A cohort was established for evaluation of cancer risk factors in Sancheong-gun, Gyeongsangnam-do, Korea. As one of the cohort studies, stools of 947 residents (403 males and 544 females, age range: 29-86 years) were screened for Clonorchis sinensis eggs using both Kato-Katz method and formalin-ether sedimentation technique. The overall egg positive rate of C. sinensis was 37.7% and individual EPG (eggs per gram of feces) counts ranged from 24 to 28,800. Eight egg positive residents voluntarily joined a process of collection of the passed worms after praziquantel treatment. A total of 158 worms were recovered from 5 of the 8 treated persons, ranged from 3 to 108 in each individual. The worms were 15-20 mm x 2-3 mm in size, and showed brown-pigmented, red, or white body colors. This is the first collection record of C. sinensis adult worms from humans through anthelmintic treatment and purgation. The adult worms of C. sinensis may be paralyzed by praziquantel and then discharged passively through bile flow in the bile duct and by peristaltic movement of the bowel.
Adult ; Aged ; Aged, 80 and over ; Animals ; Antiplatyhelmintic Agents/*therapeutic use ; Clonorchiasis/*drug therapy/epidemiology/*parasitology ; Clonorchis sinensis/anatomy & histology/*isolation & purification ; Feces/parasitology ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Neoplasms/epidemiology ; Parasite Egg Count ; Praziquantel/*therapeutic use ; Risk Factors

We measured changes in sonographic findings of patients with clonorchiasis after a treatment in a highly endemic area. A total of 347 residents showed positive stool results for Clonorchis sinensis eggs in a village in northeastern China, and were treated with praziquantel. Of them, 132 patients underwent abdominal sonography both before and 1 year after treatment, and the changes in sonographic findings of 83 cured subjects were compared. Diffuse dilatation of intrahepatic bile ducts (DDIHD) was found in 82 patients (98.2%) before and 80 (96.4%) after treatment, which was improved in 3, aggravated in 1, and unchanged in 79 patients. Increased periductal echogenicity (IPDE) was observed in 42 patients (50.6%) before and 45 (54.2%) after treatment, which was improved in 5, aggravated in 8, and unchanged in 70 patients. Floating echogenic foci in the gallbladder (FEFGB) was detected in 32 patients (38.6%) before and 17 (20.5%) after treatment, which was improved in 20, aggravated in 5, and unchanged in 58 patients. Improvement of FEFGB only was statistically significantly (P = 0.004). The present results confirm that DDIHD and IPDE persist but FEFGB decreases significantly at 1 year after treatment. In a heavy endemic area, the sonographic finding of FEFGB may suggest active clonorchiasis 1 year after treatment.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bile Ducts, Intrahepatic/parasitology/ultrasonography ; Child ; China/epidemiology ; Clonorchiasis/complications/*drug therapy/epidemiology/*ultrasonography ; *Endemic Diseases ; Female ; Gallbladder/parasitology/ultrasonography ; Humans ; Male ; Middle Aged ; Praziquantel/*therapeutic use ; Treatment Outcome ; Young Adult

Oriental liver fluke (Clonorchis sinensis) infection was surveyed among residents of Hamyang-gun, Gyeongsangnam-do, Korea during the period of January 2001 to March 2002. Total 1,041 stool samples were collected from residents who visited Public Health Center and its branches in Hamyang-gun and examined using formalin-ether sedimentation method. The overall egg positive rate was 16%, male showing higher positive rate (21%) than female (10%). The age group of 30 to 50 years had the highest egg positive rate of C. sinensis from 20% to 22%. The positive examinees were treated with praziquantel and educated individually to prevent reinfection. Egg positive rate in this area was decreased when compared with results recorded in the past, however, still remained more than 10%. This study suggests that periodic examination, treatment as well as education of residents should be continued and systematized.
Adolescent ; Adult ; Age Factors ; Aged ; Child ; Clonorchiasis/drug therapy/*epidemiology/parasitology ; Feces/parasitology ; Female ; Human ; Korea/epidemiology ; Male ; Middle Aged ; Parasite Egg Count ; Patient Education ; Praziquantel/therapeutic use ; Sex Factors ; Support, Non-U.S. Gov't