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Peng Z, Tan X, Xiong P, Ren Q, Sun D, Lin Z. Case report: Intrahepatic cholangiectasis with Clonorchis sinensis infection. Radiol Case Rep 2024; 19:3258-3262. [PMID: 38812594 PMCID: PMC11133502 DOI: 10.1016/j.radcr.2024.04.085] [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: 12/17/2023] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 05/31/2024] Open
Abstract
Clonorchis sinensis infections persist globally among humans. These pathogens mainly inhabit the intrahepatic biliary system. Most individuals with clonorchiasis exhibit mild symptoms. The absence of distinctive symptoms often results in delayed diagnosis and treatment, potentially leading to chronic infection. We herein report a case of a 29-year-old female presented with a year-long history of abdominal distention and dyspepsia. Imaging revealed intrahepatic bile duct dilatation, intrahepatic bile duct cyst, and associated deposits. One month post-cystectomy, the patient developed massive ascites and a significant increase in eosinophil count. After treatment, multiple worms were observed in the drainage tube. Morphological and DNA metagenomic analyses confirmed the presence of C. sinensis. Clinical manifestations of C. sinensis vary widely. Imaging serves as a valuable diagnostic tool in endemic areas, especially in detecting intrahepatic duct dilation where the flukes reside. In addition to intrahepatic bile duct dilation, abnormal echoes within the bile duct and the presence of floating objects in the gallbladder significantly aid in diagnosis. Clinicians may encounter these parasitic diseases unexpectedly, underscoring the importance of understating such cases in routine practice and contributing to our broader understanding of managing similar cases in clinical settings.
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Affiliation(s)
- Zhen Peng
- Peking University Shenzhen Hospital Medical School, Anhui Medical University, Shenzhen, Guangdong, PR China
- Peking University Shenzhen Hospital, Shenzhen, Guangdong, PR China
- Fifth Clinical Medical School, Anhui Medical University, Hefei, Anhui, PR China
| | - Xiao Tan
- Peking University Shenzhen Hospital, Shenzhen, Guangdong, PR China
- Department of Graduate school, Zunyi Medical University, Zunyi, Guizhou, PR China
| | - Pei Xiong
- Peking University Shenzhen Hospital, Shenzhen, Guangdong, PR China
| | - Qingqi Ren
- Peking University Shenzhen Hospital, Shenzhen, Guangdong, PR China
| | - Desheng Sun
- Peking University Shenzhen Hospital, Shenzhen, Guangdong, PR China
- Department of Graduate school, Zunyi Medical University, Zunyi, Guizhou, PR China
| | - Zewei Lin
- Peking University Shenzhen Hospital Medical School, Anhui Medical University, Shenzhen, Guangdong, PR China
- Peking University Shenzhen Hospital, Shenzhen, Guangdong, PR China
- Fifth Clinical Medical School, Anhui Medical University, Hefei, Anhui, PR China
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Sota P, Andityas M, Kotepui M, Sripa B. Prevalence estimates of Opisthorchis viverrini and Clonorchis sinensis infection in the Greater Mekong subregion: a systematic review and meta-analysis. Infect Dis Poverty 2024; 13:33. [PMID: 38720371 PMCID: PMC11077858 DOI: 10.1186/s40249-024-01201-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/23/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Opisthorchiasis and clonorchiasis, caused by Opisthorchis viverrini and Clonorchis sinensis, respectively, are significant yet neglected foodborne trematodiases in the Great Mekong Subregion (GMS). Despite the reporting of the prevalence of these human liver flukes in the region over the past decades, there has been a lack of a comprehensive and systematic consolidation of this data. Therefore, we aimed to conduct a thorough systematic review and meta-analysis to synthesize and analyze time-trend prevalence estimates of both O. viverrini and C. sinensis across the GMS for the past 30 years. METHODS This study undertakes a systematic review using a comprehensive search for published articles in PubMed, EMBASE, Scopus, Cochrane and Thai Journal Online databases until early 2023. The pooled prevalence of O. viverrini and C. sinensis infection was analyzed through a random-effects meta-analysis, with meta-regression analysis used to quantify associations with study characteristics. Sub-group analysis was conducted, whenever comparison data were available, to assess the risk of O. viverrini and C. sinensis infection in each GMS country. Heterogeneity among studies was assessed using the Q statistic and quantified by using the I 2 Index. RESULTS From a total of 2997 articles, 155 articles comprising 218 datasets and 751,108 participants were included for review. The GMS prevalence of O. viverrini was 21.11% [45,083/260,237; 95% confidence interval (CI): 17.74-24.47%]. Pooled prevalence estimates were highly observed in Laos (34.06%, 95% CI: 26.85-41.26%), followed by Thailand (18.19%, 95% CI: 13.86-22.51%), and Cambodia (10.48%, 95% CI: 5.52-15.45%). Myanmar and Vietnam had limited data sources for calculation. Clonorchis sinensis infection in GMS was 25.33% (95% CI: 18.32-32.34%), with Guangxi, China, exhibiting the highest prevalence rates at 26.89% (95% CI: 18.34-35.43%), while Vietnam had a prevalence rate of 20.30% (95% CI: 9.13-31.47%). O. viverrini prevalence decreased significantly over time, whereas C. sinensis infection appeared to be stable consistently over time in both China and Vietnam. CONCLUSIONS This comprehensive study, drawing from the largest datasets to date, offers an in-depth systematic prevalence review of human liver flukes in the Greater Mekong Subregion. It underscores the imperative for systematic surveillance, data collection, and the implementation of intervention and control measures for these infectious diseases of poverty.
