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Sripa B, Yurlova N, Suwannatrai AT, Serbina E, Tangkawattana S, Sayasone S, Varnakovida P. Potential impact of climate change on Opisthorchis viverrini and Opisthorchis felineus transmission in Eurasia. Acta Trop 2025; 263:107574. [PMID: 40037476 DOI: 10.1016/j.actatropica.2025.107574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2025] [Revised: 02/21/2025] [Accepted: 03/01/2025] [Indexed: 03/06/2025]
Abstract
Human liver flukes of the family Opisthorchiidae, particularly Opisthorchis viverrini and Opisthorchis felineus, are major foodborne trematode parasites endemic to the Lower Mekong River Basin (Southeast Asia) and the Ob-Irtysh Basins (southern Western Siberia, Russian Federation), respectively. Together, these parasites infect over 14 million people, with an estimated 300 million at risk. Their transmission cycles involve Bithynia snails and Cyprinidae fish as first and second intermediate hosts, respectively, with humans and other fish-eating mammals serving as definitive hosts. The geographical distribution of these flukes is shaped by specific Bithynia species: B. siamensis, B. s. goniomphalos, and B. funiculata for O. viverrini, and B. troschelii, B. leachi, and B. inflata for O. felineus. Climate change directly influences liver fluke transmission by affecting parasite survival, host biology, and environmental conditions. Bithynia snails are highly temperature-sensitive, and O. viverrini transmission is notably temperature-dependent, with a 1 °C increase raising infection odds by 5.4 %. Temperatures exceeding 30 °C reduce cercarial survival and infectivity. In Western Siberia, favorable water temperatures for O. felineus transmission start at +15 °C, with higher temperatures leading to an increased infection rate in snails while permafrost regions lack Bithynia snails entirely. Projections from the Intergovernmental Panel on Climate Change (IPCC) indicate that warming will exceed the global average in northern Asia (affecting O. felineus) and approach the global average in Southeast Asia (impacting O. viverrini). These trends suggest that climate change may have a more pronounced impact on O. felineus transmission in Siberia than on O. viverrini transmission in Southeast Asia. This review provides an in-depth discussion of Bithynia biology and the effects of temperature on snail growth, cercarial release, survival, infection, and aestivation, emphasizing how global warming could influence the transmission dynamics of these liver flukes.
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Affiliation(s)
- Banchob Sripa
- WHO Collaborating Centre for Research and Control of Opisthorchiasis, Tropical Disease Research Center, Department of Tropical Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
| | - Natalia Yurlova
- Laboratory of Parasitology, Institute of Systematics and Ecology of Animals SB RAS, Frunze Str.,11, 630091 Novosibirsk, Russia.
| | - Apiporn T Suwannatrai
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
| | - Elena Serbina
- Laboratory of Parasitology, Institute of Systematics and Ecology of Animals SB RAS, Frunze Str.,11, 630091 Novosibirsk, Russia.
| | | | - Somphou Sayasone
- Lao Tropical and Public Health Institute, Ministry of Health, Vientiane Capital, Lao People's Democratic Republic
| | - Pariwate Varnakovida
- Geospatial Engineering and Innovation Center (KGEO), Faculty of Science, King Mongkut's University of Technology Thonburi, Bangkok, Thailand
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Huang G, Peng X. Genus Bithynia: morphological classification to molecular identification. Parasit Vectors 2024; 17:496. [PMID: 39616387 PMCID: PMC11608500 DOI: 10.1186/s13071-024-06591-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 11/19/2024] [Indexed: 12/06/2024] Open
Abstract
Snails of the genus Bithynia, whose primary habitat is slow-flowing ponds and ditches, serve as the first intermediate hosts of liver fluke. Currently, approximately 200 million individuals worldwide are at risk of liver fluke infection, yet questions still persist regarding the taxonomic identification of Bithynia genus, a crucial player in the transmission of this disease. Accurate taxonomic classification of the Bithynia genus could significantly enhance current understanding of the disease's transmission mechanisms. In this article we comprehensively review the extensive research conducted on Bithynia genus, spanning past inquiries up to the latest findings. The primary emphasis is placed on exploring the taxonomic identification of this genus within various technological settings. We then present a consolidated analysis of the morphological taxonomic identification methods, highlighting their strengths and limitations. We also introduce a novel perspective on the future direction of identification and classification efforts for the members of this genus, emphasizing the crucial role Bithynia plays in the epidemiological cycle of liver fluke transmission. We conclude by urging researchers to prioritize the significance of the members of this genus in the epidemiological cycle of liver fluke transmission and in control measures for disease dissemination, within the context of the vector organisms.
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Affiliation(s)
- Guoyang Huang
- Guangxi University Key Laboratory of Pathogenic Biology, Guilin Medical University, Guilin, Guangxi, People's Republic of China
| | - Xiaohong Peng
- Guangxi University Key Laboratory of Pathogenic Biology, Guilin Medical University, Guilin, Guangxi, People's Republic of China.
- Guangxi Key Laboratory of Molecular Medicine in Liver Injury and Repair, The Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People's Republic of China.
