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Mas-Coma S, Valero MA, Bargues MD. One Health for fascioliasis control in human endemic areas. Trends Parasitol 2023; 39:650-667. [PMID: 37385922 DOI: 10.1016/j.pt.2023.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/24/2023] [Accepted: 05/24/2023] [Indexed: 07/01/2023]
Abstract
Fasciola hepatica and F. gigantica are liver flukes causing fascioliasis, a worldwide zoonotic, complex disease. Human infection/reinfection occurs in endemic areas where preventive chemotherapy is applied, because of fasciolid transmission ensured by livestock and lymnaeid snail vectors. A One Health control action is the best complement to decrease infection risk. The multidisciplinary framework needs to focus on freshwater transmission foci and their environment, lymnaeids, mammal reservoirs, and inhabitant infection, ethnography and housing. Local epidemiological and transmission knowledge furnished by previous field and experimental research offers the baseline for control design. A One Health intervention should be adapted to the endemic area characteristics. Long-term control sustainability may be achieved by prioritizing measures according to impact depending on available funds.
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Affiliation(s)
- Santiago Mas-Coma
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicente Andrés Estellés s/n, 46100 Burjassot, - Valencia, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain.
| | - M Adela Valero
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicente Andrés Estellés s/n, 46100 Burjassot, - Valencia, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - M Dolores Bargues
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicente Andrés Estellés s/n, 46100 Burjassot, - Valencia, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
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Rosas-Hostos Infantes LR, Paredes Yataco GA, Ortiz-Martínez Y, Mayer T, Terashima A, Franco-Paredes C, Gonzalez-Diaz E, Rodriguez-Morales AJ, Bonilla-Aldana DK, Vargas Barahona L, Grimshaw AA, Chastain DB, Sillau S, Marcos LA, Henao-Martínez AF. The global prevalence of human fascioliasis: a systematic review and meta-analysis. Ther Adv Infect Dis 2023; 10:20499361231185413. [PMID: 37434654 PMCID: PMC10331341 DOI: 10.1177/20499361231185413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/14/2023] [Indexed: 07/13/2023] Open
Abstract
Background Fascioliasis is a parasitic zoonosis that can infect humans and be a source of significant morbidity. The World Health Organization lists human fascioliasis as a neglected tropical disease, but the worldwide prevalence of fascioliasis data is unknown. Objective We aimed to estimate the global prevalence of human fascioliasis. Data sources and methods We performed a systematic review and prevalence meta-analysis. We used the following inclusion criteria: articles published in the English, Portuguese, or Spanish languages from December 1985 to October 2022 and studies assessing the prevalence of Fasciola in the general population with an appropriate diagnostic methodology, including longitudinal studies, prospective and retrospective cohorts, case series, and randomized clinical trials (RCTs). We excluded animal studies. Two reviewers independently reviewed the selected studies for methodological quality, performing critical standard measures from JBI SUMARI. A random-effects model was conducted of the summary extracted data on the prevalence proportions. We reported the estimates according to the GATHER statement. Results In all, 5617 studies were screened for eligibility. Fifty-five studies from 15 countries were selected, including 154,697 patients and 3987 cases. The meta-analysis revealed a pooled prevalence of 4.5% [95% confidence interval (CI): 3.1-6.1; I2 = 99.4%; T2 = 0.07]. The prevalence in South America, Africa, and Asia was 9.0%, 4.8%, and 2.0%, respectively. The highest prevalence was found in Bolivia (21%), Peru (11%), and Egypt (6%). Subgroup analysis showed higher prevalence estimates in children, in studies from South America, and when Fas2-enzyme-linked immunosorbent assay (ELISA) was used as a diagnostic method. A larger study sample size (p = 0.027) and an increase in female percentage (p = 0.043) correlated with a decrease in prevalence. Multiple meta-regression showed a higher prevalence for hyperendemic than hypoendemic (p = 0.002) or mesoendemic (p = 0.013) regions. Conclusion The estimated prevalence and projected disease burden of human fascioliasis are high. Study findings support that fascioliasis continues to be a globally neglected tropical disease. Strengthening epidemiological surveillance and implementing measures to control and treat fascioliasis is imperative in the most affected areas.
