Status and emerging issues in the use of praziquantel for treatment of human trematode and cestode infections are briefly reviewed. Since praziquantel was first introduced as a broadspectrum anthelmintic in 1975, innumerable articles describing its successful use in the treatment of the majority of human-infecting trematodes and cestodes have been published. The target trematode and cestode diseases include schistosomiasis, clonorchiasis and opisthorchiasis, paragonimiasis, heterophyidiasis, echinostomiasis, fasciolopsiasis, neodiplostomiasis, gymnophalloidiasis, taeniases, diphyllobothriasis, hymenolepiasis, and cysticercosis. However, Fasciola hepatica and Fasciola gigantica infections are refractory to praziquantel, for which triclabendazole, an alternative drug, is necessary. In addition, larval cestode infections, particularly hydatid disease and sparganosis, are not successfully treated by praziquantel. The precise mechanism of action of praziquantel is still poorly understood. There are also emerging problems with praziquantel treatment, which include the appearance of drug resistance in the treatment of Schistosoma mansoni and possibly Schistosoma japonicum, along with allergic or hypersensitivity reactions against praziquantel treatment. To cope with and overcome these problems, combined use of drugs, i.e., praziquantel and other newly introduced compounds such as triclabendazole, artemisinins, and tribendimidine, is being tried.
Artemisinins ; Benzimidazoles ; Cestoda ; Cestode Infections ; Clonorchiasis ; Cysticercosis ; Diphyllobothriasis ; Drug Resistance ; Echinostomiasis ; Fasciola ; Fasciola hepatica ; Humans ; Hymenolepiasis ; Hypersensitivity ; Opisthorchiasis ; Paragonimiasis ; Phenylenediamines ; Phosphatidylethanolamines ; Praziquantel ; Schistosoma japonicum ; Schistosoma mansoni ; Schistosomiasis ; Sparganosis ; Taenia ; Taeniasis ; Trematode Infections

The central nervous system involvement of Schistosomiasis is rarely reported in the literatures. The authors report a case of cerebellar Schistosomiasis. A 40-year-old man presented to our hospital with a one year history of dizziness and gait disturbance. The computerized tomography and MRI of the brain and spinal cord showed tumoral form of mass on cerebellar vermis and roof of the fourth ventricle. The histological study of the partially excised cerebellar mass demonstrated granulomatous reaction around Schistosoma mansoni eggs. After operation, praziquantel was used for 7 days(60 mg/kg/day) drally. This is the first case report of central nervous system Schistosomiasis in Korea.
Adult ; Brain ; Central Nervous System ; Cerebellum ; Dizziness ; Eggs ; Fourth Ventricle ; Gait ; Humans ; Korea ; Magnetic Resonance Imaging ; Neuroschistosomiasis ; Ovum ; Praziquantel ; Schistosoma mansoni ; Schistosomiasis* ; Spinal Cord

The transition of important parasitic diseases in Korea is briefly reviewed in this article. Soiltransmitted helminthiases, such as ascariasis, trichuriasis, and hookworm infections, which had been prevalent all over the country, decreased remarkably, largely owing to the national control activities by means of mass examination-mass treatment schemes for school students. Paragonimiasis has shown significant reduction in its incidence, but clonorchiasis still remains as an important health-threatening trematode infection. Intestinal trematodiases, including metagonimiasis, heterophyidiases, and echinostomiases are prevalent, and new species, such as Gymonphalloides seoi and Neodiplostomum seoulense, have been documented as new human parasitic diseases. Tapeworm infections including larval cestodiases are also decreasing. Among the protozoan infections, amebiasis and malaria showed an apparent decreasing trend, but in recent years, vivax malaria has become a re-emerging disease. Brugian filariasis, which was prevalent in southern parts of the Korean peninsula, has been completely eliminated nowadays. In terms of the prevalence and distribution, clonorchiasis, enterobiasis, and vivax malaria are currently the major parasitoses of public health importance in Korea.
Amebiasis ; Ascariasis ; Cestode Infections ; Clonorchiasis ; Echinostomiasis ; Enterobiasis ; Filariasis ; Helminthiasis ; Hookworm Infections ; Humans ; Incidence ; Korea* ; Malaria ; Malaria, Vivax ; Paragonimiasis ; Parasitic Diseases* ; Prevalence ; Protozoan Infections ; Public Health ; Trematode Infections ; Trichuriasis

