Adult ; Animals ; Fasciolidae ; Hepatitis B ; complications ; surgery ; Humans ; Liver Cirrhosis ; etiology ; surgery ; Liver Transplantation ; Living Donors ; Male ; Trematode Infections ; drug therapy

Phongsaly Province, located in the northernmost area of Lao PDR, was previously suggested to be endemic for the liver fluke Opisthorchis viverrini infection. To confirm, or rule out, this suggestion, the Phonxay village in the Khoua District, Phongsaly Province, was selected for a survey. Ten volunteers (8 men and 2 women aged 31-57 years) who consumed raw freshwater fish and had gastrointestinal troubles were treated with a single dose of praziquantel (40 mg/kg) and pyrantel pamoate (10 mg/kg) and purged with magnesium sulfate to recover any worm parasites. Eight of the 10 volunteers expelled 1 or more species of trematodes, nematodes, or cestodes (worm positive rate; 80%). The worms were morphologically identified as H. taichui (861 worms from 8 people), H. yokogawai (59 from 6 people), Phaneropsolus bonnei (1 from 1 person), Trichostrongylus sp. (2 from 2 people), Ascaris lumbricoides (2 from 1 person), Enterobius vermicularis (11 from 3 people), and Taenia saginata (1 strobila with scolex from 1 person). The results indicate that the mountainous area of Phongsaly Province, Lao PDR, is not endemic for the liver fluke but endemic for intestinal flukes, in particular, Haplorchis taichui and H. yokogawai.
Adult ; Animals ; Antiparasitic Agents/administration & dosage ; Feces/parasitology ; Female ; Heterophyidae/anatomy & histology/classification/*isolation & purification ; Humans ; Laos/epidemiology ; Male ; Middle Aged ; Praziquantel/administration & dosage ; Prevalence ; Pyrantel Pamoate/administration & dosage ; Trematode Infections/drug therapy/*epidemiology/*parasitology

In November 2007, a 46-year-old male Thai patient presented with chronic abdominal pain for over 3 years. Colonoscopy revealed a small parasite of about 2 x 1 mm in size attached to the cecum mucosa. The worm was removed endoscopically, fixed, and stained for morphological observations. The specimen was identified as Anchitrema sanguineum (Digenea: Anchitrematidae), a trematode first reported in a reptile, Chamaeleo vulgaris, from Egypt, and then sporadically found in the intestines of insectivorous bats and other mammals. The patient was treated with praziquantel but no more worms were found in his stool. His symptoms improved slightly but not cured completely. It remains unclear whether the chronic abdominal pain of the patient was caused by this trematode infection. Whatever is the pathogenicity of this trematode, this is the first human case of A. sanguineum infection in the literature.
Abdominal Pain/*etiology ; Animals ; Antiprotozoal Agents/therapeutic use ; Cecum/parasitology ; Colonoscopy ; Humans ; Intestinal Mucosa/parasitology ; Male ; Middle Aged ; Praziquantel/therapeutic use ; Thailand ; Trematoda/*isolation & purification ; Trematode Infections/*diagnosis/drug therapy/pathology

The effects of anti-allergic drugs on intestinal mastocytosis and the expulsion of Neodiplostomum seoulense were observed in Sprague-Dawley rats, after oral infection with 500 metacercariae. The drugs used were hydroxyzine (a histamine receptor H1 blocker), cimetidine (a H2 blocker), cyclosporin-A (a helper T-cell suppressant), and prednisolone (a T- and B-cell suppressant). Infected, but untreated controls, and uninfected controls, were prepared. Worm recovery rate and intestinal mastocytosis were measured on weeks 1, 2, 3, 5, and 7 post-infection. Compared with the infected controls, worm expulsion was significantly (P < 0.05) delayed in hydroxyzine- and cimetidine-treated rats, despite mastocytosis being equally marked in the duodenum of all three groups. In the cyclosporin-A- and prednisolone-treated groups, mastocytosis was suppressed, but worm expulsion was only slightly delayed, without statistical significance. Our results suggest that binding of histamine to its receptors on intestinal smooth muscles is more important in terms of the expulsion of N. seoulense from rats than the levels of histamine alone, or mastocytosis.
Animals ; Cimetidine/pharmacology ; Cyclosporine/pharmacology ; Histamine H1 Antagonists/*pharmacology ; Histamine H2 Antagonists/*pharmacology ; Hydroxyzine/pharmacology/therapeutic use ; Immunosuppressive Agents/*pharmacology ; Intestinal Diseases, Parasitic/*drug therapy ; Mastocytosis/*drug therapy/parasitology ; Prednisolone/*pharmacology ; Rats ; Rats, Sprague-Dawley ; Support, Non-U.S. Gov't ; Trematoda/*growth & development/metabolism ; Trematode Infections/*drug therapy

