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Yoshida A, Doanh PN, Maruyama H. Paragonimus and paragonimiasis in Asia: An update. Acta Trop 2019; 199:105074. [PMID: 31295431 DOI: 10.1016/j.actatropica.2019.105074] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/28/2019] [Accepted: 07/05/2019] [Indexed: 01/22/2023]
Abstract
Paragonimiasis, or lung fluke disease, is a typical food-borne parasitic zoonosis caused by infection with trematodes belonging to the genus Paragonimus. More than 50 species of Paragonimus have been reported throughout the world, of which seven valid species infect humans, an estimated one million people annually worldwide. Among the seven species, P. westermani, P. heterotremus, and P. skrjabini/P. s. miyazakii, distributed in Asia, are the most important species as the cause of paragonimiasis. Humans acquire infection through the ingestion of raw, pickled or undercooked freshwater crustaceans, 2nd intermediate hosts, or consuming raw meat of wild boar or deer, paratenic hosts. Infections often occur clustered in foci where dietary habits allow transmission of the parasites. Paragonimiasis typically causes a subacute to chronic inflammatory disease of the lungs. The symptoms, including chronic cough, chest pain, dyspnea and hemoptysis, mimic those of tuberculosis and lung cancer. Serologic tests are commonly used for the diagnosis of paragonimiasis, and Praziquantel is the treatment of choice. In this review, the current status of Paragonimus and paragonimiasis in Asia is outlined based on the latest information and findings. We also summarize current trends of paragonimiasis in Japan, which is one of the most endemic area of paragonimiasis in the world, for the better understanding and control of paragonimiasis.
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Abstract
Paragonimiasis is a zoonotic disease caused by lung flukes of the genus Paragonimus. Humans usually become infected by eating freshwater crabs or crayfish containing encysted metacercariae of these worms. However, an alternative route of infection exists: ingestion of raw meat from a mammalian paratenic host. Adult worms normally occur in pairs in cysts in the lungs from which they void their eggs via air passages. The pulmonary form is typical in cases of human infection due to P. westermani, P. heterotremus, and a few other species (Table 5.1). Worms may occupy other sites in the body, notably the brain, but lung flukes have made their presence felt in almost every organ. Ectopic paragonimiasis is particularly common when infection is due to members of the P. skrjabini complex (Table 5.1). Human paragonimiasis occurs primarily in the tropics and subtropics of Asia, Africa, and the Americas, with different species being responsible in different areas (Table 5.1).
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Affiliation(s)
- David Blair
- College of Science and Engineering, James Cook University, Townsville, QLD, Australia.
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Field SK, Escalante P, Fisher DA, Ireland B, Irwin RS. Cough Due to TB and Other Chronic Infections: CHEST Guideline and Expert Panel Report. Chest 2018; 153:467-497. [PMID: 29196066 PMCID: PMC6689101 DOI: 10.1016/j.chest.2017.11.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 10/26/2017] [Accepted: 11/16/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Cough is common in pulmonary TB and other chronic respiratory infections. Identifying features that predict whether pulmonary TB is the cause would help target appropriate individuals for rapid and cost-effective screening, potentially limiting disease progression and preventing transmission to others. METHODS A systematic literature search for individual studies to answer eight key questions (KQs) was conducted according to established Chest Organization methods by using the following databases: MEDLINE via PubMed, Embase, Scopus, and the Cochrane Database of Systematic Reviews from January 1, 1984, to April 2014. Searches for KQ 1 and KQ 3 were updated in February 2016. An updated KQ 2 search was undertaken in March 2017. RESULTS Even where TB prevalence is greatest, most individuals with cough do not have pulmonary TB. There was no evidence that 1, 3, or 4 weeks' duration were better predictors than cough lasting ≥ 2 weeks to screen for pulmonary TB. In people living with HIV (PLWHIV), screening for fever, night sweats, hemoptysis, and/or weight loss in addition to cough (any World Health Organization [WHO]-endorsed symptom) increases the diagnostic sensitivity for TB. Although the diagnostic accuracy of symptom-based screening remains low, the negative predictive value of the WHO-endorsed symptom screen in PLWHIV may help to risk-stratify individuals who are not close TB contacts and who do not require further testing for pulmonary TB in resource-limited settings. However, pregnant PLWHIV are more likely to be asymptomatic, and the WHO-endorsed symptom screen is not sensitive enough to be reliable. Combined with passive case finding (PCF), active case finding (ACF) identifies pulmonary TB cases earlier and possibly when less advanced. Whether outcomes are improved or transmission is reduced is unclear. Screening asymptomatic patients is cost-effective only in populations with a very high TB prevalence. The Xpert MTB/RIF assay on sputum is more cost-effective than clinical diagnosis. To our knowledge, no published comparative studies addressed whether the rate of cough resolution is a reliable determinant of the response to treatment or whether the rate of cough resolution was faster in the absence of cavitary lung disease. All studies on cough prevalence in Mycobacterium avium complex (MAC) lung disease, other nontuberculous mycobacterial infections, fungal lung disease, and paragonimiasis were of poor quality and were excluded from the evidence review. CONCLUSIONS On the basis of relatively few studies of fair to good quality, we conclude that most individuals at high risk and household contacts with cough ≥ 2 weeks do not have pulmonary TB, but we suggest screening them regardless of cough duration. In PLWHIV, the addition of the other WHO-endorsed symptoms increases the diagnostic sensitivity of cough. Earlier screening of patients with cough will help diagnose pulmonary TB sooner but will increase the cost of screening. The addition of ACF to PCF will increase the number of pulmonary TB cases identified. Screening asymptomatic individuals is cost-effective only in groups with a very high TB prevalence. Data are insufficient to determine whether cough resolution is delayed in individuals with cavitary lung disease or in those for whom treatment fails because of drug resistance, poor adherence, and/or drug malabsorption compared with results in other individuals with pulmonary TB. Cough is common in patients with lung infections due to MAC, other nontuberculous mycobacteria, fungal diseases, and paragonimiasis.
