TY - JOUR
T1 - Repeated praziquantel treatment and Opisthorchis viverrini infection
T2 - a population-based cross-sectional study in northeast Thailand
AU - Thinkhamrop, Kavin
AU - Khuntikeo, Narong
AU - Sithithaworn, Paiboon
AU - Thinkhamrop, Wilaiphorn
AU - Wangdi, Kinley
AU - Kelly, Matthew J
AU - Suwannatrai, Apiporn T
AU - Gray, Darren J
N1 - Funding Information:
This study was supported by Khon Kaen University (KKU) through CASCAP (Grant No. CASCAP 1/60), the National Research Council of Thailand through the Medical Research Network of the Consortium of Thai Medical Schools (Grant No. MRF.59-076) and National Research Council of Thailand (NRCT/ 2559-134). The funders played no role in the study design, data collection or analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2019 The Author(s).
PY - 2019/3/20
Y1 - 2019/3/20
N2 - BACKGROUND: Opisthorchis viverrini infection is highly prevalent in northeast Thailand. This liver fluke is classified as a carcinogen due to its causal links with cholangiocarcinoma (CCA) development. Although treatment with praziquantel (PZQ) effectively cures O. viverrini infection, the prevalence remains high due to the traditional consumption of raw fish. Therefore, re-infection is common in the endemic community, leading to severe hepato-biliary morbidities including the fatal CCA. In this study, we evaluate the association between the frequency of previous PZQ treatment and current O. viverrini infections among Thai adults living in the endemic area of northeast Thailand.METHODS: This study includes all participants who were screened for O. viverrini infection in the Cholangiocarcinoma Screening and Care Program (CASCAP), northeast Thailand. History of PZQ treatment was recorded using a health questionnaire. O. viverrini infections were diagnosed using urine antigen detection. Associations between PZQ and O. viverrini were determined by adjusted odds ratio (aOR) and 95% confidence interval (CI) using multiple logistic regression.RESULTS: Among participants, 27.7% had previously been treated once with PZQ, 8.2% twice, 2.8% three times, and 3.5% more than three times. Current O. viverrini prevalence was 17% (n = 524). Compared with participants who never used PZQ, the aOR for infection among those who used the drug once was 1.09 (95% CI: 0.88-1.37), twice was 1.19 (95% CI: 0.85-1.68), three times was 1.28 (95% CI: 0.74-2.21), and more than three times was 1.86 (95% CI: 1.18-2.93; P = 0.007).CONCLUSIONS: The population with a frequent history of PZQ use and still continued raw fish consumption showed high levels of repeated reinfection with O. viverrini. They were infected, treated and re-infected repeatedly. These findings suggest that certain participants continue raw fish consumption even after previous infection. This is a particular problem in highly endemic areas for O. viverrini and increases the risk of CCA.
AB - BACKGROUND: Opisthorchis viverrini infection is highly prevalent in northeast Thailand. This liver fluke is classified as a carcinogen due to its causal links with cholangiocarcinoma (CCA) development. Although treatment with praziquantel (PZQ) effectively cures O. viverrini infection, the prevalence remains high due to the traditional consumption of raw fish. Therefore, re-infection is common in the endemic community, leading to severe hepato-biliary morbidities including the fatal CCA. In this study, we evaluate the association between the frequency of previous PZQ treatment and current O. viverrini infections among Thai adults living in the endemic area of northeast Thailand.METHODS: This study includes all participants who were screened for O. viverrini infection in the Cholangiocarcinoma Screening and Care Program (CASCAP), northeast Thailand. History of PZQ treatment was recorded using a health questionnaire. O. viverrini infections were diagnosed using urine antigen detection. Associations between PZQ and O. viverrini were determined by adjusted odds ratio (aOR) and 95% confidence interval (CI) using multiple logistic regression.RESULTS: Among participants, 27.7% had previously been treated once with PZQ, 8.2% twice, 2.8% three times, and 3.5% more than three times. Current O. viverrini prevalence was 17% (n = 524). Compared with participants who never used PZQ, the aOR for infection among those who used the drug once was 1.09 (95% CI: 0.88-1.37), twice was 1.19 (95% CI: 0.85-1.68), three times was 1.28 (95% CI: 0.74-2.21), and more than three times was 1.86 (95% CI: 1.18-2.93; P = 0.007).CONCLUSIONS: The population with a frequent history of PZQ use and still continued raw fish consumption showed high levels of repeated reinfection with O. viverrini. They were infected, treated and re-infected repeatedly. These findings suggest that certain participants continue raw fish consumption even after previous infection. This is a particular problem in highly endemic areas for O. viverrini and increases the risk of CCA.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Animals
KW - Anthelmintics/therapeutic use
KW - Bile Duct Neoplasms/complications
KW - Cholangiocarcinoma/complications
KW - Cross-Sectional Studies
KW - Feces/parasitology
KW - Female
KW - Humans
KW - Logistic Models
KW - Male
KW - Middle Aged
KW - Opisthorchiasis/complications
KW - Opisthorchis
KW - Praziquantel/therapeutic use
KW - Raw Foods/parasitology
KW - Recurrence
KW - Risk Factors
KW - Sentinel Surveillance
KW - Surveys and Questionnaires
KW - Thailand/epidemiology
KW - Young Adult
KW - Praziquantel
KW - Thailand
KW - Urine
KW - Screening
KW - Opisthorchis viverrini
UR - http://www.scopus.com/inward/record.url?scp=85063189010&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/record.url?scp=85065906468&partnerID=8YFLogxK
U2 - 10.1186/s40249-019-0529-5
DO - 10.1186/s40249-019-0529-5
M3 - Article
C2 - 30890188
SN - 2049-9957
VL - 8
SP - 18
JO - Infectious Diseases of Poverty
JF - Infectious Diseases of Poverty
IS - 1
M1 - 18
ER -