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Konyaev S, Ponomareva N, Serbina E, Prilepsky Y, Krivopalov A, Yurlova N. Prevalence of opisthorchiid and other endoparasitic infections among cats and dogs in Novosibirsk oblast (Western Siberia, Russia). Vet Parasitol Reg Stud Reports 2024; 53:101075. [PMID: 39025551 DOI: 10.1016/j.vprsr.2024.101075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 06/06/2024] [Accepted: 06/24/2024] [Indexed: 07/20/2024]
Abstract
To determine the current reservoir status and prevalence of Opisthorchis felineus infection in opisthorchiosis-endemic areas, feces samples were collected from 103 cats and 101 dogs admitted to shelters or discount sterilization centers from various districts of Novosibirsk city and from villages and towns along the Ob River (Novosibirsk Oblast). The feces samples were evaluated using two methods simultaneously: the formalin-ether sedimentation assay and a modified flotation assay. The prevalence of opisthorchiid infection was higher among cats (12.6%; 95% confidence interval 6.9-20.6%) than among dogs (4.0%; 95% confidence interval 1.1-9.8%). Overall prevalence of endoparasites among cats was 42.7% (five helminthic and four protozoan species) and among dogs 51.5% (eight helminthic and five protozoan species). Among the parasites found in the dogs, the prevalence of Sarcocystis sp. was the highest (16.8%), and in cats, the highest prevalence was shown by Giardia sp. and Toxocara cati (14.6% for each species). These results confirm the considerable contribution of stray cats and dogs to the maintenance of opisthorchiid eggs in the environment; these data should be taken into account for the development of effective control and education programs.
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Affiliation(s)
- Sergey Konyaev
- Institute of Systematics and Ecology of Animals, Siberian Branch of RAS, Novosibirsk, Russia
| | - Natalia Ponomareva
- Institute of Systematics and Ecology of Animals, Siberian Branch of RAS, Novosibirsk, Russia
| | - Elena Serbina
- Institute of Systematics and Ecology of Animals, Siberian Branch of RAS, Novosibirsk, Russia
| | - Yuri Prilepsky
- Institute of Systematics and Ecology of Animals, Siberian Branch of RAS, Novosibirsk, Russia
| | - Anton Krivopalov
- Institute of Systematics and Ecology of Animals, Siberian Branch of RAS, Novosibirsk, Russia.
| | - Natalia Yurlova
- Institute of Systematics and Ecology of Animals, Siberian Branch of RAS, Novosibirsk, Russia.
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Ponomareva NM, Orlova TV, Vlasenko PG, Serbina EA, Yurlova NI. Temperature dependence of Opisthorchis felineus infection in the first intermediate host snail, Bithynia troschelii. Acta Trop 2024; 253:107166. [PMID: 38431135 DOI: 10.1016/j.actatropica.2024.107166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/19/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Abstract
Opisthorchiasis is one of the most serious trematodiases in Russia, where the world's largest focus is located in the Ob basin. Temperature is an important factor affecting the metabolism of cold-blooded animals. It determines the development of the causative agent of opisthorchiasis, Opisthorchis felineus, and the success of infection of an intermediate host, the snail Bithynia troschelii. In the present study, the effect of water temperature on the development of the liver fluke O. felineus in the host snail was assessed, as was the temperature threshold at which B. troschelii hibernation initiates. Adult uninfected B. troschelii individuals collected from natural bodies of water were infected with O. felineus and maintained at different temperatures of water (18-30 °C, intervals of 3 °C) in the laboratory. Each snail was fed with embryonated uterine eggs of O. felineus at 24 °C. O. felineus infection in snails was detected using polymerase chain reaction (PCR) using specific primers. The prevalence of O. felineus infection in B. troschelii depends on the water temperature in which the snails are maintained. The highest infection rate of 45.2 % ± 12.1 % was observed at 27 °C (p ≥ 0.1). The longest lifespan of infected and uninfected B. troschelii was recorded at water temperatures of 24 and 27 °C. The snails were more successfully infected at the beginning of the warm season. Among the infected individuals, the majority (up to 85 %) were large snails. Cercarial shedding was not detected in experimentally infected snails. Apparently, this is due to the natural physiological state of Bithynia snails during the autumn-winter diapause, when opisthorchiids development in snails stops. At 10 °C, complete hibernation of all B. troschelii snails was observed, and infection by the trematodes became impossible. The highest prevalence of infection was recorded at 27 °C, suggesting that during climate warming, an increase in opisthorchiid infection of snails may occur, which must be considered when epidemiological measures are planned.