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Affiliation(s)
- Stephen K Field
- Division of Respirology and TB Services, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Patricio Escalante
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic Center for Tuberculosis, Mayo Clinic, Rochester, MN
| | - Dina A Fisher
- Division of Respirology and TB Services, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Richard S Irwin
- University of Massachusetts Memorial Medical Center, Worcester, MA
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Ribas A, Jollivet C, Morand S, Thongmalayvong B, Somphavong S, Siew CC, Ting PJ, Suputtamongkol S, Saensombath V, Sanguankiat S, Tan BH, Paboriboune P, Akkhavong K, Chaisiri K. Intestinal Parasitic Infections and Environmental Water Contamination in a Rural Village of Northern Lao PDR. THE KOREAN JOURNAL OF PARASITOLOGY 2017; 55:523-532. [PMID: 29103267 PMCID: PMC5678468 DOI: 10.3347/kjp.2017.55.5.523] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 07/20/2017] [Accepted: 08/14/2017] [Indexed: 12/02/2022]
Abstract
A field survey studying intestinal parasites in humans and microbial pathogen contamination at environment was performed in a Laotian rural village to identify potential risks for disease outbreaks. A parasitological investigation was conducted in Ban Lak Sip village, Luang Prabang, Lao PDR involving fecal samples from 305 inhabitants as well as water samples taken from 3 sites of the local stream. Water analysis indicated the presence of several enteric pathogens, i.e., Aeromonas spp., Vibrio spp., E. coli H7, E. coli O157: H7, verocytotoxin-producing E. coli (VTEC), Shigella spp., and enteric adenovirus. The level of microbial pathogens contamination was associated with human activity, with greater levels of contamination found at the downstream site compared to the site at the village and upstream, respectively. Regarding intestinal parasites, the prevalence of helminth and protozoan infections were 68.9% and 27.2%, respectively. Eight helminth taxa were identified in fecal samples, i.e., 2 tapeworm species (Taenia sp. and Hymenolepis diminuta), 1 trematode (Opisthorchis sp.), and 5 nematodes (Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis, trichostrongylids, and hookworms). Six species of intestinal protists were identified, i.e., Blastocystis hominis, Cyclospora spp., Endolimax nana, Entamoeba histolytica/E. dispar, Entamoeba coli, and Giardia lamblia. Questionnaires and interviews were also conducted to determine risk factors of infection. These analyses together with a prevailing infection level suggested that most of villagers were exposed to parasites in a similar degree due to limited socio-economic differences and sharing of similar practices. Limited access to effective public health facilities is also a significant contributing factor.
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Affiliation(s)
- Alexis Ribas
- Section of Parasitology, Department of Biology, Healthcare and the Environment, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
| | - Chloé Jollivet
- CIRAD Animal et Gestion Integree des Risques, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - Serge Morand
- CNRS-CIRAD, Faculty of Veterinary Technology, Kasetsart University, Bangkok, Thailand
| | | | - Silaphet Somphavong
- Centre Christophe Merieux du Laos, Vientiane, Lao People's Democratic Republic
| | - Chern-Chiang Siew
- Detection and Diagnostic Laboratories, DSO National Laboratories, Singapore
| | - Pei-Jun Ting
- Detection and Diagnostic Laboratories, DSO National Laboratories, Singapore
| | - Saipin Suputtamongkol
- Department of Anthropology, Faculty of Social Sciences, Thammasart University, Bangkok, Thailand
| | - Viengsaene Saensombath
- Internal Medicine Division, Luangprabang Provincial Hospital, Laos People's Democratic Republic
| | - Surapol Sanguankiat
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Boon-Huan Tan
- Detection and Diagnostic Laboratories, DSO National Laboratories, Singapore
| | - Phimpha Paboriboune
- Centre Christophe Merieux du Laos, Vientiane, Lao People's Democratic Republic
| | - Kongsap Akkhavong
- National Institute of Health, Vientiane, Lao People's Democratic Republic
| | - Kittipong Chaisiri
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Usefulness and limits of Ziehl-Neelsen staining to detect paragonimiasis in highly endemic tuberculosis areas. Parasite Epidemiol Control 2016; 2:1-7. [PMID: 29774276 PMCID: PMC5952665 DOI: 10.1016/j.parepi.2016.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 12/07/2016] [Accepted: 12/07/2016] [Indexed: 12/04/2022] Open
Key Words
- AFB, acid-fast bacilli
- ELISA, enzyme-linked immunosorbent assay
- ID, intradermal
- IFMT, Institut de la Francophonie pour la Médecine Tropicale
- Lao PDR, Lao People's Democratic Republic
- NTC, National Tuberculosis Centre
- PP, pulmonary paragonimiasis
- TB, tuberculosis
- WHO, World Health Organization
- ZN, Ziehl-Neelsen
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Molecular identification of the trematode Paragonimus in faecal samples from the wild cat Prionailurus bengalensis in the Da Krong Nature Reserve, Vietnam. J Helminthol 2015; 90:658-662. [PMID: 26388560 DOI: 10.1017/s0022149x15000838] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Conventional identification of Paragonimus species and their natural definitive hosts is based on the morphological features of adult parasites isolated from the lungs of wild mammalian hosts. However, wild animals are protected by strict regulations and sampling is not always possible. Recently, molecular techniques have been developed to identify the internal transcribed spacer (ITS) sequences of Paragonimus eggs in faeces/sputum of human patients. Also, mammalian hosts can be identified using the D-loop sequence of mitochondrial DNA in faecal samples. In this study, we used molecular techniques on faeces from wild animals collected in Da Krong Nature Reserve, Quang Tri province, central Vietnam, where Paragonimus metacercariae are highly prevalent in mountain crabs, to identify Paragonimus species and their natural definitive hosts. The results indicated that wild cats, Prionailurus bengalensis, were infected with at least three different Paragonimus species, P. westermani, P. skrjabini and P. heterotremus. Because all of these species can infect humans in Asian countries, human paragonimiasis should be considered in this area.
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Sanpool O, Intapan PM, Thanchomnang T, Janwan P, Laymanivong S, Sugiyama H, Maleewong W. Morphological and molecular identification of a lung fluke, Paragonimus macrorchis (Trematoda, Paragonimidae), found in central Lao PDR and its molecular phylogenetic status in the genus Paragonimus. Parasitol Int 2015; 64:513-8. [PMID: 26170107 DOI: 10.1016/j.parint.2015.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Revised: 06/20/2015] [Accepted: 06/23/2015] [Indexed: 10/23/2022]
Abstract
Paragonimus macrorchis is rather a rare species with sporadic discovery reports. To date, little is known about morphological features and the molecular phylogenetic status of P. macrorchis. Here we provide such information on P. macrorchis, of which metacercariae were collected from freshwater crabs in Khammouane Province, central Lao PDR. After morphological observation, metacercariae were excysted and were injected intra-peritoneally into Mongolian gerbils. Paragonimus adult worms were collected from the lungs of experimental gerbils 45 days after infection. A small piece of body tissue was cut at the posterior part of each adult worm for genomic DNA extraction. Then, the adult worms were stained and mounted for morphological identification. The second internal transcribed spacer region (ITS2) of rDNA and partial cytochrome c oxidase subunit 1 (cox1) gene were amplified using PCR method and sequenced. The results of morphological identification of metacercariae and adult worms together with their DNA sequences of ITS2 and partial cox1 gene clearly show that the specimens we collected in the central Lao PDR were P. macrorchis. Phylogenetic analyses revealed that P. macrorchis forms an independent cluster from other Paragonimus species in Asia.
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Affiliation(s)
- Oranuch Sanpool
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen Thailand; Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand
| | - Pewpan Maleewong Intapan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen Thailand
| | - Tongjit Thanchomnang
- Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen Thailand; Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand
| | - Penchom Janwan
- Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen Thailand; Department of Medical Technology, School of Allied Health Sciences and Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - Sakhone Laymanivong
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Laboratory Unit, Centre of Malariology, Parasitology and Entomology, Ministry of Health, Lao Democratic People's Republic
| | - Hiromu Sugiyama
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Wanchai Maleewong
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen Thailand.
