle, geographical distribution, and epidemiology of most of these trematode species have been well characterized. Traditionally, these infections were limited, for the most part, in populations living in low-income countries, particularly in Southeast Asia, and were associated with poverty. However, the geographical limits and the population at risk are currently expanding and changing in relation to factors such as growing international markets, improved transportation systems, and demographic changes. The diagnosis of these diseases is based on parasitological techniques and only a limited number of drugs are currently available for treatment, most of which are unspecific. Therefore, in-depth studies are urgently needed in order to clarify the current epidemiology of these helminth infections and to identify new and specific targets for both effective diagnosis and treatment. In this review, we describe the biology, medical and epidemiological features, and current treatment and diagnostic tools of the main groups of flukes and the corresponding diseases.
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Affiliation(s)
- R Toledo
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicente Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain.
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Ziegler AD, Andrews RH, Grundy-Warr C, Sithithaworn P, Petney TN. Fighting liverflukes with food safety education. Science 2011; 331:282-3. [PMID: 21252329 DOI: 10.1126/science.331.6015.282-b] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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17
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Fried B, Abruzzi A. Food-borne trematode infections of humans in the United States of America. Parasitol Res 2010; 106:1263-80. [DOI: 10.1007/s00436-010-1807-0] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Accepted: 02/19/2010] [Indexed: 11/28/2022]
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Abstract
An estimated 750 million people are at risk of infections with food-borne trematodes, which comprise liver flukes (Clonorchis sinensis, Fasciola gigantica, Fasciola hepatica, Opisthorchis felineus, and Opisthorchis viverrini), lung flukes (Paragonimus spp.), and intestinal flukes (e.g., Echinostoma spp., Fasciolopsis buski, and the heterophyids). Food-borne trematodiases pose a significant public health and economic problem, yet these diseases are often neglected. In this review, we summarize the taxonomy, morphology, and life cycle of food-borne trematodes. Estimates of the at-risk population and number of infections, geographic distribution, history, and ecological features of the major food-borne trematodes are reviewed. We summarize clinical manifestations, patterns of infection, and current means of diagnosis, treatment, and other control options. The changing epidemiological pattern and the rapid growth of aquaculture and food distribution networks are highlighted, as these developments might be associated with an elevated risk of transmission of food-borne trematodiases. Current research needs are emphasized.
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Dose-response relationships and tegumental surface alterations in Opisthorchis viverrini following treatment with mefloquine in vivo and in vitro. Parasitol Res 2009; 105:261-6. [DOI: 10.1007/s00436-009-1395-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Accepted: 03/03/2009] [Indexed: 01/17/2023]
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