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Affiliation(s)
- Natalia M Ponomareva
- Institute of Systematics and Ecology of Animals, Siberian Branch of Russian Academy of Sciences, Frunze Str. 11, Novosibirsk 630091, Russia.
| | - Tamara V Orlova
- Institute of Systematics and Ecology of Animals, Siberian Branch of Russian Academy of Sciences, Frunze Str. 11, Novosibirsk 630091, Russia
| | - Pavel G Vlasenko
- Institute of Systematics and Ecology of Animals, Siberian Branch of Russian Academy of Sciences, Frunze Str. 11, Novosibirsk 630091, Russia
| | - Elena A Serbina
- Institute of Systematics and Ecology of Animals, Siberian Branch of Russian Academy of Sciences, Frunze Str. 11, Novosibirsk 630091, Russia
| | - Natalia I Yurlova
- Institute of Systematics and Ecology of Animals, Siberian Branch of Russian Academy of Sciences, Frunze Str. 11, Novosibirsk 630091, Russia
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Qian MB, Keiser J, Utzinger J, Zhou XN. Clonorchiasis and opisthorchiasis: epidemiology, transmission, clinical features, morbidity, diagnosis, treatment, and control. Clin Microbiol Rev 2024; 37:e0000923. [PMID: 38169283 PMCID: PMC10938900 DOI: 10.1128/cmr.00009-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/18/2023] [Indexed: 01/05/2024] Open
Abstract
Clonorchis sinensis, Opisthorchis viverrini, and Opisthorchis felineus are important liver flukes that cause a considerable public health burden in eastern Asia, southeastern Asia, and eastern Europe, respectively. The life cycles are complex, involving humans, animal reservoirs, and two kinds of intermediate hosts. An interplay of biological, cultural, ecological, economic, and social factors drives transmission. Chronic infections are associated with liver and biliary complications, most importantly cholangiocarcinoma. With regard to diagnosis, stool microscopy is widely used in epidemiologic surveys and for individual diagnosis. Immunologic techniques are employed for screening purposes, and molecular techniques facilitate species differentiation in reference laboratories. The mainstay of control is preventive chemotherapy with praziquantel, usually combined with behavioral change through information, education and communication, and environmental control. Tribendimidine, a drug registered in the People's Republic of China for soil-transmitted helminth infections, shows potential against both C. sinensis and O. viverrini and, hence, warrants further clinical development. Novel control approaches include fish vaccine and biological control. Considerable advances have been made using multi-omics which may trigger the development of new interventions. Pressing research needs include mapping the current distribution, disentangling the transmission, accurately estimating the disease burden, and developing new diagnostic and treatment tools, which would aid to optimize control and elimination measures.
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Affiliation(s)
- Men-Bao Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, People’s Republic of China
- NHC Key Laboratory of Parasite and Vector Biology, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, People’s Republic of China
- NHC Key Laboratory of Parasite and Vector Biology, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
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Wong Y, Pearson MS, Fedorova O, Ivanov V, Khmelevskaya E, Tedla B, Arachchige BJ, Reed S, Field M, Laha T, Loukas A, Sotillo J. Secreted and surface proteome and transcriptome of Opisthorchis felineus. FRONTIERS IN PARASITOLOGY 2023; 2:1195457. [PMID: 39816815 PMCID: PMC11732047 DOI: 10.3389/fpara.2023.1195457] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/25/2023] [Indexed: 01/18/2025]
Abstract
Introduction Opisthorchis felineus, Opisthorchis viverrini, and Clonorchis sinensis are the most medically important species of fish-borne zoonotic trematodes. O. felineus is endemic to the river plains of Western Siberia and Eastern Europe, and it is estimated that more than 1.6 million people could be infected with this parasite. Chronic opisthorchiasis may lead to significant gastrointestinal and hepatobiliary pathology. This study aimed to identify and characterize proteins from the secreted and tegumental proteomes of O. felineus. Methods Adult flukes were collected from experimentally infected hamsters and cultured in vitro in serum-free media. We extracted proteins from different compartments of the O. felineus secretome, including (i) soluble excretory/secretory (ES) products; (ii) secreted 15K-extracellular vesicles (EVs); and (iii) tegument. Results We also generated a transcriptome using long-read sequencing, and when this was combined with high-resolution mass spectrometry, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) separation, and protein digestion, we identified 686, 894, 389, 324, and 165 proteins from the ES, 15K-EV, and the three sequentially extracted tegument (TEG) protein fractions, respectively. We conducted in-depth gene ontology and protein family analyses on the identified proteins and discussed comparisons against similar proteome data sets acquired for the Southeast Asian liver fluke O. viverrini and the Chinese liver fluke C. sinensis. Discussion The information from this study will form a biologically relevant data set of O. felineus proteins that could be used to develop diagnostic and therapeutic tools to manage the human cost of O. felineus infection and its associated comorbidities.