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Reprint of "An overview of freshwater snails in Asia with main focus on Vietnam". Acta Trop 2015; 141:372-84. [PMID: 25446169 DOI: 10.1016/j.actatropica.2014.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 08/04/2014] [Accepted: 08/07/2014] [Indexed: 01/09/2023]
Abstract
Freshwater snails have received much attention for their role as intermediate hosts for trematodes causing disease in people and animals such as schistosomiasis and various food-borne trematodes. While effective medical treatment exists for some of these diseases there is need for preventive measures to reduce transmission, e.g. control of intermediate hosts because transmission patterns are often complicated due to presence of reservoir final hosts. In order to implement control measures against the intermediate host snails with minimal impact on the freshwater ecosystems and their biodiversity, a profound knowledge on transmission patterns of the trematodes is required and this is partly related to distribution, habitat preferences, and seasonal variation in density of the intermediate host species. Identification of snail species can be problematic on the basis of morphological and anatomical characters alone as some species show morphological plasticity and similarly morphological differentiation of cercariae found in snails may be difficult and this could lead to biased perceptions of intermediate host spectra and transmission patterns. In this paper, we give an overview of the snail families and their medical and veterinary importance in Asia but with main focus on Vietnam.
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Madsen H, Hung N. An overview of freshwater snails in Asia with main focus on Vietnam. Acta Trop 2014; 140:105-17. [PMID: 25149356 DOI: 10.1016/j.actatropica.2014.08.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 08/04/2014] [Accepted: 08/07/2014] [Indexed: 12/16/2022]
Abstract
Freshwater snails have received much attention for their role as intermediate hosts for trematodes causing disease in people and animals such as schistosomiasis and various food-borne trematodes. While effective medical treatment exists for some of these diseases there is need for preventive measures to reduce transmission, e.g. control of intermediate hosts because transmission patterns are often complicated due to presence of reservoir final hosts. In order to implement control measures against the intermediate host snails with minimal impact on the freshwater ecosystems and their biodiversity, a profound knowledge on transmission patterns of the trematodes is required and this is partly related to distribution, habitat preferences, and seasonal variation in density of the intermediate host species. Identification of snail species can be problematic on the basis of morphological and anatomical characters alone as some species show morphological plasticity and similarly morphological differentiation of cercariae found in snails may be difficult and this could lead to biased perceptions of intermediate host spectra and transmission patterns. In this paper, we give an overview of the snail families and their medical and veterinary importance in Asia but with main focus on Vietnam.
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Barennes H, Slesak G, Buisson Y, Odermatt P. Paragonimiasis as an important alternative misdiagnosed disease for suspected acid-fast bacilli sputum smear-negative tuberculosis. Am J Trop Med Hyg 2014; 90:384-385. [PMID: 24501118 PMCID: PMC3919254 DOI: 10.4269/ajtmh.13-0710] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Wang Y, Wang L, Zhang J, Wang G, Chen W, Chen L, Zhang X. Preparation of colloidal gold immunochromatographic strip for detection of Paragonimiasis skrjabini. PLoS One 2014; 9:e92034. [PMID: 24643068 PMCID: PMC3958401 DOI: 10.1371/journal.pone.0092034] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 02/19/2014] [Indexed: 11/18/2022] Open
Abstract
Background Paragonimiasis is a food-borne trematodiasis, a serious public health issue and a neglected tropical disease. Paragonimus skrjabini is a unique species found in China. Unlike paragonimiasis westermani, it is nearly impossible to make a definitive diagnosis for paragonimiasis skrjabini by finding eggs in sputum or feces. Immunodiagnosis is the best choice to detect paragonimiasis skrjabini. There is an urgent need to develop a novel, rapid and simple immunoassay for large-scale screening patients in endemic areas. Methodology/Principal Findings To develop a rapid, simple immunodiagnostic assay for paragonimiasis, rabbit anti-human IgG was conjugated to colloidal gold particles and used to detect antibodies in the sera of paragonimiasis patients. The synthesis and identification of colloidal gold particles and antibody-colloidal gold conjugates were performed. The size of colloidal gold particles was examined using a transmission electron microscope (TEM). The average diameter of colloidal gold particles was 17.46 nm with a range of 14.32–21.80 nm according to the TEM images. The formation of antibody-colloidal gold conjugates was monitored by UV/Vis spectroscopy. Excretory-secretory (ES) antigen of Paragonimus skrjabini was coated on nitrocellulose membrane as the capture line. Recombinant Staphylococcus protein A was used to prepare the control line. This rapid gold immunochromatographic strip was assembled in regular sequence through different accessories sticked on PVC board. The relative sensitivity and specificity of the strip was 94.4% (51/54) and 94.1% (32/34) respectively using ELISA as the standard method. Its stability and reproducibility were quite excellent after storage of the strip at 4°C for 6 months. Conclusions/Significance Immunochromatographic strip prepared in this study can be used in a rapid one-step immunochromatographic assay, which is instantaneous and convenient.
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Affiliation(s)
- Ying Wang
- Institute of Tropical Medicine, Third Military Medical University, Chongqing, China
| | - Lifang Wang
- Department of Pathogenic Biology, Luzhou Medical College, Sichuan, China
| | - Jianwei Zhang
- Department of Physics, Chengdu Medical College, Sichuan, China
| | - Guangxi Wang
- Department of Pathogenic Biology, Luzhou Medical College, Sichuan, China
| | - Wenbi Chen
- Department of Pathogenic Biology, Luzhou Medical College, Sichuan, China
| | - Lin Chen
- Department of Pathogenic Biology, Third Military Medical University, Chongqing, China
| | - Xilin Zhang
- Institute of Tropical Medicine, Third Military Medical University, Chongqing, China
- Department of Pathogenic Biology, Third Military Medical University, Chongqing, China
- * E-mail:
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Abstract
Paragonimiasis is a zoonotic disease caused by lung flukes of the genus Paragonimus. Humans usually become infected by eating freshwater crabs or crayfish containing encysted metacercariae of these worms. However, an alternative route of infection exists: ingestion of raw meat from a mammalian paratenic host. Adult worms normally occur in pairs in cysts in the lungs from which they void their eggs via air passages. The pulmonary form is typical in cases of human infection due to P. westermani, P. heterotremus, and a few other species (Table 5.1). Worms may occupy other sites in the body, notably the brain, but lung flukes have made their presence felt in almost every organ. Ectopic paragonimiasis is particularly common when infection is due to members of the P. skrjabini complex (Table 5.1). Human paragonimiasis occurs primarily in the tropics and subtropics of Asia, Africa, and the Americas, with different species being responsible in different areas (Table 5.1).
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Affiliation(s)
- David Blair
- College of Science and Engineering, James Cook University, Townsville, QLD, Australia.
