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Kamber L, Bürli C, Harbrecht H, Odermatt P, Sayasone S, Chitnis N. Modeling the persistence of Opisthorchis viverrini worm burden after mass-drug administration and education campaigns with systematic adherence. PLoS Negl Trop Dis 2024; 18:e0011362. [PMID: 38422118 DOI: 10.1371/journal.pntd.0011362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 03/12/2024] [Accepted: 01/23/2024] [Indexed: 03/02/2024] Open
Abstract
Opisthorchis viverrini is a parasitic liver fluke contracted by consumption of raw fish, which affects over 10 million people in Southeast Asia despite sustained control efforts. Chronic infections are a risk factor for the often fatal bile duct cancer, cholangiocarcinoma. Previous modeling predicted rapid elimination of O. viverrini following yearly mass drug administration (MDA) campaigns. However, field data collected in affected populations shows persistence of infection, including heavy worm burden, after many years of repeated interventions. A plausible explanation for this observation is systematic adherence of individuals in health campaigns, such as MDA and education, with some individuals consistently missing treatment. We developed an agent-based model of O. viverrini which allows us to introduce various heterogeneities including systematic adherence to MDA and education campaigns at the individual level. We validate the agent-based model by comparing it to a previously published population-based model. We estimate the degree of systematic adherence to MDA and education campaigns indirectly, using epidemiological data collected in Lao PDR before and after 5 years of repeated MDA, education and sanitation improvement campaigns. We predict the impact of interventions deployed singly and in combination, with and without the estimated systematic adherence. We show how systematic adherence can substantially increase the time required to achieve reductions in worm burden. However, we predict that yearly MDA campaigns alone can result in a strong reduction of moderate and heavy worm burden, even under systematic adherence. We predict latrines and education campaigns to be particularly important for the reduction in overall prevalence, and therefore, ultimately, elimination. Our findings show how systematic adherence can explain the observed persistence of worm burden; while emphasizing the benefit of interventions for the entire population, even under systematic adherence. At the same time, the results highlight the substantial opportunity to further reduce worm burden if patterns of systematic adherence can be overcome.
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Affiliation(s)
- Lars Kamber
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Christine Bürli
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Helmut Harbrecht
- Department of Mathematics and Computer Science, University of Basel, Basel, Switzerland
| | - Peter Odermatt
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Somphou Sayasone
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Lao Tropical and Public Health Institute, Vientiane, Lao People's Democratic Republic
| | - Nakul Chitnis
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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2
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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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3
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Tan S, Machrumnizar M. Fish and Food-Fatale: Food-borne Trematode Opisthorchis viverrini and Cholangiocarcinoma. Helminthologia 2023; 60:287-299. [PMID: 38222491 PMCID: PMC10787637 DOI: 10.2478/helm-2023-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/20/2023] [Indexed: 01/16/2024] Open
Abstract
Neglected Tropical Diseases (NTDs) are a group of communicable diseases with a long history with human beings. NTDs are the proxy of poverty since they affect those in low-income and extreme-poverty populations, as those populations lack access to proper health care, clean water, sanitary conditions, and hygiene. NTDs create losses for a nation that come from the health and the economic sectors as well since the costs of diagnosis, prevention, and treatment strain the national purse strings. One of the 20 different forms of NTDs on the list is food-borne trematodes, comprises of Fasciola, Paragonimus, Clonorchis, and Opisthorchis. Currently, it is estimated that food-borne trematodes can cause a devastating effect on mortality and morbidity. All of them are zoonotic, as humans become infected by ingestion of a second intermediate host, such as freshwater snails, fish, or water vegetables. Opisthorchis viverrini, one of the food-borne trematodes that can be found mostly in South East Asia regions, especially in the Mekong basin, is regarded as a group 1 carcinogen leading to cholangiocarcinoma (CCA). This study aims to present the updated review of Opisthorchis viverrini and CCA.