The prevalence of liver and intestinal fluke infections was surveyed on residents of Savannakhet Province, Laos. Fecal specimens were collected from a total of 981 residents in 4 Mekong riverside villages and examined by the Kato-Katz thick smear technique. The results revealed that the overall helminth egg positive rate was 84.2%, and the positive rate for small trematode eggs, including Opisthorchis viverrini, heterophyids, or lecithodendriids, was 67.1%. To obtain adult flukes, 38 small trematode egg positive cases were treated with a 20-30 mg/kg single dose of praziquantel and purged. Diarrheic stools were then collected from 29 people and searched for helminth parasites using stereomicroscopes. Mixed infections with O. viverrini and 6 kinds of intestinal flukes were found, namely, Haplorchis taichui, Haplorchis pumilio, Haplorchis yokogawai, Prosthodendrium molenkampi, Phaneropsolus bonnei, and echinostomes. The total number of flukes collected was 7,693 specimens (av. no. per treated person; 265.3). The most common species was O. viverrini, followed by H. taichui, P. molenkampi, echinostomes, H. pumilio, P. bonnei, and H. yokogawai. The results indicate that foodborne liver and intestinal fluke infections are prevalent among residents of Savannakhet Province, Laos.
Adolescent ; Adult ; Aged ; Animals ; Anthelmintics/administration & dosage ; Child ; Child, Preschool ; Feces/parasitology ; Female ; Humans ; Intestinal Diseases, Parasitic/drug therapy/*epidemiology ; Laos/epidemiology ; Liver Diseases, Parasitic/*epidemiology ; Male ; Middle Aged ; Parasite Egg Count ; Population Surveillance ; Praziquantel/administration & dosage ; Prevalence ; Trematoda/classification/*isolation & purification ; Trematode Infections/drug therapy/*epidemiology

One coastal village in Haenam-gun and two in Yeongam-gun, Jeollanam-do were surveyed for intestinal parasite infections by fecal examination. The egg positive rates of Gymnophalloides seoi were high, 24.1% (14/58) in Haenam-gun and 9.3% (11/118) in Yeongam-gun. The egg positive rates of heterophyids, including Heterophyes nocens, and of Clonorchis sinensis were 10.3% and 6.9% in Haenam-gun, and 14.4% and 8.5% in Yeongam-gun, respectively. After praziquantel treatment and purgation, a total of 37,761 fluke specimens were recovered from 17 patients; 11 in Haenam-gun and 6 in Yeongam-gun. Gymnophalloides seoi was the most commonly recovered species, with 37,489 specimens in total (2,205 per person). Other recovered flukes included Heterophyes nocens, Stictodora fuscata, Heterophyopsis continua, Pygidiopsis summa, and undetermined species. These results indicate that the areas surveyed are new endemic foci of G. seoi.
Trematode Infections/drug therapy/*epidemiology/parasitology ; Trematoda/*classification/drug effects/*isolation & purification ; Prevalence ; Praziquantel/administration & dosage ; Parasite Egg Count/methods ; Middle Aged ; Male ; Korea/epidemiology ; Humans ; Heterophyidae/isolation & purification ; Female ; Feces/parasitology ; Clonorchis sinensis/isolation & purification ; Anthelmintics/administration & dosage ; Animals ; Aged, 80 and over ; Aged ; Adult