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Habe S, Doanh PN, Yahiro S, Vannavong N, Barennes H, Odermatt P, Dreyfuss G, Horii Y, Nawa Y. Paragonimus paishuihoensis metacercariae in freshwater crabs, Potamon lipkei, in Vientiane Province, Lao PDR. THE KOREAN JOURNAL OF PARASITOLOGY 2013; 51:683-7. [PMID: 24516274 PMCID: PMC3916458 DOI: 10.3347/kjp.2013.51.6.683] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 08/07/2013] [Accepted: 10/11/2013] [Indexed: 11/23/2022]
Abstract
Among Paragonimus species, P. paishuihoensis is one of the most mysterious and poorly understood species. Metacercariae are characterized by having a unique dendritically branched excretory bladder. However, the morphology of the adult worm remains unknown. To date, metacercariae of this species have been reported only in China and Thailand. In this study, we first found P. paishuihoensis metacercariae in freshwater crabs, Potamon lipkei, in Hinheub District, Vientiane, Lao PDR, with a prevalence of 77.7% and the average intensity of 10.3 (range 1-28) metacercariae per crab. The molecular data based on ITS2 and CO1 markers indicated that P. paishuihoensis from Laos and Thailand were almost completely identical and were close to members of the Paragonimus bangkokensis/Paragonimus harinasutai complex. Attempts to infect experimental animals (cats, dogs, and rats) with P. paishuihoensis were unsuccessful, suggesting that these animals might be unsuitable definitive hosts for the species. Further studies are necessary to elucidate the taxonomic status and life cycle of P. paishuihoensis.
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Affiliation(s)
- Shigehisa Habe
- Department of Microbiology and Immunology, School of Medicine, Fukuoka University, Fukuoka, Japan
| | - Pham Ngoc Doanh
- Institute of Ecology and Biological Resources, Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | | | | | - Hubert Barennes
- Institut de la Francophonie pour la Médecine Tropicale, Vientiane, Lao PDR
| | - Peter Odermatt
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Yoichiro Horii
- Laboratory of Veterinary Parasitic Diseases, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Yukifumi Nawa
- Research Affairs, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Tantrawatpan C, Intapan PM, Thanchomnang T, Sanpool O, Janwan P, Lulitanond V, Anamnart W, Maleewong W. Application of a real-time fluorescence resonance energy transfer polymerase chain reaction assay with melting curve analysis for the detection of Paragonimus heterotremus eggs in the feces of experimentally infected cats. J Vet Diagn Invest 2013; 25:620-6. [DOI: 10.1177/1040638713497944] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Paragonimus heterotremus is a medically important lung fluke that causes human and animal paragonimiasis in Southeast Asia, including Thailand. In the current study, a real-time fluorescence resonance energy transfer polymerase chain reaction (real-time FRET PCR) with melting curve analysis was developed and evaluated to detect P. heterotremus eggs in the feces of experimentally infected cats. The detection limit of this method for the P. heterotremus DNA sequence was 3 × 102 copies of the positive control plasmid and 10−3 ng of P. heterotremus genomic DNA. The assay system could detect 10 eggs of P. heterotremus per gram of cat feces. No fluorescence signal was observed when DNA purified from 16 other organisms or genomic DNA from cats and human beings were tested. Real-time FRET PCR yielded positive results for all fecal samples from 17 P. heterotremus–infected cats and showed a negative relationship ( r = −0.852, P < 0.001) between the number of parasite eggs in feces and the number of PCR cycles. The assay could detect genomic DNA from P. heterotremus, P. westermani, P. macrorchis, P. siamensis, P. harinasutai, and P. bangkokensis and can differentiate P. heterotremus from the other 5 species. The 6 Paragonimus species examined were divided into 4 groups by melting peak analysis. This assay can be useful for the detection of, and epidemiological studies on, P. heterotremus infection in endemic areas.
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Affiliation(s)
- Chairat Tantrawatpan
- Research and Diagnostic Center for Emerging Infectious Diseases (Tantrawatpan, Intapan, Thanchomnang, Sanpool, Janwan, Lulitanond, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Departments of Parasitology (Intapan, Sanpool, Janwan, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Microbiology (Lulitanond), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Division of Cell Biology, Department of Preclinical Sciences, Faculty of Medicine, Thammasat University, Rangsit Campus, Pathum Thani, Thailand (Tantrawatpan)
- Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand (Thanchomnang)
| | - Pewpan M. Intapan
- Research and Diagnostic Center for Emerging Infectious Diseases (Tantrawatpan, Intapan, Thanchomnang, Sanpool, Janwan, Lulitanond, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Departments of Parasitology (Intapan, Sanpool, Janwan, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Microbiology (Lulitanond), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Division of Cell Biology, Department of Preclinical Sciences, Faculty of Medicine, Thammasat University, Rangsit Campus, Pathum Thani, Thailand (Tantrawatpan)
- Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand (Thanchomnang)
| | - Tongjit Thanchomnang
- Research and Diagnostic Center for Emerging Infectious Diseases (Tantrawatpan, Intapan, Thanchomnang, Sanpool, Janwan, Lulitanond, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Departments of Parasitology (Intapan, Sanpool, Janwan, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Microbiology (Lulitanond), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Division of Cell Biology, Department of Preclinical Sciences, Faculty of Medicine, Thammasat University, Rangsit Campus, Pathum Thani, Thailand (Tantrawatpan)
- Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand (Thanchomnang)
| | - Oranuch Sanpool
- Research and Diagnostic Center for Emerging Infectious Diseases (Tantrawatpan, Intapan, Thanchomnang, Sanpool, Janwan, Lulitanond, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Departments of Parasitology (Intapan, Sanpool, Janwan, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Microbiology (Lulitanond), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Division of Cell Biology, Department of Preclinical Sciences, Faculty of Medicine, Thammasat University, Rangsit Campus, Pathum Thani, Thailand (Tantrawatpan)
- Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand (Thanchomnang)
| | - Penchom Janwan
- Research and Diagnostic Center for Emerging Infectious Diseases (Tantrawatpan, Intapan, Thanchomnang, Sanpool, Janwan, Lulitanond, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Departments of Parasitology (Intapan, Sanpool, Janwan, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Microbiology (Lulitanond), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Division of Cell Biology, Department of Preclinical Sciences, Faculty of Medicine, Thammasat University, Rangsit Campus, Pathum Thani, Thailand (Tantrawatpan)
- Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand (Thanchomnang)
| | - Viraphong Lulitanond