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Affiliation(s)
- S. Tan
- Department of Parasitology, Faculty of Medicine, Universitas Trisakti, Jakarta11440, Indonesia
- Tropical Diseases and Public Health Research Centre, Faculty of Medicine, Universitas Trisakti, Jakarta11440, Indonesia
| | - M. Machrumnizar
- Department of Parasitology, Faculty of Medicine, Universitas Trisakti, Jakarta11440, Indonesia
- Tropical Diseases and Public Health Research Centre, Faculty of Medicine, Universitas Trisakti, Jakarta11440, Indonesia
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4
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Saijuntha W, Andrews RH, Sithithaworn P, Petney TN. Opisthorchis viverrini Life Cycle, Distribution, Systematics, and Population Genetics. Recent Results Cancer Res 2023; 219:7-25. [PMID: 37660329 DOI: 10.1007/978-3-031-35166-2_2] [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
Opisthorchis viverrini plays a key role as the carcinogenic liver fluke causing bile duct cancer in Southeast Asia. A comprehensive understanding of its life cycle, distribution, systematics, and population genetics is critically important as they underpin the effective development and establishment of future prevention and control programs that center on opisthorchiasis and cholangiocarcinoma. This chapter provides detailed information concerning the basic biology and updated information of O. viverrini related to its host life cycle, transmission route via raw, partially cooked or fermented freshwater cyprinid fish, endemic areas, and the discovery of new foci. Previous sequential studies over the last two decades on the phylogenetic and systematic relationships, genetic variation, and population genetics of O. viverrini as well as its snail intermediate host Bithynia spp. are presented and discussed, which have led to the currently known complex species level systematics and population genetics framework of this host-parasite system. Additionally, further directions for comprehensive research are suggested to provide a more complete understanding of liver fluke, O. viverrini-related cholangiocarcinoma.
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Affiliation(s)
- Weerachai Saijuntha
- Faculty of Medicine, Mahasarakham University, Maha Sarakham, 44000, Thailand.
| | - Ross H Andrews
- Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, UK
| | - Paiboon Sithithaworn
- Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Trevor N Petney
- Departments of Zoology and Paleontology and Evolution, State Museum of Natural History Karlsruhe, Erbprinzenstrasse 13, 76133, Karlsruhe, Germany
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Saijuntha W, Andrews RH, Sithithaworn P, Petney TN. Current assessment of the systematics and population genetics of Opisthorchis viverrini sensu lato (Trematoda: Opisthorchiidae) and its first intermediate host Bithynia siamensis sensu lato (Gastropoda: Bithyniidae) in Thailand and Southeast Asia. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2022; 97:105182. [PMID: 34902557 DOI: 10.1016/j.meegid.2021.105182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/05/2021] [Accepted: 12/07/2021] [Indexed: 06/14/2023]
Abstract
The group 1 carcinogen, the liver fluke Opisthorchis viverrini is the causative agent of opisthorchiasis and subsequent bile duct cancer (cholangiocarcinoma; CCA), which is an important public health problem in Southeast Asia. Bithynia snails are known to be the sole intermediate host of O. viverrini, and distributed throughout endemic areas of opisthorchiasis. Since 2001, the genetic variation investigation of O. viverrini has progressively been investigated. Comprehensive genetic variation studies of O. viverrini and Bithynia snails were undertaken and consecutively published in 2007 by Saijuntha and colleagues. These studies provided genetic evidence that O. viverrini and Bithynia snails are both species complex with evidence of co-evolution. Later, several studies have provided data in support of this finding, and have continuously to date reinforced that both O. viverrini and Bithynia are species complexes. Moreover, studies have shown that genetic variation of O. viverrini is related to geographical, temporal, fish host species including geographical genetic variation of its snail host, Bithynia siamensis sensu lato. This is significant and important in our understanding of the evolution and phylogenetic relationships between species within the O. viverrini and Bithynia species complexes. A comprehensive knowledge of the systematics and population genetics of O. viverrini and Bithynia snails provides a sound basis to instigate and develop effective prevention and control programs targeting opisthorchiasis and CCA in the endemic areas of Southeast Asia. Thus, this review examines the historical series of investigations of the systematics and population genetics of O. viverrini including Bithynia spp. in Southeast Asia since molecular genetic investigations commenced some 20 years ago.