There have been some reports on schistosomiasis of school children in Sudan’s Nile River basin area; however, information about the infection status of Schistosoma species and intestinal helminths among village residents of this area is very limited. Urine and stool samples were collected from the 1,138 residents of the Al Hidaib and Khour Ajwal villages of White Nile State, Sudan in 2014. The prevalence of overall schistosomiasis and intestinal helminthiasis was 36.3% and 7.7%, respectively. Egg positive rates were 35.6% for Schistosoma haematobium, 2.6% for S. mansoni, and 1.4% were mixed. The prevalence of schistosomiasis was significantly higher in men (45.6%) than in women (32.0%), in Khou Ajwal villagers (39.4%) than in Al Hidaib villagers (19.2%), and for age groups ≤15 years old (51.5%) than for age groups >15 years old (13.2%). The average number of eggs per 10 ml urine (EP10) of S. haematobium infections was 18.9, with 22.2 eggs in men vs 17.0 in women and 20.4 in Khou Ajwal villagers vs 8.1 in Al Hidaib villagers. In addition to S. mansoni eggs, 4 different species of intestinal helminths were found in the stool, including Hymenolepis nana (6.6%) and H. diminuta (1.0%). Collectively, urinary schistosomiasis is still prevalent among village residents in Sudan’s White Nile River basin and was especially high in men, children ≤15 years, and in the village without a clean water system. H. nana was the most frequently detected intestinal helminths in the 2 villages.
Child ; Eggs ; Female ; Helminthiasis ; Helminths ; Humans ; Hymenolepis nana ; Male ; Ovum ; Prevalence ; Rivers ; Schistosoma ; Schistosoma haematobium ; Schistosoma mansoni ; Schistosomiasis haematobia ; Schistosomiasis ; Sudan ; Water

Neuroschistosomiasis is a serious complication of schistosomiasis, where Schistosoma parasites migrate to the central nervous system. It is often overlooked but can cause significant neurological symptoms. We present a 10-year-old male with headache and papilledema, emphasizing the importance of considering neuroschistosomiasis in patients with neurological symptoms and a history of schistosomiasis exposure. Early diagnosis and timely treatment with antischistosomal drugs and corticosteroids are crucial for positive outcomes. Raising awareness and implementing appropriate management approaches can improve the prognosis of neuroschistosomiasis.
Neuroschistosomiasis

OBJECTIVETo study an intervention model of "schools without infected students with schistosoma japonica", to control and prevent students from schistosoma infection.

METHODSTwelve primary schools of four heavy endemic counties (districts) with schistosomiasis in the Poyang Lake areas were selected as the study fields, of which, ten schools were the experimental groups, and the other two schools were the control groups by cluster random sampling. All enrolment students were the target population. The baseline survey was carried out in 2005, and an intervention model, "information dissemination + behavior participation + behavior encouragement", was applied in the experiment groups in 2006 - 2008, then the effect of intervention was assessed.