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Affiliation(s)
- Yide Wong
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
- Centre for Tropical Bioinformatics and Molecular Biology, James Cook University, Cairns, QLD, Australia
| | - Mark S. Pearson
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
| | - Olga Fedorova
- Department of Faculty Pediatrics, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russia
| | - Vladimir Ivanov
- Laboratory of Biological Models, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russia
| | - Ekaterina Khmelevskaya
- Central Research Laboratory, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Tomsk, Russia
| | - Bemnet Tedla
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
- Centre for Tropical Bioinformatics and Molecular Biology, James Cook University, Cairns, QLD, Australia
| | | | - Sarah Reed
- Mass Spectrometry Facility, Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia
| | - Matt Field
- College of Public Health, Medical and Veterinary Science, James Cook University, Cairns, QLD, Australia
- Immunogenomics Lab, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Thailand
| | - Thewarach Laha
- Department of Parasitology, Faculty of Medicine, Khon Kaen Universit, Khon Kaen, Thailand
| | - Alex Loukas
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
| | - Javier Sotillo
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, Australia
- Parasitology Reference and Research Laboratory, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
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Lvova MN, Ponomarev DV, Tarasenko AA, Kovner AV, Minkova GA, Tsyganov MA, Li M, Lou Y, Evseenko VI, Dushkin AV, Sorokina IV, Tolstikova TG, Mordvinov VA, Avgustinovich DF. Curcumin and Its Supramolecular Complex with Disodium Glycyrrhizinate as Potential Drugs for the Liver Fluke Infection Caused by Opisthorchis felineus. Pathogens 2023; 12:819. [PMID: 37375509 DOI: 10.3390/pathogens12060819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Opisthorchiosis is a parasitic liver disease found in mammals that is widespread throughout the world and causes systemic inflammation. Praziquantel remains the drug of choice for the treatment of opisthorchiosis, despite its many adverse effects. An anthelmintic effect is attributed to the main curcuminoid of Curcuma longa L. roots-curcumin (Cur)-along with many other therapeutic properties. To overcome the poor solubility of curcumin in water, a micellar complex of curcumin with the disodium salt of glycyrrhizic acid (Cur:Na2GA, molar ratio 1:1) was prepared via solid-phase mechanical processing. In vitro experiments revealed a noticeable immobilizing effect of curcumin and of Cur:Na2GA on mature and juvenile Opisthorchis felineus individuals. In vivo experiments showed that curcumin (50 mg/kg) had an anthelmintic effect after 30 days of administration to O. felineus-infected hamsters, but the effect was weaker than that of a single administration of praziquantel (400 mg/kg). Cur:Na2GA (50 mg/kg, 30 days), which contains less free curcumin, did not exert this action. The complex, just as free curcumin or better, activated the expression of bile acid synthesis genes (Cyp7A1, Fxr, and Rxra), which was suppressed by O. felineus infection and by praziquantel. Curcumin reduced the rate of inflammatory infiltration, whereas Cur:Na2GA reduced periductal fibrosis. Immunohistochemically, a decrease in liver inflammation markers was found, which is determined by calculating the numbers of tumor-necrosis-factor-positive cells during the curcumin treatment and of kynurenine-3-monooxygenase-positive cells during the Cur:Na2GA treatment. A biochemical blood test revealed a normalizing effect of Cur:Na2GA (comparable to that of curcumin) on lipid metabolism. We believe that the further development and investigation of therapeutics based on curcuminoids in relation Opisthorchis felineus and other trematode infections will be useful for clinical practice and veterinary medicine.
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Affiliation(s)
- Maria N Lvova
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia
| | - Denis V Ponomarev
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia
| | - Alena A Tarasenko
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia
| | - Anna V Kovner
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia
| | - Galina A Minkova
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia
| | - Michail A Tsyganov
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia
- Department of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
| | - Meijun Li
- Department of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
| | - Yan Lou
- Department of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
| | - Veronica I Evseenko
- Institute of Solid State Chemistry and Mechanochemistry, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia
| | - Alexander V Dushkin
- Institute of Solid State Chemistry and Mechanochemistry, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia
| | - Irina V Sorokina
- N.N. Vorozhtsov Novosibirsk Institute of Organic Chemistry, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia
| | - Tatiana G Tolstikova
- N.N. Vorozhtsov Novosibirsk Institute of Organic Chemistry, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia
| | - Viatcheslav A Mordvinov
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia
| | - Damira F Avgustinovich
- Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia
- Institute of Solid State Chemistry and Mechanochemistry, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia
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Katokhin AV, Serbina EA. Molecular genetic species definition of Opisthorchiidae-like cercariae from Bithyniidae snails of Chany Lake (South-Western Siberia, Russia). Parasitol Res 2023; 122:341-345. [PMID: 36399170 DOI: 10.1007/s00436-022-07725-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/09/2022] [Indexed: 11/19/2022]
Abstract
The studies of opisthorchiids larval stages associated with Bithyniidae snails can provide important and the most reliable data for opisthorchiidoses foci characterization due to the low mobility of such opisthorchiid's host species as Bithyniidae snails. The foci of opisthorchiosis (caused by Opisthorchis felineus) and metorchiosis (caused by Metorchis bilis) are overlapping in the basins of the Ob and Irtysh Rivers. Thus, difficulties with determining the species of cercariae significantly reduce the accuracy of epidemiological conclusions regarding opisthorchiosis, which has a much higher medical significance. Moreover, M. bilis cercariae identification is complicated by the fact that the focus of metorchiosis caused by Metorchis xanthosomus (infecting fish-eating predatory birds) occurs on the same territory. In this study, we for the first time carried out the molecular genetic identification of West-Siberian opisthorchiid cercariae to verify morphological identification and confirmed O. felineus's main association with Bithynia troschelii snail and M. bilis'-with B. tentaculata snail. Thus, our study applied a two-stage approach: the morphological identification of any opisthorchiid-like cercariae in Bithynia snails and subsequent molecular genetic precise species determination of cercariae in the reduced samples.