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Affiliation(s)
| | | | - Yeimer Ortiz-Martínez
- Department of Internal Medicine, Universidad Industrial de Santander and Hospital Universitario de Santander, Bucaramanga, Colombia
| | - Treana Mayer
- Department of Microbiology, Immunology & Pathology, Colorado State University, Fort Collins, CO, USA
| | - Angelica Terashima
- Laboratorio de Parasitología, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Perú
- Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas, Hospital Nacional Cayetano Heredia, Lima, Perú
| | - Carlos Franco-Paredes
- Hospital Infantil de México Federico Gómez, México City, México
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá
| | - Esteban Gonzalez-Diaz
- Epidemiological Surveillance and Preventive Medicine Unit, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico
| | - Alfonso J. Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundacion Universitaria Autónoma de las Américas-Institucion Universitaria Vision de las Americas, Pereira, Risaralda, Colombia
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
- Master of Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima, Peru
| | | | - Lilian Vargas Barahona
- Division of Infectious Diseases, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Daniel B. Chastain
- Department of Clinical & Administrative Pharmacy, University of Georgia College of Pharmacy, Albany, GA, USA
| | - Stefan Sillau
- Department of Neurology and Biostatistics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Luis A. Marcos
- Division of Infectious Diseases, Departments of Medicine, Microbiology and Immunology, Stony Brook University, Stony Brook, NY, USA
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Nguyen Thu H, Dermauw V, Tran Huy T, Roucher C, Dorny P, Nguyen Thi H, Trung KH, Dao Van T, Do Nhu B, Nguyen Kim T. Diagnosing Human Fascioliasis Using ELISA Immunoassays at a Tertiary Referral Hospital in Hanoi: A Cross-Sectional Study. Trop Med Infect Dis 2022; 7:76. [PMID: 35622703 PMCID: PMC9147183 DOI: 10.3390/tropicalmed7050076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/16/2022] Open
Abstract
Infections with the zoonotic liver flukes Fasciola gigantica and Fasciola hepatica may result in severe disease in humans. In Vietnam, an emergence of fascioliasis cases has been observed from the late 1990s onwards. Various diagnostic tools are used in the country, but the agreement between these tools has not been critically evaluated. We aimed to describe the clinical presentation and diagnostic outcomes in fascioliasis patients in Vietnam. A retrospective, cross-sectional study was conducted on the medical records of a group of 145 patients diagnosed with fascioliasis at a tertiary referral hospital in Hanoi. Based on the review, sociodemographic background and clinical presentation were recorded. These patients all received standard routine serologic tests, including internal antibody (Ab)-ELISA, an enzyme-linked immunosorbent assay (ELISA), and commercial coproantigen (cAg)-ELISA. The majority of cases were between 30 and 59 years old (68.3%), and about half of them were male (51.0%). Upper quadrant and epigastric pain were the most commonly reported symptoms (61.4% and 35.2%, respectively). All but one patient had liver lesions upon ultrasound examination (99.3%), and eosinophilia was present in most of the patients (89.7%). A high number of patients were positive in the in-house and the commercial Ab-ELISA (95.9% and 87.4%, respectively), yet only a slight agreement was observed between the two tests (kappa coefficient, 0.06). A further 47.4% of cases were positive for the commercial cAg-ELISA, whereas stool microscopy indicated the presence of Fasciola spp. eggs in 25.7% of patients. The current study emphasizes the challenges related to the diagnosis of human fascioliasis in Vietnam.
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Affiliation(s)
- Huong Nguyen Thu
- Department of Microbiology-Parasitology, Faculty of Basic Medicine, Hanoi University of Public Health, Hanoi 11900, Vietnam;
| | - Veronique Dermauw
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2180 Antwerp, Belgium; (V.D.); (C.R.); (P.D.)
| | - Tho Tran Huy
- National Institute of Malariology, Parasitology and Entomology, Hanoi 12000, Vietnam;
| | - Clémentine Roucher
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2180 Antwerp, Belgium; (V.D.); (C.R.); (P.D.)
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, 2180 Antwerp, Belgium; (V.D.); (C.R.); (P.D.)