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Affiliation(s)
- Weerachai Saijuntha
- Walai Rukhavej Botanical Research Institute, Mahasarakham University, Maha Sarakham 44150, Thailand.
| | - Ross H Andrews
- Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; Faculty of Medicine, St Mary's Campus, Imperial College London, United Kingdom
| | - Paiboon Sithithaworn
- Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Trevor N Petney
- Departments of Zoology and Paleontology and Evolution, State Museum of Natural History Karlsruhe, Erbprinzenstrasse 13, 76133 Karlsruhe, Germany
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Young ND, Stroehlein AJ, Kinkar L, Wang T, Sohn WM, Chang BCH, Kaur P, Weisz D, Dudchenko O, Aiden EL, Korhonen PK, Gasser RB. High-quality reference genome for Clonorchis sinensis. Genomics 2021; 113:1605-1615. [PMID: 33677057 DOI: 10.1016/j.ygeno.2021.03.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/18/2021] [Accepted: 03/01/2021] [Indexed: 12/13/2022]
Abstract
The Chinese liver fluke, Clonorchis sinensis, causes the disease clonorchiasis, affecting ~35 million people in regions of China, Vietnam, Korea and the Russian Far East. Chronic clonorchiasis causes cholangitis and can induce a malignant cancer, called cholangiocarcinoma, in the biliary system. Control in endemic regions is challenging, and often relies largely on chemotherapy with one anthelmintic, called praziquantel. Routine treatment carries a significant risk of inducing resistance to this anthelmintic in the fluke, such that the discovery of new interventions is considered important. It is hoped that the use of molecular technologies will assist this endeavour by enabling the identification of drug or vaccine targets involved in crucial biological processes and/or pathways in the parasite. Although draft genomes of C. sinensis have been published, their assemblies are fragmented. In the present study, we tackle this genome fragmentation issue by utilising, in an integrated way, advanced (second- and third-generation) DNA sequencing and informatic approaches to build a high-quality reference genome for C. sinensis, with chromosome-level contiguity and curated gene models. This substantially-enhanced genome provides a resource that could accelerate fundamental and applied molecular investigations of C. sinensis, clonorchiasis and/or cholangiocarcinoma, and assist in the discovery of new interventions against what is a highly significant, but neglected disease-complex.
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Affiliation(s)
- Neil D Young
- Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia.
| | - Andreas J Stroehlein
- Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Liina Kinkar
- Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Tao Wang
- Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Woon-Mok Sohn
- Department of Parasitology and Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Bill C H Chang
- Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Parwinder Kaur
- UWA School of Agriculture and Environment, Faculty of Science, University of Western Australia, Perth, Western Australia 6009, Australia
| | - David Weisz
- The Center for Genome Architecture, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Olga Dudchenko
- The Center for Genome Architecture, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Center for Theoretical Biological Physics, Rice University, Houston, TX 77005, USA
| | - Erez Lieberman Aiden
- UWA School of Agriculture and Environment, Faculty of Science, University of Western Australia, Perth, Western Australia 6009, Australia; The Center for Genome Architecture, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Center for Theoretical Biological Physics, Rice University, Houston, TX 77005, USA; Shanghai Institute for Advanced Immunochemical Studies, ShanghaiTech, Pudong 201210, China
| | - Pasi K Korhonen
- Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Robin B Gasser
- Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia
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Namsanor J, Pitaksakulrat O, Kopolrat K, Kiatsopit N, Webster BL, Gower CM, Webster JP, Laha T, Saijuntha W, Laoprom N, Andrews RH, Petney TN, Blair D, Sithithaworn P. Impact of geography and time on genetic clusters of Opisthorchis viverrini identified by microsatellite and mitochondrial DNA analysis. Int J Parasitol 2020; 50:1133-1144. [PMID: 32866491 DOI: 10.1016/j.ijpara.2020.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/14/2020] [Accepted: 06/26/2020] [Indexed: 02/07/2023]
Abstract
Infection by the small liver fluke, Opisthorchis viverrini, causes serious public health problems, including cholangiocarcinoma, in Thailand and southeastern Asian countries. Previous studies have reported that O. viverrini represents a species complex with varying levels of genetic differentiation in Thailand and Lao PDR. In this study, we re-examined population genetic structure and genetic diversity of O. viverrini using extensive samples of the parasite collected over 15 years from 12 geographical localities in Thailand and eight localities in Lao PDR. Parasite life-cycle stages of 721 individuals of O. viverrini (91 cercariae, 230 metacercariae and 400 adult worms) were genotyped using 12 microsatellite loci. Metacercariae exhibited genetic diversity comparable with that of experimentally raised adults: metacercariae can therefore be used to represent O. viverrini populations without the need for laboratory definitive hosts. Data obtained from larval as well as adult worms identified two distinct genetic clusters of O. viverrini. Sequences of a portion of the mitochondrial cox1 gene strongly supported the existence of these two clusters. One, the widespread cluster, was found at all sampled sites. The second cluster occurred only in Phang Khon District, Sakon Nakhon Province (SPk), within the Songkram River wetland in Thailand. A striking feature of our data relates to the temporal dynamics of the SPk cluster, which was largely replaced by representatives of the widespread cluster over time. If the SPk cluster is excluded, no marked genetic differences were seen among O. viverrini populations from Thailand and Lao PDR. The underlying causes of the observed population structure and population dynamics of O. viverrini are not known.