- Research and Diagnostic Center for Emerging Infectious Diseases (Tantrawatpan, Intapan, Thanchomnang, Sanpool, Janwan, Lulitanond, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Departments of Parasitology (Intapan, Sanpool, Janwan, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Microbiology (Lulitanond), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Division of Cell Biology, Department of Preclinical Sciences, Faculty of Medicine, Thammasat University, Rangsit Campus, Pathum Thani, Thailand (Tantrawatpan)
- Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand (Thanchomnang)
| | - Witthaya Anamnart
- Research and Diagnostic Center for Emerging Infectious Diseases (Tantrawatpan, Intapan, Thanchomnang, Sanpool, Janwan, Lulitanond, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Departments of Parasitology (Intapan, Sanpool, Janwan, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Microbiology (Lulitanond), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Division of Cell Biology, Department of Preclinical Sciences, Faculty of Medicine, Thammasat University, Rangsit Campus, Pathum Thani, Thailand (Tantrawatpan)
- Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand (Thanchomnang)
| | - Wanchai Maleewong
- Research and Diagnostic Center for Emerging Infectious Diseases (Tantrawatpan, Intapan, Thanchomnang, Sanpool, Janwan, Lulitanond, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Departments of Parasitology (Intapan, Sanpool, Janwan, Maleewong), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Microbiology (Lulitanond), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Division of Cell Biology, Department of Preclinical Sciences, Faculty of Medicine, Thammasat University, Rangsit Campus, Pathum Thani, Thailand (Tantrawatpan)
- Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand (Thanchomnang)
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Doanh PN, Guo Z, Nonaka N, Horii Y, Nawa Y. Natural hybridization between Paragonimus bangkokensis and Paragonimus harinasutai. Parasitol Int 2013; 62:240-5. [DOI: 10.1016/j.parint.2013.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 01/03/2013] [Accepted: 01/28/2013] [Indexed: 10/27/2022]
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Tantrawatpan C, Intapan PM, Janwan P, Sanpool O, Lulitanond V, Srichantaratsamee C, Anamnart W, Maleewong W. Molecular identification of Paragonimus species by DNA pyrosequencing technology. Parasitol Int 2012; 62:341-5. [PMID: 23246361 DOI: 10.1016/j.parint.2012.11.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 11/12/2012] [Accepted: 11/26/2012] [Indexed: 10/27/2022]
Abstract
DNA pyrosequencing for PCR amplicons is an attractive strategy for the identification of microorganisms because of its short time performance for large number of samples. In this study, the primers targeting the fragment of ITS2 region of nuclear ribosomal RNA gene were newly developed for pyrosequencing-based identification of 6 Paragonimus species, Paragonimus bangkokensis, Paragonimus harinasutai, Paragonimus heterotremus, Paragonimus macrorchis, Paragonimus siamensis and Paragonimus westermani. Pyrosequencing determination of 39 nucleotides of partial ITS2 region could discriminate 6 Paragonimus species, and could also detect intra-species genetic variation of P. macrorchis. This DNA pyrosequencing-based identification can be a valuable tool to improve species-level identification of Paragonimus in the endemic areas.
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Affiliation(s)
- Chairat Tantrawatpan
- Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University, Khon Kaen, Thailand
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17
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Zhang XL, Wang Y, Wang GX, Chen WB, He X, Niu H, Li ZL, Chen L, Wang LF. Distribution and clinical features of Paragonimiasis skrjabini in Three Gorges Reservoir Region. Parasitol Int 2012; 61:645-9. [DOI: 10.1016/j.parint.2012.06.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Revised: 06/10/2012] [Accepted: 06/25/2012] [Indexed: 11/26/2022]
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18
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Doanh PN, Van Hien H, Nonaka N, Horii Y, Nawa Y. Co-existence of Paragonimus harinasutai and Paragonimus bangkokensis metacercariae in fresh water crab hosts in central Viet Nam with special emphasis on their close phylogenetic relationship. Parasitol Int 2012; 61:399-404. [DOI: 10.1016/j.parint.2012.01.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 01/30/2012] [Accepted: 01/30/2012] [Indexed: 11/17/2022]
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19
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Traoré SG, Odermatt P, Bonfoh B, Utzinger J, Aka ND, Adoubryn KD, Assoumou A, Dreyfuss G, Koussémon M. No Paragonimus in high-risk groups in Côte d'Ivoire, but considerable prevalence of helminths and intestinal protozoon infections. Parasit Vectors 2011; 4:96. [PMID: 21639877 PMCID: PMC3130684 DOI: 10.1186/1756-3305-4-96] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Accepted: 06/03/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Paragonimiasis is a neglected tropical disease caused by an infection with lung flukes that is transmitted through the consumption of undercooked crabs. The disease is often confused with tuberculosis. Paragonimiasis is thought to be endemic in south-western Côte d'Ivoire. METHODS Two cross-sectional surveys were carried out in the first half of 2009 in patients attending two tuberculosis centres of Abidjan. A third cross-sectional survey was conducted in May 2010 in children of two primary schools in Dabou, where crabs are frequently consumed. Patients with chronic cough provided three sputum samples plus one stool sample. Sputum samples were examined for tuberculosis with an auramine staining technique and for Paragonimus eggs using a concentration technique. Stool samples were subjected to the Ritchie technique. Schoolchildren provided a single stool sample, and samples were subjected to the Kato-Katz and an ether-concentration technique. A pre-tested questionnaire was administered to patients and schoolchildren to investigate food consumption habits. Additionally, between June 2009 and August 2010, shellfish were purchased from markets in Abidjan and Dabou and examined for metacercariae. RESULTS No human case of paragonimiasis was diagnosed. However, trematode infections were seen in 32 of the 272 shellfish examined (11.8%). Questionnaire results revealed that crab and pig meat is well cooked before consumption. Among the 278 patients with complete data records, 62 had tuberculosis, with a higher prevalence in males than females (28.8% vs. 13.9%, χ2 = 8.79, p = 0.003). The prevalence of helminths and intestinal protozoa was 4.6% and 16.9%, respectively. In the school survey, among 166 children with complete data records, the prevalence of helminths and intestinal protozoa was 22.3% and 48.8%, respectively. Boys had significantly higher prevalences of helminths and intestinal protozoa than girls. Hookworm was the predominant helminth species and Entamoeba coli was the most common intestinal protozoon species (13.8%). CONCLUSIONS Not a single case of Paragonimus was found in two high-risk groups of Côte d'Ivoire, most likely explained by food consumption habits. However, other helminth and intestinal protozoon infections were common.
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Affiliation(s)
- Sylvain G Traoré
- Laboratoire de Biotechnologie et Microbiologie des Aliments, UFR des Sciences et Technologies des Aliments, Université d'Abobo-Adjamé, Abidjan, Côte d'Ivoire.