- Department of Virology, Parasitology and Immunology, 9820 Merelbeke, Belgium
| | - Hoai Nguyen Thi
- Department of Informatic Science, Vietnam Military Medical University, Hanoi 12108, Vietnam;
| | - Kien Hoang Trung
- Department of Immunology, Vietnam Military Medical University, Hanoi 12108, Vietnam;
| | - Thang Dao Van
- Department of Infectious Disease, Military Hospital 103, Hanoi 12108, Vietnam;
| | - Binh Do Nhu
- Department of Infectious Disease, Military Hospital 103, Hanoi 12108, Vietnam;
| | - Thu Nguyen Kim
- Department of Infectious Disease, Hanoi Medical University, Hanoi 11520, Vietnam
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Periago MV, Valero MA, Artigas P, Agramunt VH, Bargues MD, Curtale F, Mas-Coma S. Very High Fascioliasis Intensities in Schoolchildren from Nile Delta Governorates, Egypt: The Old World Highest Burdens Found in Lowlands. Pathogens 2021; 10:pathogens10091210. [PMID: 34578242 PMCID: PMC8470878 DOI: 10.3390/pathogens10091210] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/30/2021] [Accepted: 09/15/2021] [Indexed: 01/22/2023] Open
Abstract
Quantitative coprological analyses of children were performed in Alexandria and Behera governorates, Egypt, to ascertain whether individual intensities in the Nile Delta lowlands reach high levels as those known in hyperendemic highland areas of Latin America. Analyses focused on subjects presenting intensities higher than 400 eggs per gram of faeces (epg), the high burden cut-off according to WHO classification. A total of 96 children were found to shed between 408 and 2304 epg, with arithmetic and geometric means of 699.5 and 629.07 epg, respectively. Intensities found are the highest hitherto recorded in Egypt, and also in the whole Old World. A total of 38 (39.6%) were males and 58 (60.4%) were females, with high intensities according to gender following a negative binomial distribution. The high burden distribution shows a peak in the 7-10 year-old children group, more precocious in females than males. Results showed high burdens in winter to be remarkably higher than those known in summer. The fascioliasis scenario in Egyptian lowlands shows similarities to highlands of Bolivia and Peru. Diagnostic methods, pathogenicity and morbidity in high burdens should be considered. The need for an appropriate quantitative assessment of heavy infected children to avoid post-treatment colic episodes is highlighted.
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Affiliation(s)
- M. Victoria Periago
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andres Estelles s/n, 46100 Valencia, Spain; (M.V.P.); (M.A.V.); (P.A.); (V.H.A.)
| | - M. Adela Valero
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andres Estelles s/n, 46100 Valencia, Spain; (M.V.P.); (M.A.V.); (P.A.); (V.H.A.)
| | - Patricio Artigas
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andres Estelles s/n, 46100 Valencia, Spain; (M.V.P.); (M.A.V.); (P.A.); (V.H.A.)
| | - Verónica H. Agramunt
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andres Estelles s/n, 46100 Valencia, Spain; (M.V.P.); (M.A.V.); (P.A.); (V.H.A.)
| | - M. Dolores Bargues
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andres Estelles s/n, 46100 Valencia, Spain; (M.V.P.); (M.A.V.); (P.A.); (V.H.A.)
- Correspondence: (M.D.B.); (S.M.-C.)
| | - Filippo Curtale
- U.O.C. Rapporti internazionali, con le Regioni e Gestione del Ciclo di Progetto, Istituto Nazionale per la Promozione della Salute delle Popolazioni Migranti e il Contrasto delle Malattie della Povertà, 00153 Roma, Italy;
| | - Santiago Mas-Coma
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andres Estelles s/n, 46100 Valencia, Spain; (M.V.P.); (M.A.V.); (P.A.); (V.H.A.)
- Correspondence: (M.D.B.); (S.M.-C.)