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Affiliation(s)
- Jutamas Namsanor
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Opal Pitaksakulrat
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Kulthida Kopolrat
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Nadda Kiatsopit
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Bonnie L Webster
- Department of Life Sciences, Parasites and Vectors Division, Natural History Museum, London SW7 5BD, United Kingdom
| | - C M Gower
- Department of Pathobiology and Population Sciences, Centre for Emerging, Endemic and Exotic Diseases (CEEED), Royal Veterinary College, University of London, Hertfordshire, AL9 7TA, United Kingdom
| | - Joanne P Webster
- Department of Pathobiology and Population Sciences, Centre for Emerging, Endemic and Exotic Diseases (CEEED), Royal Veterinary College, University of London, Hertfordshire, AL9 7TA, United Kingdom
| | - Thewarach Laha
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Weerachai Saijuntha
- Walai Rukhavej Botanical Research Institute, Mahasarakham University, Mahasarakham 44150 Thailand
| | - Nongluk Laoprom
- Department of Science, Faculty of Science and Engineering, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon 47000, Thailand
| | - Ross H Andrews
- Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; Imperial College London, Faculty of Medicine, St Mary's Campus, South Wharf Street, London W2 1NY, United Kingdom
| | - Trevor N Petney
- Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; State Museum of Natural History Karlsruhe, Evolution and Paleontology, Erbprinzenstrasse 13, 76133 Karlsruhe, Germany
| | - David Blair
- College of Science and Engineering, James Cook University, Townsville, Australia
| | - Paiboon Sithithaworn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; Cholangiocarcinoma Research Institute, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
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8
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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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Improved genomic resources and new bioinformatic workflow for the carcinogenic parasite Clonorchis sinensis: Biotechnological implications. Biotechnol Adv 2018; 36:894-904. [DOI: 10.1016/j.biotechadv.2018.02.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/08/2018] [Accepted: 02/13/2018] [Indexed: 12/27/2022]
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10
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Saijuntha W, Duenngai K, Tangkawattana S, Petney TN, Andrews RH, Sithithaworn P. Recent Advances in the Diagnosis and Detection of Opisthorchis viverrini Sensu Lato in Human and Intermediate Hosts for Use in Control and Elimination Programs. ADVANCES IN PARASITOLOGY 2018; 101:177-214. [PMID: 29907254 DOI: 10.1016/bs.apar.2018.05.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Opisthorchiasis is a neglected tropical disease, caused by infection with the fish-borne trematode Opisthorchis viverrini sensu lato that afflicts more than 10million people in Southeast Asia, including Thailand, Lao PDR, Vietnam and Cambodia. The disease is characterized by a chronic infection that induces hepatobiliary inflammation, especially periductal fibrosis, which can be detected by ultrasonography. This chronic inflammation eventually leads to cholangiocarcinoma (CCA), a usually fatal bile duct cancer that develops in approximately 1% of O. viverrini-infected individuals. In Thailand alone, 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 O. viverrini-associated morbidity and CCA, the primary intervention measures focus on opisthorchiasis control and elimination. Accurate diagnoses of O. viverrini infection, in both mammalian, snail and fish intermediate hosts, are important for achieving these goals. Despite extensive efforts over several decades to find sensitive and specific diagnostics for opisthorchiasis, a simple and robust diagnostic method is still required. Here we review earlier and current developments in the search for new diagnostics for opisthorchiasis, with practical applications in the research laboratory, the clinic and the field. Of the methods currently available, the urine antigen assay shows considerable potential for the diagnosis and screening of opisthorchiasis. Nevertheless, these new assays require validation, determination of their cost-effectiveness when applied for mass screening in an endemic setting in support of policy decisions for national public health programs aimed at the control and elimination of opisthorchiasis.