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Slesak G, Mounlaphome K, Inthalad S, Phoutsavath O, Mayxay M, Newton PN. Bowel obstruction from wild bananas: a neglected health problem in Laos. Trop Doct 2011; 41:85-90. [PMID: 21421885 PMCID: PMC3125700 DOI: 10.1258/td.2011.100293] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We investigated the significance and risk factors of bowel obstruction caused by the consumption of wild bananas (BOWB) in Laos. Of six patients with BOWB in Luang Namtha, North Laos, five required enterotomy for phytobezoars. All had eaten wild banana (WB) seeds. Of 227 other patients/relatives: 91.2% had eaten WB; 46.3% had also eaten the seeds and 45.4% knew of complications resulting from eating WB; 42.3% were aware of the complications of ingesting the seeds (constipation [37.9%], appendicitis/abdominal pain/vomiting [2.6% each] and bloated stomach/death [1.3% each]). Middle/highland Lao ethnicity was associated with WB and seed consumption (odds ratio [OR] 9.91 and 2.33), male sex with WB consumption and unawareness (OR 4.31 and 1.78). At all surgically-equipped hospitals in Laos, 33/44 doctors knew of BOWB, describing patients as young adults (16/30), male (24/30) and from middleland Lao (18/30). Countrywide, 46/48 patients with BOWB required laparotomy in 2009 (incidence 0.8/100,000). All consumed WB seeds. BOWB is widespread in Laos, especially among young middleland Lao men consuming WB seeds on an empty stomach.
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Slesak G, Inthalad S, Basy P, Keomanivong D, Phoutsavath O, Khampoui S, Grosrenaud A, Amstutz V, Barennes H, Buisson Y, Odermatt P. Ziehl-Neelsen staining technique can diagnose paragonimiasis. PLoS Negl Trop Dis 2011; 5:e1048. [PMID: 21610861 PMCID: PMC3096611 DOI: 10.1371/journal.pntd.0001048] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 04/14/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We evaluated the Ziehl-Neelsen staining (ZNS) technique for the diagnosis of paragonimiasis in Laos and compared different modifications of the ZNS techniques. METHODOLOGY WE APPLIED THE FOLLOWING APPROACH: We (1) examined a paragonimiasis index case's sputum with wet film direct examination (WF) and ZNS; (2) re-examined stored ZNS slides from two provinces; (3) compared prospectively WF, ZNS, and formalin-ether concentration technique (FECT) for sputum examination of patients with chronic cough; and (4) compared different ZNS procedures. Finally, we assessed excess direct costs associated with the use of different diagnostic techniques. PRINCIPAL FINDINGS Paragonimus eggs were clearly visible in WF and ZNS sputum samples of the index case. They appeared brownish-reddish in ZNS and were detected in 6 of 263 archived ZNS slides corresponding to 5 patients. One hundred sputum samples from 43 patients were examined with three techniques, which revealed that 6 patients had paragonimiasis (13 positive samples). Sensitivity per slide of the FECT, ZNS and the WF technique was 84.6 (p = 0.48), 76.9 (p = 0.25) and 61.5% (p = 0.07), respectively. Percentage of fragmented eggs was below 19% and did not differ between techniques (p = 0.13). Additional operational costs per slide were 0 (ZNS), 0.10 US$ (WF), and 0.79 US$ (FECT). ZNS heated for five minutes contained less eggs than briefly heated slides (29 eggs per slide [eps] vs. 42 eps, p = 0.01). Bloodstained sputum portions contained more eggs than unstained parts (3.3 eps vs. 0.7 eps, p = 0.016). CONCLUSIONS/SIGNIFICANCE Paragonimus eggs can easily be detected in today's widely used ZNS of sputum slides. The ZNS technique appears superior to the standard WF sputum examination for paragonimiasis and eliminates the risk of tuberculosis transmission. Our findings suggest that ZNS sputum slides should also be examined routinely for Paragonimus eggs. ZNS technique has potential in epidemiological research on paragonimiasis.
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Affiliation(s)
- Günther Slesak
- Service Fraternel d'Entraide, Vientiane, Lao People's Democratic Republic.
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Hervé J, Santin A, Renaud B. Épanchement pleural non traumatique en urgence. ANNALES FRANCAISES DE MEDECINE D URGENCE 2011. [DOI: 10.1007/s13341-011-0039-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kanpittaya J, Sawanyawisuth K, Vannavong A, Intapan PM, Maleewong W, Zhang W, Strobel M. Different chest radiographic findings of pulmonary paragonimiasis in two endemic countries. Am J Trop Med Hyg 2010; 83:924-6. [PMID: 20889893 PMCID: PMC2946770 DOI: 10.4269/ajtmh.2010.10-0091] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Accepted: 04/02/2010] [Indexed: 11/07/2022] Open
Abstract
We compared the chest radiographic findings of patients with pulmonary paragonimiasis in the Lao People's Democratic Republic (PDR) with a report from Korea. The clinical and radiological characteristics of 50 confirmed Laotian pleuropulmonary paragonimiasis patients were studied between March 2003 and June 2007. In 49 patients, the chest radiographs showed abnormal findings (98%). Pulmonary parenchymal abnormalities were found in all 49 patients, whereas pleural effusion was only found in 11 patients (22%). The three most common intraparenchymal findings were multiple small cysts (90%), irregular linear densities (68%), and nodular opacities (40%). The numbers of patients who had these three findings were significantly different from the Korean report (P < 0.001). In conclusion, radiographic findings of pulmonary paragonimiasis may vary among countries.
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Affiliation(s)
| | - Kittisak Sawanyawisuth
- Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Institut de la Francophonie pour la Médecine Tropicale (IFMT), Vientiane, Lao People's Democratic Republic; First Affiliated Hospital of Kunming Medical College, Yunnan, China; Research and Diagnosis Center for Emerging Infectious Disease, Khon Kaen University, Khon Kaen, Thailand
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Barennes H, Keophithoun T, Nguyen TH, Strobel M, Odermatt P. Survival and health status of DOTS tuberculosis patients in rural Lao PDR. BMC Infect Dis 2010; 10:265. [PMID: 20831780 PMCID: PMC2944351 DOI: 10.1186/1471-2334-10-265] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Accepted: 09/10/2010] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Contact tracing of tuberculosis (TB) patients is rarely performed in low-income countries. Our objective was to assess the outcome of and compliance with directly observed treatment (DOTS) of TB patients over a 3 year period in rural Lao PDR. METHODS We performed a retrospective cohort study in which we enrolled TB patients who started DOTS treatment at Attapeu Provincial Hospital. We traced, through hospital records, all patients in their residential village. We conducted a standardized questionnaire with all TB patients and performed physical and anthropometric examinations as well as evaluations of compliance through counting of treatment pills at home and at the health facilities. RESULTS Of 172 enrolled TB patients (sex ratio female/male: 0.52, mean age: 46.9 years ± 16.9), 26 (15.1%) died. These had a lower weight at the start (34.6 vs. 40.8 kg, p < 0.001) and were less compliant (91.6% vs. 19.2%, p < 0.001) than survivors. Low compliance was associated with poor accessibility to health care (p = 0.01) and symptomatic improvement (p = 0.02). Survivors had persistently poor health status. They were underweight (54.7%), and still had clinical symptoms (53.5%), including dyspnoea (28.8%) and haemoptysis (9.5%). CONCLUSION Our study suggests a lower rate of survival than expected from official statistics. Additionally, it showed that follow-up of TB patients is feasible although the patients lived in very remote area of Laos. Follow-up should be strengthened as it can improve patient compliance, and allow contact tracing, detection of new cases and collection of accurate treatment outcome information.