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González-Miguel J, Valero MA, Reguera-Gomez M, Mas-Bargues C, Bargues MD, Simón F, Mas-Coma S. Numerous Fasciola plasminogen-binding proteins may underlie blood-brain barrier leakage and explain neurological disorder complexity and heterogeneity in the acute and chronic phases of human fascioliasis. Parasitology 2019; 146:284-298. [PMID: 30246668 PMCID: PMC6402360 DOI: 10.1017/s0031182018001464] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 07/26/2018] [Accepted: 07/27/2018] [Indexed: 12/17/2022]
Abstract
Human fascioliasis is a worldwide, pathogenic food-borne trematodiasis. Impressive clinical pictures comprising puzzling polymorphisms, manifestation multifocality, disease evolution changes, sequelae and mortality, have been reported in patients presenting with neurological, meningeal, neuropsychic and ocular disorders caused at distance by flukes infecting the liver. Proteomic and mass spectrometry analyses of the Fasciola hepatica excretome/secretome identified numerous, several new, plasminogen-binding proteins enhancing plasmin generation. This may underlie blood-brain barrier leakage whether by many simultaneously migrating, small-sized juvenile flukes in the acute phase, or by breakage of encapsulating formations triggered by single worm tracks in the chronic phase. Blood-brain barrier leakages may subsequently occur due to a fibrinolytic system-dependent mechanism involving plasmin-dependent generation of the proinflammatory peptide bradykinin and activation of bradykinin B2 receptors, after different plasminogen-binding protein agglomeration waves. Interactions between diverse parasitic situations and non-imbalancing fibrinolysis system alterations are for the first time proposed that explain the complexity, heterogeneity and timely variations of neurological disorders. Additionally, inflammation and dilation of blood vessels may be due to contact system-dependent generation bradykinin. This baseline allows for search of indicators to detect neurological risk in fascioliasis patients and experimental work on antifibrinolytic treatments or B2 receptor antagonists for preventing blood-brain barrier leakage.
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Affiliation(s)
- J. González-Miguel
- Laboratorio de Parasitología, Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), Cordel de Merinas 40-52, 37008 Salamanca, Spain
| | - M. A. Valero
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - M. Reguera-Gomez
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - C. Mas-Bargues
- Departamento de Fisiología, Facultad de Medicina, Universidad de Valencia, Av. Blasco Ibáñez No. 15, 46010 Valencia, Spain
| | - M. D. Bargues
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - F. Simón
- Área de Parasitología, Facultad de Farmacia, Universidad de Salamanca, Av. Licenciado Méndez Nieto s/n, 37007 Salamanca, Spain
| | - S. Mas-Coma
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
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Mas-Coma S, Bargues MD, Valero MA. Human fascioliasis infection sources, their diversity, incidence factors, analytical methods and prevention measures. Parasitology. 2018;145:1665-1699. [PMID: 29991363 DOI: 10.1017/s0031182018000914] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Human fascioliasis infection sources are analysed for the first time in front of the new worldwide scenario of this disease. These infection sources include foods, water and combinations of both. Ingestion of freshwater wild plants is the main source, with watercress and secondarily other vegetables involved. The problem of vegetables sold in uncontrolled urban markets is discussed. Distinction between infection sources by freshwater cultivated plants, terrestrial wild plants, and terrestrial cultivated plants is made. The risks by traditional local dishes made from sylvatic plants and raw liver ingestion are considered. Drinking of contaminated water, beverages and juices, ingestion of dishes and soups and washing of vegetables, fruits, tubercles and kitchen utensils with contaminated water are increasingly involved. Three methods to assess infection sources are noted: detection of metacercariae attached to plants or floating in freshwater, anamnesis in individual patients, and questionnaire surveys in endemic areas. The infectivity of metacercariae is reviewed both under field conditions and experimentally under the effects of physicochemical agents. Individual and general preventive measures appear to be more complicated than those considered in the past. The high diversity of infection sources and their heterogeneity in different countries underlie the large epidemiological heterogeneity of human fascioliasis throughout.
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Abstract
BACKGROUND Human fascioliasis has been reported in many countries, including Iran. Various techniques have been evaluated for diagnosis of human fascioliasis using different antigens. We evaluated Fasciola gigantica partially purified fraction antigen (PPF) isolated from sheep's liver fluke for the diagnosis of human fascioliasis. MATERIALS AND METHODS Two hundred sixty-one sera were collected from 104 patients living in an area endemic for human fascioliasis, from 89 non-fascioliasis patients living in a non-endemic area, and from 68 healthy individuals. Micro-ELISA was used in the evaluation of the sensitivity and specificity of Dot-ELISA. RESULTS With a 1:800 sera dilution as the cut-off titer, the sensitivity of the Dot-ELISA test in diagnosis of human fascioliasis was 94.23% and the specificity was 99.36%. CONCLUSION Dot-ELISA using PPF antigen is a sensitive and specific method for diagnosis of human fascioliasis that is also rapid and inexpensive.
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Affiliation(s)
- Abdolhossein Dalimi
- Department of Parasitology, Medical Sciences Faculty, Tarbiat Modarres University, Tehran, I. R. Iran.
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