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Affiliation(s)
- Pornphutthachat Sota
- WHO Collaborating Centre for Research and Control of Opisthorchiasis (Southeast Asian Liver Fluke Disease), Tropical Disease Research Center, Khon Kaen University, Khon Kaen, Thailand
- Department of Tropical Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Morsid Andityas
- WHO Collaborating Centre for Research and Control of Opisthorchiasis (Southeast Asian Liver Fluke Disease), Tropical Disease Research Center, Khon Kaen University, Khon Kaen, Thailand
- Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Bioresources Technology and Veterinary, Veterinary Technology Study Program, Vocational College, Universitas Gadjah Mada, Depok, Indonesia
| | - Manas Kotepui
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
- Medical Technology Program, Faculty of Science, Nakhon Phanom University, Nakhon Phanom, Thailand
| | - Banchob Sripa
- WHO Collaborating Centre for Research and Control of Opisthorchiasis (Southeast Asian Liver Fluke Disease), Tropical Disease Research Center, Khon Kaen University, Khon Kaen, Thailand.
- Department of Tropical Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
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Huang SY, Chen JD, Zeng QS, Lai YS. High-resolution mapping of age- and gender-specific risk of Clonorchis sinensis infection risk in Guangdong, China: a geostatistical modeling study. Parasit Vectors 2024; 17:67. [PMID: 38365792 PMCID: PMC10873974 DOI: 10.1186/s13071-024-06166-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/26/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND The latest national survey on the distribution of human parasites in China demonstrated that Guangdong was among the endemic provinces with the highest Clonorchis sinensis infection rates. High-resolution, age- and gender-specific risk maps of the temporal and spatial distributions are essential for the targeted control work. METHODS Disease data on the prevalence of C. sinensis infection from 1990 onwards, either age- and gender-specific or aggregated across age and gender, were collected through systematic review and four large-scale surveys in Guangdong Province. Environmental and socioeconomic variables were obtained from open-access databases and employed as potential predictors. A Bayesian geostatistical model was developed to estimate the C. sinensis infection risk at high spatial resolution. RESULTS The final dataset included 606 surveys at 463 unique locations for C. sinensis infection. Our findings suggested that following an initial increase and stabilization, the overall population-adjusted prevalence had declined to 2.2% (95% Bayesian credible interval: 1.7-3.0%) in the period of 2015 onwards. From 2015 onwards, moderate and high infection risks were found in the northern regions (e.g. Heyuan and Shaoguan cities) and the southern Pearl River Delta (e.g. Foshan, Zhongshan, Zhuhai and Jiangmen cities), respectively. Age- and gender-specific risk maps revealed that males had a higher infection risk than females, and the infection risk was higher in adults compared to children. CONCLUSIONS Our high-resolution risk maps of C. sinensis infection in Guangdong Province identified the spatial, temporal, age and gender heterogeneities, which can provide useful information assisting tailored control strategies.
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Affiliation(s)
- Si-Yue Huang
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong Province, People's Republic of China
| | - Jing-Diao Chen
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province, People's Republic of China
| | - Qing-Sheng Zeng
- Xinhui District Center for Disease Control and Prevention, Jiangmen, Guangdong Province, People's Republic of China
| | - Ying-Si Lai
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong Province, People's Republic of China.
- Sun Yat-Sen Global Health Institute, Sun Yat-Sen University, Guangzhou, Guangdong Province, People's Republic of China.