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Affiliation(s)
- Hubert Barennes
- Institut de la Francophonie pour la Médecine Tropicale, Vientiane, Lao PDR
| | | | - Tuan H Nguyen
- Institut de la Francophonie pour la Médecine Tropicale, Vientiane, Lao PDR
| | - Michel Strobel
- Institut de la Francophonie pour la Médecine Tropicale, Vientiane, Lao PDR
| | - Peter Odermatt
- Swiss Tropical and Public Health Institute, Department of Public Health and Epidemiology, PO Box, 4002 Basel, Switzerland
- University of Basel, 4003 Basel, Switzerland
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Odermatt P, Lv S, Sayasone S. Less Common Parasitic Infections in Southeast Asia that can Produce Outbreaks. ADVANCES IN PARASITOLOGY 2010; 72:409-35. [DOI: 10.1016/s0065-308x(10)72013-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Paragonimiasis in a person whose symptoms were shown 22 years after emigrating to Japan from Laos. J Infect Chemother 2010; 16:49-52. [DOI: 10.1007/s10156-009-0005-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Accepted: 08/29/2009] [Indexed: 10/20/2022]
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Studies on the Parasitology, Phylogeography and the Evolution of Host–Parasite Interactions for the Snail Intermediate Hosts of Medically Important Trematode Genera in Southeast Asia. ADVANCES IN PARASITOLOGY 2010; 73:405-40. [DOI: 10.1016/s0065-308x(10)73013-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Vidamaly S, Choumlivong K, Keolouangkhot V, Vannavong N, Kanpittaya J, Strobel M. Paragonimiasis: a common cause of persistent pleural effusion in Lao PDR. Trans R Soc Trop Med Hyg 2009; 103:1019-23. [DOI: 10.1016/j.trstmh.2008.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2008] [Revised: 12/04/2008] [Accepted: 12/04/2008] [Indexed: 10/21/2022] Open
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Odermatt P, Veasna D, Zhang W, Vannavong N, Phrommala S, Habe S, Barennes H, Strobel M. Rapid identification of paragonimiasis foci by lay informants in Lao People's Democratic Republic. PLoS Negl Trop Dis 2009; 3:e521. [PMID: 19771150 PMCID: PMC2737634 DOI: 10.1371/journal.pntd.0000521] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Accepted: 08/26/2009] [Indexed: 11/24/2022] Open
Abstract
Background Paragonimiasis is a food-borne trematodiasis leading to lung disease. Worldwide, an estimated 21 million people are infected. Foci of ongoing transmission remain often unnoticed. We evaluated a simple questionnaire approach using lay-informants at the village level to identify paragonimiasis foci and suspected paragonimiasis cases. Methodology/Principal Findings The study was carried out in an endemic area of Lao People's Democratic Republic. Leaders of 49 remote villages in northern Vientiane Province were asked to notify suspected paragonimiasis patients using a four-item questionnaire sent through administrative channels: persons responding positively for having chronic cough (more than 3 weeks) and/or blood in sputum with or without fever. We validated the village leaders' reports in ten representative villages with a door-to-door survey. We examined three sputa of suspected patients for the presence of Paragonimus eggs and acid fast bacilli. 91.8% of village leaders participated and notified a total of 220 suspected patients; 76.2% were eventually confirmed; an additional 138 suspected cases were found in the survey. Sensitivity of village leaders' notice for “chronic cough” and “blood in sputum” was 100%; “blood in sputum” alone reached a sensitivity of 85.7%. Significance Our approach led to the identification of three previously unknown foci of transmission. A rapid and simple lay-informant questionnaire approach is a promising low-cost community diagnostic tool of paragonimiasis control programs. Paragonimiasis is a neglected pulmonary disease provoked by a food-borne trematode parasite. The infection may develop into severe pulmonary disease, often diagnosed with delay and confused with tuberculosis. Globally an estimated 21 millions people are infected. Human infection is acquired through consumption of raw crab, crayfish or wild boar. Typically infections occur clustered in foci of few to several villages where nutritional habits allow transmission. A major challenge for control is to identify the transmission foci. We evaluated a questionnaire approach using lay-informants at the village level to identify paragonimiasis foci and suspected cases. We sent a 4-item questionnaire to 49 village-leaders of a district in rural Lao PDR asking them to report patients with key symptoms of paragonimiasis, i.e. “chronic cough” and “blood in sputum”. The evaluation showed that lay-informants' report had a high sensitivity to identify suspected cases of paragonimiasis using “blood in sputum” as indicator. The approach allowed identifying 3 new, previously unknown foci of transmission in the district. We conclude that lay-informant questionnaires using easily identifiable key symptoms are simple to carry out and are promising low-cost tools for paragonimiasis control.
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Affiliation(s)
- Peter Odermatt
- Department of Public Health and Epidemiology, Swiss Tropical Institute, Basel, Switzerland
- Institut de la Francophonie pour la médicine tropicale, Vientiane, Laos
- * E-mail:
| | - Duong Veasna
- Institut de la Francophonie pour la médicine tropicale, Vientiane, Laos
- Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Wei Zhang
- Institut de la Francophonie pour la médicine tropicale, Vientiane, Laos
| | | | | | - Shigehisa Habe
- Department of Microbiology and Immunology, School of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hubert Barennes
- Institut de la Francophonie pour la médicine tropicale, Vientiane, Laos
| | - Michel Strobel
- Institut de la Francophonie pour la médicine tropicale, Vientiane, Laos
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Ngoc Doanh P, Shinohara A, Horii Y, Yahiro S, Habe S, Vannavong N, Strobel M, Nakamura S, Nawa Y. Morphological differences and molecular similarities between Paragonimus bangkokensis and P. harinasutai. Parasitol Res 2009; 105:429-39. [DOI: 10.1007/s00436-009-1402-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Accepted: 03/10/2009] [Indexed: 10/21/2022]
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Sohn WM, Ryu JS, Min DY, Song HO, Rim HJ, Vonghachack Y, Bouakhasith D, Banouvong V. Indochinamon ou (Crustacea: Potamidae) as a new second intermediate host for Paragonimus harinasutai in Luang Prabang Province, Lao PDR. THE KOREAN JOURNAL OF PARASITOLOGY 2009; 47:25-9. [PMID: 19290088 DOI: 10.3347/kjp.2009.47.1.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2008] [Revised: 01/05/2009] [Accepted: 01/14/2009] [Indexed: 11/23/2022]
Abstract
Paragonimus harinasutai metacercariae were found in a species of freshwater crab, Indochinamon ou, collected in a small stream of Namback District, Luang Prabang Province, Lao PDR. Adult flukes were recovered after experimental infection of the metacercariae to dogs. Metacercariae were round or slightly elliptical, 0.666 x 0.626 mm in average size, and had a thin cyst wall of about 20 microm in thickness, a black excretory bladder, convoluted ceca, and some pinkish materials in the body. Adults were somewhat elongated, 95.2 x 36.5 mm in average size, covered with single-tipped tegumental spines, had a smaller oral sucker than the ventral sucker, a moderately branched ovary, and 5-6 lobulated testes. Eggs were ovoid and bilaterally symmetrical in shape, 79 x 45 microm in average size, and had a uniformly thickened shell. By the present study, it has been confirmed that I. ou is a new second intermediate host for P. harinasutai.