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Affiliation(s)
- Aleksei V Katokhin
- Institute of Cytology and Genetics, Russian Academy of Sciences, Siberian Branch, ac. Lavrent'ev ave, 10, Novosibirsk, 630090, Russia.
| | - Elena A Serbina
- Institute of Systematics and Ecology of Animals, Russian Academy of Sciences, Siberian Branch, Frunze, 11, Novosibirsk, 630091, Russia
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Bithyniid snails as hosts of Opisthorchiidae and Notocotylidae in the south of Western Siberia, Russia. Parasitol Res 2022; 121:2367-2377. [DOI: 10.1007/s00436-022-07558-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
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10
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Simakova AV, Chitnis N, Babkina IB, Fedorova OS, Fedotova MM, Babkin AM, Khodkevich NE. Abundance of Opisthorchis felineus Metacercariae in cyprinid fish in the middle Ob River basin (Tomsk region, Russia). Food Waterborne Parasitol 2021; 22:e00113. [PMID: 33681491 PMCID: PMC7930129 DOI: 10.1016/j.fawpar.2021.e00113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/22/2021] [Accepted: 01/26/2021] [Indexed: 11/16/2022] Open
Abstract
Infection with the liver fluke, Opisthorchis felineus, caused by the consumption of infected raw or undercooked cyprinid fish is common in humans and carnivores in the middle Ob River basin (Tomsk region, Russia) and can lead to diseases in humans. The goal of this study was the status of fish infection with O. felineus metacercariae in order to assess the role of fish in the infection of the human population in the middle Ob River basin. Of the 14 Cyprinidae species recorded in the middle Ob River basin, we examined 6 cyprinid species for prevalence and intensity of infection with O. felineus metacercariae. Five of these species (Leuciscus idus, Leuciscus leuciscus, Rutilus rutilus, Abramis brama, and Carassius gibelio) are of commercial value, while the common bleak is an object of amateur fishing. In addition, we conducted a survey of the fish consumption habits as part of a community-based cross-sectional study in the rural Shegarsky district, Tomsk region, Russian Federation. O. felineus metacercariae were observed in muscles of all examined species except for the Prussian carp. The ide is the main infection source in the Ob River (prevalence of infection, 100%, and intensity, 50.5 metacercariae per fish) and the common dace in the Tom River (91.1% and 12.7 metacercariae). Although the two alien species (bream and common bleak) are susceptible to infection with O. felineus metacercariae, the prevalence of infection in these fish and in the roach did not exceed 3%. The prevalence and intensity of infection in fish increased with age and size. The infection characteristics of fish in different water flows were different. The cyprinid species account on average for 69.8% of the commercial fish harvested in the Tomsk region. According to epidemiological survey, among 600 participants, 87.5% (n = 525) of respondents consumed river fish, with the most popular fish being cyprinids including Prussian carp, dace, ide and bream, followed by pike and perch. Thus, the epizootological state of the water flows in the middle Ob River basin is adverse with respect to opisthorchiasis, as indicated by high infection rates of liver fluke metacercariae in ide and common dace, which are abundant species of high commercial value. An extremely high prevalence of infection suggests a strong transmission cycle with a high rate of infection from infected humans and/or animal reservoir hosts to snails and fish. In addition to treating humans, there should be a strong focus on identifying these potential reservoir hosts to reduce subsequent infection in humans. Furthermore, since the intensity of infection in humans is determined by the presence of fish species such as ide and dace in the diet, they should be included in a dietary change campaign by eliminating the consumption of raw fish. Commercial cyprinid species play the key role in maintaining opisthorchiasis foci. The ide and common dace are the main source of human and animal infection. Measures to control Opisthorchis felineus should target these two species of fish. The invasion of fish increases with their age and size.