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Affiliation(s)
- Weerachai Saijuntha
- Walai Rukhavej Botanical Research Institute, Mahasarakham University, Maha Sarakham, Thailand
| | - Kanyarat Duenngai
- Department of Public Health, Faculty of Science and Technology, Phetchabun Rajabhat University, Phetchabun, Thailand
| | - Sirikachorn Tangkawattana
- Department of Vetrinary Pathobiology, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Trevor N Petney
- Cholangiocarcinoma Screening and Care Program (CASCAP) and Institute of Cholangiocarcinoma, Khon Kaen University, Khon Kaen, Thailand; Institute of Zoology 1: Ecology and Parasitology, Karlsruhe Institute of Technology, Karlsruhe, Germany; State Museum of Natural History Karlsruhe, Karlsruhe, Germany
| | - Ross H Andrews
- Cholangiocarcinoma Screening and Care Program (CASCAP) and Institute of Cholangiocarcinoma, Khon Kaen University, Khon Kaen, Thailand; Faculty of Medicine, St Mary's Campus, Imperial College, London, United Kingdom
| | - Paiboon Sithithaworn
- Cholangiocarcinoma Screening and Care Program (CASCAP) and Institute of Cholangiocarcinoma, Khon Kaen University, Khon Kaen, Thailand
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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: 38] [Impact Index Per Article: 6.3] [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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12
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Petney TN, Andrews RH, Saijuntha W, Tesana S, Prasopdee S, Kiatsopit N, Sithithaworn P. Taxonomy, Ecology and Population Genetics of Opisthorchis viverrini and Its Intermediate Hosts. ADVANCES IN PARASITOLOGY 2018; 101:1-39. [PMID: 29907251 DOI: 10.1016/bs.apar.2018.05.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
There have been considerable advances in our understanding of the systematics and ecology of Opisthorchis viverrini; however, this new knowledge has not only clarified but also complicated the situation. We now know that what was once considered to be a single species is, in fact, a species complex, with the individual species being confined to specific wetland areas. There is also a strong genetic association between the members of the O. viverrini species complex and their Bithynia snail intermediate hosts. Although this does not negate data collected before the recognition of this situation, it does lead to the caveat that regional and temporal variations in data collected may be related to the species examined. The advances in ecology have generally been spatially limited and have led, in part, to contradictory results that may well be related to nonrecognition of the species studied. It may also be related to natural temporal and spatial variation related, for example, to habitat characteristics. To understand the variation present, it will be necessary to conduct long-term (several years at least) sampling projects after defining the genetic characteristics of O. viverrini sensu lato and its Bithynia snail intermediate hosts.
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Affiliation(s)
- Trevor N Petney
- Cholangiocarcinoma Screening and Care Program (CASCAP), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Institute of Zoology 1: Ecology and Parasitology, Karlsruhe Institute of Technology, Karlsruhe, Germany; State Museum of Natural History Karlsruhe, Karlsruhe, Germany
| | - Ross H Andrews
- Cholangiocarcinoma Screening and Care Program (CASCAP), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Weerachai Saijuntha
- Walai Rukhavej Botanical Research Institute, Mahasarakham University, Maha Sarakham, Thailand
| | - Smarn Tesana
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sattrachai Prasopdee
- Chulabhorn International College of Medicine, Thammasat University, Bangkok, Thailand
| | - Nadda Kiatsopit
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Paiboon Sithithaworn
- Cholangiocarcinoma Screening and Care Program (CASCAP), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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13
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Pitaksakulrat O, Kiatsopit N, Laoprom N, Webster BL, Webster JP, Lamberton PHL, Laha T, Andrews RH, Petney TN, Blair D, Carlton EJ, Spear RC, Sithithaworn P. Preliminary genetic evidence of two different populations of Opisthorchis viverrini in Lao PDR. Parasitol Res 2017; 116:1247-1256. [PMID: 28238124 DOI: 10.1007/s00436-017-5401-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 02/03/2017] [Indexed: 11/28/2022]
Abstract
Opisthorchis viverrini is a major public health concern in Southeast Asia. Various reports have suggested that this parasite may represent a species complex, with genetic structure in the region perhaps being dictated by geographical factors and different species of intermediate hosts. We used four microsatellite loci to analyze O. viverrini adult worms originating from six species of cyprinid fish in Thailand and Lao PDR. Two distinct O. viverrini populations were observed. In Ban Phai, Thailand, only one subgroup occurred, hosted by two different fish species. Both subgroups occurred in fish from That Luang, Lao PDR, but were represented to very different degrees among the fish hosts there. Our data suggest that, although geographical separation is more important than fish host specificity in influencing genetic structure, it is possible that two species of Opisthorchis, with little interbreeding, are present near Vientiane in Lao PDR.