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Affiliation(s)
- Woon-Mok Sohn
- Department of Parasitology and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Korea
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Song HO, Min DY, Rim HJ, Youthanavanh V, Daluny B, Sengdara V, Virasack B, Bounlay P. Skin test for paragonimiasis among schoolchildren and villagers in Namback District, Luangprabang Province, Lao PDR. THE KOREAN JOURNAL OF PARASITOLOGY 2008; 46:179-82. [PMID: 18830059 DOI: 10.3347/kjp.2008.46.3.179] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
As a part of a broader effort to determine the status of Paragonimus species infection in Lao PDR, an epidemiological survey was conducted on villagers and schoolchildren in Namback District between 2003 and 2005. Among 308 villagers and 633 primary and secondary schoolchildren, 156 villagers and 92 children evidenced a positive reaction on a Paragonimus skin test. Only 4 schoolchildren out of 128 skin test-positive cases had Paragonimus sp. eggs in their sputum, all of which was collected on 1 day. Several types of crabs, which were identified as the second intermediate host of the Paragonimus species, were collected from markets and streams in a paragonimiasis endemic area for the inspection of metacercariae. Among the examined crabs, only "rock crabs" (Indochinamon ou) harbored Paragonimus sp. metacercariae, and it is speculated that the life cycle of Paragonimus sp. was maintained via rock crabs in Namback District, Lao PDR.
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Affiliation(s)
- Hyun-Ouk Song
- Department of Parasitology, Hanyang University College of Medicine, Seoul 133-791, Korea
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Yahiro S, Habe S, Duong V, Odermatt P, Barennes H, Strobel M, Nakamura S. Identification of the Human Paragonimiasis Causative Agent in Lao People's Democratic Republic. J Parasitol 2008; 94:1176-7. [DOI: 10.1645/ge-1457.1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2007] [Accepted: 02/18/2008] [Indexed: 11/10/2022] Open
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Odermatt P, Nanthaphone S, Barennes H, Chanthavysouk K, Tran DS, Kosanouvong B, Keola S, Mathouchanh P, Choumlivong K, Keoluangkhot V, Phoumindr N, Nanthanavone S, Phrommala S, Degrémont A, Strobel M. Improving tuberculosis case detection rate with a lay informant questionnaire: an experience from the Lao People's Democratic Republic. Bull World Health Organ 2008; 85:727-31. [PMID: 18026630 DOI: 10.2471/blt.06.038539] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2006] [Accepted: 04/03/2007] [Indexed: 11/27/2022] Open
Abstract
PROBLEM In many countries, the tuberculosis (TB) annual case detection rate is below the target of 70%. In the Lao People's Democratic Republic in 2005, it did not exceed 55% APPROACH The DOTS strategy promotes passive case detection of TB. In order to increase the detection rate, we validated a questionnaire targeting lay informants at village level to notify patients with chronic cough and assessed the relevance for TB case-finding. A three-item questionnaire was sent through the district health departments to all villages in six districts in six provinces. The village headmen were asked to notify chronic cough patients. Answers were validated in a door-to-door survey (20 villages/district). In a sub-sample (four villages/district) all confirmed patients were screened for TB and paragonimiasis. LOCAL SETTING Attapeu, Luang Namtha, Luang Prabang, Saravane, Savanakhet and Vientiane provinces in the Lao People's Democratic Republic. RELEVANT CHANGES Lay informant questionnaires sent from district health offices to villages are cost-effective and foster interaction between the health services and remote and underserved communities. Although the correct detection of patients is highly dependent on direct respondents, a substantial number of new TB and paragonimiasis cases were consistently diagnosed in chronic cough patients. LESSONS LEARNED Out of 456 questionnaires, 295 were returned (65%). Return rates were highly variable between districts (48-87%), questionnaires' sensitivity (56-98%), positive predictive value (34-88%) and correlation between number of notified and confirmed patients (r: 0.26-0.78). In sub-sampled villages (13,541 population) 19 (5.1%) TB and 26 (7.0%) paragonimiasis cases were detected in 374 chronic cough patients. This quick questionnaire approach proved motivating for district authorities and village key informants, although no incentives were provided. The highly operator-dependent approach yielded a consistent detection rate of TB and paragonimiasis cases. This approach brings health services and populations in need in close contact, which is particularly crucial in remote and underserved areas.
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Affiliation(s)
- Peter Odermatt
- Institut de la Francophonie pour la médecine tropicale, Vientiane, Lao People's Democratic Republic.
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Choi DW, Horii Y, Nawa Y. Paragonimus and paragonimiasis in Korea. ACTA ACUST UNITED AC 1992; 51:621-7. [PMID: 24516264 PMCID: PMC3916448 DOI: 10.3347/kjp.2013.51.6.621] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 09/19/2013] [Accepted: 10/11/2013] [Indexed: 12/14/2022]
Abstract
The lung fluke, Paragonimus, and lung fluke disease, were reviewed, especially on the works performed in Korea. Among 43 species of Paragonimus recorded in the world literature, P. westermani, P. pulmonalis, and P. iloktsuenensis are known to distribute in Korea. Biological studies on P. westermani have revealed that its snail intermediate host is Semisulcospira spp. and major second intermediate hosts are crabs such as Eriocheir japonicus and E. sinensis or crayfish such as Cambaroides similis and C. dauricus. The final hosts other than man are dogs, cats, pigs, and wild animals. Paragonimiasis has been known to distribute widely over the south Korea, however, the prevalence among people and intermediate hosts is gradually decreasing in recent years. In Korean people, the lung fluke have caused pulmonary infections in a great many of cases but as well extrapulmonary ones including cerebral, spinal, subcutaneous, hepatic, splenic, abdominal, urinary, gynecologic, and other types. The definite diagnosis of paragonimiasis can be executed by the recovery of eggs from sputum or feces of patients, however, immunological methods such as intradermal test, complement-fixation test, precipitin reactions, immunofluorescent techniques, enzyme-linked immunosorbent assay (ELISA) are greatly helpful for egg-negative or extrapulmonary cases. Various drugs have been introduced for the treatment of paragonimiasis, and among them, bithionol, niclofolan and praziquantel have shown high therapeutic efficacy. The most recommendable one is considered praziquantel. For control of this disease, mass chemotherapy of patients seems to be the most efficient and feasible measure.
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Affiliation(s)
- D W Choi
- Department of Parasitology, Kyungpook National University School of Medicine, Taegu, Korea
| | - Yoichiro Horii
- Laboratory of Veterinary Parasitic Diseases, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
| | - Yukifumi Nawa
- Research Affairs, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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