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Affiliation(s)
- Anastasia V Simakova
- Biological Institute, Tomsk State University, Tomsk, Russian Federation.,Department of Integrated Environmental Projects, Tomsk Oil and Gas Research and Design Institute, Tomsk, Russian Federation
| | - Nakul Chitnis
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Irina B Babkina
- Biological Institute, Tomsk State University, Tomsk, Russian Federation
| | - Olga S Fedorova
- Department of Faculty Pediatrics, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russian Federation
| | - Marina M Fedotova
- Department of Faculty Pediatrics, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russian Federation
| | - Alexandr M Babkin
- Biological Institute, Tomsk State University, Tomsk, Russian Federation
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Fedorova OS, Fedotova MM, Zvonareva OI, Mazeina SV, Kovshirina YV, Sokolova TS, Golovach EA, Kovshirina AE, Konovalova UV, Kolomeets IL, Gutor SS, Petrov VA, Hattendorf J, Ogorodova LM, Odermatt P. Opisthorchis felineus infection, risks, and morbidity in rural Western Siberia, Russian Federation. PLoS Negl Trop Dis 2020; 14:e0008421. [PMID: 32598389 PMCID: PMC7351239 DOI: 10.1371/journal.pntd.0008421] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 07/10/2020] [Accepted: 05/24/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The liver fluke, Opisthorchis felineus, is widely distributed throughout Europe and large parts of the Russian Federation. In Western Siberia, information about opisthorchiasis is lacking although infection may lead to severe liver and bile duct diseases. We aimed to assess the current prevalence of O. felineus infection along with associated risk factors and morbidity in rural Western Siberia. METHODS We conducted a community-based, cross-sectional study in the rural Shegarskiy district, Tomsk Oblast, Russian Federation. All household members (≥ 7 years) present on the survey day were enrolled (n = 600). Two stool samples per person were examined for helminth eggs, using PARASEP (DiaSys Ltd, UK). The number of eggs per gram (EPG) of feces was recorded. Each study participant was interviewed to determine risk factors, using a pre-tested questionnaire. An abdominal ultrasonography examination of liver and bile ducts was performed with a mobile, high resolution ultrasound device. In total, 488 persons completed assessments (two stool samples, completed questionnaires); of those, 436 individuals had an ultrasonography (US) examination. RESULTS We observed a prevalence of O. felineus infection of 60.2%. Significant risk factors for infection were the consumption of river fish (odds ratio from adjusted analysis [aOR] 2.4, 95% CI 1.52-3.95, p<0.001), particularly stock fish (OR from multivariable analysis [mOR] 3.2, 95% CI 2.63-3.80, p<0.001), smoked fish (mOR 1.5, 95% CI 1.24-1.72, p<0.001), frozen fish (mOR 1.6, 95% CI 1.29-2.02, p<0.001), and raw fish (mOR 1.4, 95% CI 1.05-1.84, p = 0.02); and fishing activities (mOR 1.2, 95% CI 1.03-1.43, p = 0.019). Women had a higher risk of infection than men. Infection was associated positively with age and negatively with socio-economic status. The respondents' general awareness of opisthorchiasis was quite high (93.2%), but their knowledge about infection transmission and prevention was insufficient. Children aged 7-18 years old had a lower level of awareness compared to adults. The abdominal ultrasonography results demonstrated a strong association between O. felineus infection and gallbladder stones (mOR 2.8, 95% CI 1.33-6.04, p = 0.007) and periductal fibrosis of intrahepatic bile ducts (mOR 1.9, 95% CI 1.08-3.46, p = 0.026). CONCLUSION O. felineus infection is highly prevalent in rural regions of Western Siberia, and associated with severe hepatobiliary pathology. Identified risk factors will be used to develop a comprehensive targeted O. felineus infection control program.
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Affiliation(s)
- Olga S. Fedorova
- Department of Faculty Pediatrics, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russian Federation
- * E-mail:
| | - Marina M. Fedotova
- Department of Faculty Pediatrics, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russian Federation
| | - Olga I. Zvonareva
- Department of Health, Ethics and Society, Maastricht University, Maastricht, the Netherlands
- Central Research laboratory, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russian Federation
| | | | - Yulia V. Kovshirina
- Department of Infectious diseases and Epidemiology, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russian Federation
| | - Tatiana S. Sokolova
- Department of Faculty Pediatrics, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russian Federation
| | - Ekaterina A. Golovach
- Department of Faculty Pediatrics, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russian Federation
| | - Anna E. Kovshirina
- Department of Faculty Pediatrics, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russian Federation
| | - Uliana V. Konovalova
- Department of Faculty Pediatrics, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russian Federation
| | - Ivan L. Kolomeets
- Department of Faculty Pediatrics, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russian Federation
| | - Sergey S. Gutor
- Central Research laboratory, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russian Federation
| | - Vyacheslav A. Petrov
- Central Research laboratory, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russian Federation
| | - Jan Hattendorf
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Ludmila M. Ogorodova
- Department of Faculty Pediatrics, Federal State Budget Educational Institution of Higher Education, Siberian State Medical University, Ministry of Healthcare of Russian Federation, Tomsk, Russian Federation
| | - Peter Odermatt
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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The New Data on the Serotonin and FMRFamide Localization in the Nervous System of Opisthorchis felineus Metacercaria. Acta Parasitol 2020; 65:361-374. [PMID: 32002774 DOI: 10.2478/s11686-019-00165-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/30/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Trematoda Opisthorchis felineus Rivolta, 1884 is the causative agent of dangerous parasite disease-opisthorchiasis, widespread in the Russian Federation. The details of the neuroanatomical localization of the serotoninergic and FMRFamidergic neurotransmitter elements as well as their functional roles remain not studied enough in both adult and larval forms of O. felineus. The studies in this area are important in term of the development of a new pharmacological strategy of the struggle with the causative agent of opisthorchiasis affecting the neuronal signal substances and the function of its nervous system. PURPOSE The aim of this work was the immunocytochemical study of the neurotransmitters serotonin (5-HT, 5-Hydroxitryptamine) and neuropeptide FMRFamide localization in the nervous system of the opisthorchiasis causative agent-O. felineus metacercaria. To study the relationship between the detected neurotransmitters and the muscular elements of the parasite, the muscle staining was carried out simultaneously using fluorophore-conjugated phalloidin. METHODS The localization of 5-HTergic and FMRFamidergic nerve structures was determined by immunocytochemical method. The staining samples were analyzed using a fluorescent and confocal laser scanning microscopies. RESULTS The new data on the presence and distribution of the serotonin-immunopositive (IP)- and FMRFa-IP components in the central and peripheral departments of the nervous system of O. felineus metacercaria has been obtained. Besides that a number of the new anatomical details of the nervous system organization and of the innervation of the organs and tissues in the investigated parasite have been revealed. CONCLUSION The data obtained on the presence and localization of the 5-HTergic and peptidergic (FMRFamide) components in central and peripheral departments of the nervous system of O. felineus metacercaria elaborated and expanded the existing information about the nervous system as well as the innervations of the tissues and organs in the causative agent of opistchorchiasis.