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Epidemiology and determinants of Clonorchis sinensis infection: A community-based study in southeastern China. Acta Trop 2022; 233:106545. [PMID: 35649496 DOI: 10.1016/j.actatropica.2022.106545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 11/20/2022]
Abstract
Clonorchiasis is caused by the ingestion of raw freshwater fish and causes high burden in East Asia. The epidemiological profiles and determinants of C. sinensis infection, knowledge, practice and attitude related to clonorchiasis were demonstrated in Hengxian county, Guangxi, China. The overall prevalence of C. sinensis was 60.3%, which was higher in male than in female and in elder population compared to children. The percentage knowing local transmission, transmission route and harm of C. sinensis was 20.9%, 31.4% and 32.5%. A percentage of 60.4% reported ingestion of raw freshwater fish, while 70.1% persons would like to accept treatment if infected with C. sinensis. Of the individuals ingesting raw freshwater fish, 82.0% did at home and 81.3% drunk alcohol when ingesting raw freshwater fish. Sixty-two percent showed the persistence on ingestion of raw freshwater fish in future. The ingestion of raw freshwater fish varied by seasons, with a proportion of 57.8% in spring, 48.3% in summer, 60.2% in autumn and 92.2% in winter. In multivariable regression models, age groups, history with C. sinensis treatment, and frequency on ingesting raw freshwater fish were related to C. sinensis infection, while gender, educational level, history with C. sinensis infection, and knowing local transmission were related to the practice of ingesting raw freshwater fish. Gender, history with C. sinensis treatment, frequency on ingesting raw freshwater fish, duration of ingesting raw freshwater fish and drinking alcohol when ingesting raw freshwater fish were associated to the attitude to the ingestion of raw freshwater fish in future. Great efforts are needed to combat clonorchiasis, in which the heterogeneity of population in knowledge, practice, attitude and infection needs to be considered. Men are of crucial importance in term of the morbidity control through chemotherapy. Meanwhile, massive education is expected to implement, which needs to promote the change of ingesting raw freshwater fish for sustainable control of clonorchiasis.
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Li Z, Xin H, Qian MB, Sun J, Yang Y, Chen Y, Yu J, Chen Y, Huang Z, Hay SI, Jiang Z, Li SZ. Clonorchis sinensis re-infection rate and the determinants: a prospective cohort study in Hengxian County, Guangxi, China. J Infect Dis 2021; 225:481-491. [PMID: 34375427 DOI: 10.1093/infdis/jiab403] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/08/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To understand Clonorchis sinensis re-infection and the determinants in endemic areas is important in establishment of control measures. METHODS A prospective cohort study was implemented in Hengxian County, Guangxi, China. Individuals with C. sinensis infection were completely treated, and those cured were enrolled as study subjects and followed up for 3, 6 and 12 months. The re-infection frequency and incidence were calculated, and a multivariable Cox proportional hazard model was constructed to capture re-infection determinants. RESULTS Among 635 enrolled subjects, 436 (68.7%) completed follow-up. Of these, 177 (40.6%) were re-infected; 133 (75.1%) were re-infected once, 41 (23.2%) twice and 3 (1.7%) three times. The incidence of re-infection was 64.0 per 100 person-years. Males (aHR: 1.67, 95% CI: 1.14-2.44), those with underlying diseases (aHR: 1.41, 95% CI: 1.02-1.95), and those with moderate- and heavy-intensity infections (aHR: 1.45, 95% CI: 1.14-1.85) had increasing re-infection probabilities. CONCLUSIONS C. sinensis re-infection is high in endemic areas. Males and high-intensity infection are important determinants of re-infection. Repeated chemotherapy is necessary to control re-infection and its associated morbidities, especially in high-risk individuals. In addition, behavioural education is advised to decrease overall re-infection in endemic areas.
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Affiliation(s)
- Zhongjie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hualei Xin
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.,WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Division of Infectious Disease, Qingdao City Center for Disease Control and Prevention, Qingdao, China
| | - Men-Bao Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, China.,School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junling Sun
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yichao Yang
- Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Yingdan Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, China
| | - Jianxing Yu
- State Key Laboratory of Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Beijing, China
| | - Yu Chen
- Hengxian Center for Disease Control and Prevention, Hengxian, China
| | - Zhuoxin Huang
- Hengxian Center for Disease Control and Prevention, Hengxian, China
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.,Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Zhihua Jiang
- Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, China.,School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, China
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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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