Repeated praziquantel treatment and Opisthorchis viverrini infection: a population-based cross-sectional study in northeast Thailand

Infectious Diseases of Poverty

Kinley Wangdi¹  Matthew J. Kelly¹  Darren J. Gray¹  Kavin Thinkhamrop²  Wilaiphorn Thinkhamrop²  Apiporn T. Suwannatrai³  Paiboon Sithithaworn³  Narong Khuntikeo⁴ 

[1] 0000 0001 2180 7477, grid.1001.0, Department of Global Health, Research School of Population Health, Australian National University, 2601, Canberra, ACT, Australia;0000 0004 0470 0856, grid.9786.0, Cholangiocarcinoma Screening and Care Program (CASCAP), Faculty of Medicine, Khon Kaen University, 40002, Khon Kaen, Thailand;0000 0004 0470 0856, grid.9786.0, Data Management and Statistical Analysis Center (DAMASAC), Faculty of Public Health, Khon Kaen University, 40002, Khon Kaen, Thailand;0000 0004 0470 0856, grid.9786.0, Cholangiocarcinoma Screening and Care Program (CASCAP), Faculty of Medicine, Khon Kaen University, 40002, Khon Kaen, Thailand;0000 0004 0470 0856, grid.9786.0, Department of Parasitology, Faculty of Medicine, Khon Kaen University, 40002, Khon Kaen, Thailand;0000 0004 0470 0856, grid.9786.0, Cholangiocarcinoma Screening and Care Program (CASCAP), Faculty of Medicine, Khon Kaen University, 40002, Khon Kaen, Thailand;0000 0004 0470 0856, grid.9786.0, Department of Surgery, Faculty of Medicine, Khon Kaen University, 40002, Khon Kaen, Thailand;

关键词: Praziquantel;    Opisthorchis viverrini;    Screening;    Urine;    Thailand;   

DOI  :  10.1186/s40249-019-0529-5

来源: publisher

【 摘 要 】

BackgroundOpisthorchis 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.MethodsThis 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.ResultsAmong 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).ConclusionsThe 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.

【 授权许可】

CC BY