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Saposin-like proteins in Opisthorchis felineus and related opisthorchids. INFECTION GENETICS AND EVOLUTION 2019; 78:104132. [PMID: 31805380 DOI: 10.1016/j.meegid.2019.104132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/25/2019] [Accepted: 11/30/2019] [Indexed: 12/12/2022]
Abstract
Saposin B domain-containing or saposin-like proteins (SAPs, SAPLIPs) have been described as lipid/membrane-binding and often show antibacterial and cytolytic activity. Members of this protein family are present in phylogenetically distant organisms, pointing to their functional importance. Several SAPs are found in trematodes and some of them apparently are related to host-parasite interaction as they show cytolytic activity or immunogenicity. In the present study, we search for SAP genes of Opisthorchis felineus, Clonorchis sinensis and O. viverrini, compare and analyze their structure and expression patterns. We define three orthologous groups of SAPs in opisthorchids and suggest a unique protein motif with unknown function in one group of orthologs.
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Gorchilova EG, Kolenchukova OA, Gvozdev II, Savchenko AA, Vasyutin AV, Tonkikh YL, Borisov AG, Rzhavicheva OS, Tsukanov VV. Functional activity of blood phagocytes in opistorchiasis patients. MEDICAL COUNCIL 2019:58-63. [DOI: 10.21518/2079-701x-2019-14-58-63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2025]
Abstract
Introduction. The urgency of the problem of opistorchiasis is dictated by the long clinical course of the disease with the possibility of formation of hepatobiliary pathology, including cancer. Aim. To study the peculiarities of the production of active oxygen forms of blood phagocytes in patients with opistorchiasis. Material and methods. A total of 42 patients with chronic opisthorchiasis (22 men and 20 women) and 35 apparently healthy patients (18 men and 17 women) between the ages of 24 and 45 were examined. Opistorchiasis was diagnosed by three methods: microscopic examination of duodenal bile, coproovoscopy and serological method. The control group was composed of healthy individuals who underwent routine medical examinations, which included biochemical blood tests, identification of markers for viral hepatitis and antibodies to opistorchs. The culture of neutrophils and blood monocytes was isolated by fractionation of cells on the ficoll with subsequent cleaning from adhering cells. Functional activity of neutrophils and blood monocytes was estimated by chemiluminescence method on production of active oxygen species: basic and after induction with zymosan. Results. In patients with opistorchiasis in comparison with healthy people, in neutrophil granulocytes, the maximum intensity of active oxygen species production decreased and the time to reach the maximum of active oxygen species production was increased both in spontaneous and zymosan-induced reactions in luminoland lucigenin-dependent processes. In monocytes during spontaneous reaction study it was discovered that the maximum intensity of oxygen production in luminoland lucigenindependent processes decreased and the time of reaching the maximum of oxygen production in luminol-dependent process increased in opistorchiasis patients in comparison with healthy people. When studying the zymosan-induced reaction in monocytes, a decrease in the maximum intensity of active oxygen species production in both reactions and an increase in the time to reach the maximum output of active oxygen species in the luminol-dependent process was registered in patients with opistorchiasis in comparison with healthy people. Conclusion. The data obtained indicate low functional activity of blood phagocytes in patients with chronic opistorchiasis in comparison with healthy people.