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Affiliation(s)
- Opal Pitaksakulrat
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Liver Fluke and Cholangiocarcinoma Research Center, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Faculty of Veterinary Science, Prince of Songkla University, Songkhla, 90110, Thailand
| | - Nadda Kiatsopit
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Liver Fluke and Cholangiocarcinoma Research Center, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Nonglak Laoprom
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Liver Fluke and Cholangiocarcinoma Research Center, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Department of General Science, Faculty of Science and Engineering, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, 47000, Thailand
| | - Bonnie L Webster
- Department of Life Sciences, Parasites and Vectors Division, Natural History Museum, London, SW7 5BD, UK.,The London Centre for Neglected Tropical Disease Research (LCNTDR), Imperial College, Faculty of Medicine (St Mary's Campus), Norfolk Place, London, W2 1PG, UK
| | - Joanne P Webster
- Department of Infectious Disease Epidemiology, Imperial College, Faculty of Medicine (St Mary's Campus), Norfolk Place, London, W2 1PG, UK.,Department of Pathology and Pathogen Biology, Centre for Emerging, Endemic and Exotic Diseases (CEEED), Royal Veterinary College, University of London, Hertfordshire, London, AL9 7TA, UK
| | - Poppy H L Lamberton
- Institute of Biodiversity, Animal Health and Comparative Medicine, and Wellcome Centre for Molecular Parasitology, Graham Kerr Building, The University of Glasgow, Glasgow, G12 8QQ, UK
| | - Thewarach Laha
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Ross H Andrews
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Liver Fluke and Cholangiocarcinoma Research Center, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Department of Infectious Disease Epidemiology, Imperial College, Faculty of Medicine (St Mary's Campus), Norfolk Place, London, W2 1PG, UK.,Cholangiocarcinoma Screening and Care Program, (CASCAP) Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Trevor N Petney
- Cholangiocarcinoma Screening and Care Program, (CASCAP) Khon Kaen University, Khon Kaen, 40002, Thailand.,Institute of Zoology 1: Ecology and Parasitology, Karlsruhe Institute of Technology, KornblumenStrasse 13, Karlsruhe, Germany
| | - David Blair
- Centre for Tropical Diversity and Climate change, James Cook University, Townsville, Australia
| | - Elizabeth J Carlton
- Department of Environmental and Occupational Health, Colorado School of Public Health, 13001 E. 17th Place, B119, Aurora, CO, 8004510, USA
| | - Robert C Spear
- Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Paiboon Sithithaworn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. .,Liver Fluke and Cholangiocarcinoma Research Center, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
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Genetic differences among Haplorchis taichui populations in Indochina revealed by mitochondrial COX1 sequences. J Helminthol 2016; 91:597-604. [PMID: 27411962 DOI: 10.1017/s0022149x1600050x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Haplorchis taichui is an intestinal heterophyid fluke that is pathogenic to humans. It is widely distributed in Asia, with a particularly high prevalence in Indochina. Previous work revealed that the lack of gene flow between three distinct populations of Vietnamese H. taichui can be attributed to their geographic isolation with no interconnected river basins. To test the hypothesis that interconnected river basins allow gene flow between otherwise isolated populations of H. taichui, as previously demonstrated for another trematode, Opisthorchis viverrini, we compared the genetic structures of seven populations of H. taichui from various localities in the lower Mekong Basin, in Thailand and Laos, with those in Vietnam, using the mitochondrial cytochrome c oxidase subunit 1 (COX1) gene. To determine the gene flow between these H. taichui populations, we calculated their phylogenetic relationships, genetic distances and haplotype diversity. Each population showed very low nucleotide diversity at this locus. However, high levels of genetic differentiation between the populations indicated very little gene flow. A phylogenetic analysis divided the populations into four clusters that correlated with the country of origin. The negligible gene flow between the Thai and Laos populations, despite sharing the Mekong Basin, caused us to reject our hypothesis. Our data suggest that the distribution of H. taichui populations was incidentally associated with national borders.
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