Repeated praziquantel treatment and Opisthorchis viverrini infection: a population-based cross-sectional study in northeast Thailand.
Adult
Aged
Aged, 80 and over
Animals
Anthelmintics
/ therapeutic use
Bile Duct Neoplasms
/ complications
Cholangiocarcinoma
/ complications
Cross-Sectional Studies
Feces
/ parasitology
Female
Humans
Logistic Models
Male
Middle Aged
Opisthorchiasis
/ complications
Opisthorchis
Praziquantel
/ therapeutic use
Raw Foods
/ parasitology
Recurrence
Risk Factors
Sentinel Surveillance
Surveys and Questionnaires
Thailand
/ epidemiology
Young Adult
Opisthorchis viverrini
Praziquantel
Screening
Thailand
Urine
Journal
Infectious diseases of poverty
ISSN: 2049-9957
Titre abrégé: Infect Dis Poverty
Pays: England
ID NLM: 101606645
Informations de publication
Date de publication:
20 Mar 2019
20 Mar 2019
Historique:
received:
29
07
2018
accepted:
01
03
2019
entrez:
21
3
2019
pubmed:
21
3
2019
medline:
27
6
2019
Statut:
epublish
Résumé
Opisthorchis viverrini infection is highly prevalent in northeast Thailand. This liver fluke is classified as a carcinogen due to its causal links with cholangiocarcinoma (CCA) development. Although treatment with praziquantel (PZQ) effectively cures O. viverrini infection, the prevalence remains high due to the traditional consumption of raw fish. Therefore, re-infection is common in the endemic community, leading to severe hepato-biliary morbidities including the fatal CCA. In this study, we evaluate the association between the frequency of previous PZQ treatment and current O. viverrini infections among Thai adults living in the endemic area of northeast Thailand. This study includes all participants who were screened for O. viverrini infection in the Cholangiocarcinoma Screening and Care Program (CASCAP), northeast Thailand. History of PZQ treatment was recorded using a health questionnaire. O. viverrini infections were diagnosed using urine antigen detection. Associations between PZQ and O. viverrini were determined by adjusted odds ratio (aOR) and 95% confidence interval (CI) using multiple logistic regression. Among participants, 27.7% had previously been treated once with PZQ, 8.2% twice, 2.8% three times, and 3.5% more than three times. Current O. viverrini prevalence was 17% (n = 524). Compared with participants who never used PZQ, the aOR for infection among those who used the drug once was 1.09 (95% CI: 0.88-1.37), twice was 1.19 (95% CI: 0.85-1.68), three times was 1.28 (95% CI: 0.74-2.21), and more than three times was 1.86 (95% CI: 1.18-2.93; P = 0.007). The population with a frequent history of PZQ use and still continued raw fish consumption showed high levels of repeated reinfection with O. viverrini. They were infected, treated and re-infected repeatedly. These findings suggest that certain participants continue raw fish consumption even after previous infection. This is a particular problem in highly endemic areas for O. viverrini and increases the risk of CCA.
Sections du résumé
BACKGROUND
BACKGROUND
Opisthorchis viverrini infection is highly prevalent in northeast Thailand. This liver fluke is classified as a carcinogen due to its causal links with cholangiocarcinoma (CCA) development. Although treatment with praziquantel (PZQ) effectively cures O. viverrini infection, the prevalence remains high due to the traditional consumption of raw fish. Therefore, re-infection is common in the endemic community, leading to severe hepato-biliary morbidities including the fatal CCA. In this study, we evaluate the association between the frequency of previous PZQ treatment and current O. viverrini infections among Thai adults living in the endemic area of northeast Thailand.
METHODS
METHODS
This study includes all participants who were screened for O. viverrini infection in the Cholangiocarcinoma Screening and Care Program (CASCAP), northeast Thailand. History of PZQ treatment was recorded using a health questionnaire. O. viverrini infections were diagnosed using urine antigen detection. Associations between PZQ and O. viverrini were determined by adjusted odds ratio (aOR) and 95% confidence interval (CI) using multiple logistic regression.
RESULTS
RESULTS
Among participants, 27.7% had previously been treated once with PZQ, 8.2% twice, 2.8% three times, and 3.5% more than three times. Current O. viverrini prevalence was 17% (n = 524). Compared with participants who never used PZQ, the aOR for infection among those who used the drug once was 1.09 (95% CI: 0.88-1.37), twice was 1.19 (95% CI: 0.85-1.68), three times was 1.28 (95% CI: 0.74-2.21), and more than three times was 1.86 (95% CI: 1.18-2.93; P = 0.007).
CONCLUSIONS
CONCLUSIONS
The population with a frequent history of PZQ use and still continued raw fish consumption showed high levels of repeated reinfection with O. viverrini. They were infected, treated and re-infected repeatedly. These findings suggest that certain participants continue raw fish consumption even after previous infection. This is a particular problem in highly endemic areas for O. viverrini and increases the risk of CCA.
Identifiants
pubmed: 30890188
doi: 10.1186/s40249-019-0529-5
pii: 10.1186/s40249-019-0529-5
pmc: PMC6425692
doi:
Substances chimiques
Anthelmintics
0
Praziquantel
6490C9U457
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
18Subventions
Organisme : Khon Kaen University
ID : CASCAP 1/60
Organisme : National Research Council of Thailand
ID : MRF.59-076
Organisme : National Research Council of Thailand
ID : NRCT/2559-134
Commentaires et corrections
Type : ErratumIn
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