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Affiliation(s)
| | - O. A. Kolenchukova
- Research Institute for Medical Problems in the North Division of Federal Research Center «Krasnoyarsk Scientific Center of the Siberian Branch of the RAS»
| | - I. I. Gvozdev
- Research Institute for Medical Problems in the North Division of Federal Research Center «Krasnoyarsk Scientific Center of the Siberian Branch of the RAS»
| | - A. A. Savchenko
- Research Institute for Medical Problems in the North Division of Federal Research Center «Krasnoyarsk Scientific Center of the Siberian Branch of the RAS»
| | - A. V. Vasyutin
- Research Institute for Medical Problems in the North Division of Federal Research Center «Krasnoyarsk Scientific Center of the Siberian Branch of the RAS»
| | - Yu. L. Tonkikh
- Research Institute for Medical Problems in the North Division of Federal Research Center «Krasnoyarsk Scientific Center of the Siberian Branch of the RAS»
| | - A. G. Borisov
- Research Institute for Medical Problems in the North Division of Federal Research Center «Krasnoyarsk Scientific Center of the Siberian Branch of the RAS»
| | | | - V. V. Tsukanov
- Research Institute for Medical Problems in the North Division of Federal Research Center «Krasnoyarsk Scientific Center of the Siberian Branch of the RAS»
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Simakova AV, Babkina IB, Khodkevich NE, Babkin AM, Interesova EA. Infestation of Alien Cyprinid Fishes with Trematode Opisthorchis felineus Rivolta, 1884 in the Middle Ob River Basin. RUSSIAN JOURNAL OF BIOLOGICAL INVASIONS 2019. [DOI: 10.1134/s2075111719020115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Tsyganov MA, Vishnevetskaya GB, Kukina TP, Sorokina IV, Lvova MN, Protsenko MA, Kostina NE, Avgustinovich DF. Studyng the effects of Cantharellus cibarius fungi on Opisthorchis felineus trematode and on parasite host - C57BL/6 inbred mice. Vavilovskii Zhurnal Genet Selektsii 2018. [DOI: 10.18699/vj18.426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Opisthorchiasis is a dangerous parasitic disease caused by trematodes in the family Opisthorchiidae. One of the causes of this infection is the species Opisthorchis felineus, which is common in the Russian Federation and Western Europe. The disease has a large number of complications and relatively few effective treatments, so nowadays it is relevant to look for new drugs for the treatment of opisthorchiasis, with the maximum antiparasitic and minimal side effect. In this work, a potentially anthelmintic effect of the methanol extract of the golden chanterelle mushroom (Cantharellus cibarius) was investigated. In in vitro experiments, the significantly reduced mobility and survival rates of juvenile O. felineus specimens with increasing concentrations (10-1000 pg/ml) of the C. cibarius extract were shown. In in vivo studies, administration of the C. cibarius extract on the first day after parasitic infection of inbred C57BL/6 mice resulted in a decrease of the number of helminths in the bile ducts of the liver, evaluated 6 weeks after infection. In another series of experiments, administration of the C. cibarius extract for 7 days to mice infected with O. felineus for five weeks had no anthelmintic effect. In both cases, the state of the infected hosts, evaluated by a number of physiological and biochemical parameters (relative weight of organs, blood indices), did not deteriorate, indicating that there was no adverse effect of the C. cibarius extract. The results obtained suggest that the C. cibarius extract might have anthelmintic properties if applied as parasite larvae excyst.
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Affiliation(s)
- M. A. Tsyganov
- Institute of Cytology and Genetics, SB RAS; Novosibirsk State University
| | | | - T. P. Kukina
- N.N. Vorozhtsov Novosibirsk Institute of organic Chemistry, SB RAS
| | - I. V. Sorokina
- N.N. Vorozhtsov Novosibirsk Institute of organic Chemistry, SB RAS
| | - M. N. Lvova
- Institute of Cytology and Genetics, SB RAS; Novosibirsk State Medical University
| | - M. A. Protsenko
- State Research Center of Virology and Biotechnology "Vector" Koltsovo
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Zvonareva O, Odermatt P, Golovach EA, Fedotova MM, Kovshirina YV, Kovshirina AE, Kobyakova OS, Fedorova OS. Life by the river: neglected worm infection in Western Siberia and pitfalls of a one-size-fits-all control approach. CRITICAL PUBLIC HEALTH 2017. [DOI: 10.1080/09581596.2017.1378425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Olga Zvonareva
- Department of Health, Ethics and Society, Maastricht University , Maastricht, The Netherlands
- Research Centre for Policy Analysis and Studies of Technologies, National Research Tomsk State University , Tomsk, Russian Federation
- Central Research and Development Laboratory, Siberian State Medical University , Tomsk, Russian Federation
| | - Peter Odermatt
- Helminths and Health, Swiss Tropical and Public Health Institute, University of Basel , Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, University of Basel , Basel, Switzerland
| | - Ekaterina A. Golovach
- Department of Faculty Pediatrics, Siberian State Medical University , Tomsk, Russian Federation
| | - Marina M. Fedotova
- Department of Faculty Pediatrics, Siberian State Medical University , Tomsk, Russian Federation
| | - Yulia V. Kovshirina
- Department of Infectious Diseases and Epidemiology, Siberian State Medical University , Tomsk, Russian Federation
| | - Anna E. Kovshirina
- Department of General Practice, Siberian State Medical University , Tomsk, Russian Federation
| | - Olga S. Kobyakova
- Department of General Practice, Siberian State Medical University , Tomsk, Russian Federation
| | - Olga S. Fedorova
- Department of Faculty Pediatrics, Siberian State Medical University , Tomsk, Russian Federation
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