RESULTSBefore intervention (2005), the anti-schistosomiasis knowledge awareness rate of experimental and control groups were 14.75% (324/2196) and 16.58% (91/549), and the different was not significant (χ(2) = 1.14, P > 0.05); the rate of accurate attitude of anti-schistosomiasis were 14.71% (323/2196) and 11.84% (65/549) in experimental and control groups, and the difference was not significant (χ(2) = 2.98, P > 0.05); the rate of contacting infected water were 15.44% (18 988/122 976) and 15.03% (4622/30 744) in experimental and control group and the difference was not significant (χ(2) = 3.13, P > 0.05); and the infection rate of schistosomiasis of experiment control groups were 9.65% (212/2196) and 10.56% (58/549), the difference was not significant (χ(2) = 0.41, P > 0.05). After one year intervention (2006), the anti-schistosomiasis knowledge awareness rate of experimental and control groups were 97.79% (2032/2078) and 18.11% (98/541), and the different was significant (χ(2) = 1794.31, P < 0.01); the rate of accurate attitude of anti-schistosomiasis were 99.09% (2059/2078) and 13.49% (73/541) in experimental and control group, and the difference was significant (χ(2) = 2077.45, P < 0.01). After 1 - 3 years intervention (2006 - 2008), there were no any contactors with infected water and infectors with schistosome in students of the experiment group in successive 3 years. While in the control group of the same period, the rate contacting infected water were 16.12% (4884/30 296), 11.11% (3079/27 720) and 12.25% (3451/28 168); the infection rate of schistosomiasis were 8.87% (48/541), 7.47% (37/495) and 7.95% (40/503), respectively.

CONCLUSIONThe intervention model of health promotion, "information dissemination + behavior participation + behavior encouragement", can effectively control and prevent students from infecting schistosoma japonica in heavy endemic areas with schistosomiasis.

Animals ; Health Promotion ; Humans ; Schistosomiasis ; prevention & control ; Schistosomiasis japonica ; School Health Services ; Schools ; Students

OBJECTIVE: To construct a schistosomiasis transmission risk assessment system in Wuhan City and preliminary evaluate its application effect, so as to promote the rational allocation of schistosomiasis control resources and accelerate the progress towards schistosomiasis elimination. METHODS: The schistosomiasis risk assessment indicators were collected through referring schistosomiasis surveillance data of Wuhan City from 2014 to 2020, literature review and expert interviews. Indicators within each criterion and sub-criterion were screened using the Delphi method, and a hierarchical structure model was created based on analytic hierarchy process. Quantitative assignment of each indicator was conducted according to relative importance, and the weight and combination weight of each criterion were calculated in each analytic hierarchy framework to create a schistosomiasis transmission risk assessment system, which was used for the schistosomiasis transmission risk assessment in 12 national schistosomiasis surveillance sites in Wuhan City. RESULTS: A three-level schistosomiasis transmission risk assessment system was preliminarily constructed, which included a target layer, 5 criterion layers and 21 sub-criterion layers. Of all indicators in the criterion layer, transmission route had the highest weight (0.433), followed by source of Schistosoma japonicum infection (0.294); and among all indicators in the sub-criterion layer, S. japonicum infection in Oncomelania hupensis and sentinel mice had the highest combination weight (0.125), followed by prevalence of S. japonicum infection in humans (0.091) and bovines (0.053), snail control by chemical treatment (0.049), positive rate of inquiry examinations (0.048), allocation of schistosomiasis control professionals (0.045), and areas of submerged snail-infested settings (0.041). Of the 12 national schistosomiasis surveillance sites in Wuhan City, there were 5 sites with weights of > 0.8, 4 sites with weights of 0.6 to 0.8, and 3 sites with weights of < 0.6 in 2020. CONCLUSIONS A schistosomiasis transmission risk assessment system has been constructed based on analytic hierarchy process in Wuhan City, which may provide a evidence-based basis for health resource allocation and decision-making for schistosomiasis control.
Animals ; Humans ; Cattle ; Mice ; Analytic Hierarchy Process ; Schistosomiasis/prevention & control* ; Schistosomiasis japonica/epidemiology* ; Snails ; Risk Assessment

BACKGROUND: Schistosoma haematobium which causes urogenital schistosomiasis (UGS) is highly prevalent in African countries. Urine microscopy (UM) is the first-line diagnostic method of UGS. Enzyme-linked immunosorbent assay (ELISA) is a common method for screening many parasite infections primarily or alternatively. The present study established an in-house diagnostic system by ELISA and evaluated its diagnostic efficacy in comparison with UM for screening UGS in White Nile State, Republic of Sudan, 2011–2013. METHODS: A total of 490 participants were screened by UM or ELISA, and 149 by both. The in-house ELISA system was established employing soluble egg antigen of S. haematobium and the cut-off absorbance was set at 0.270. RESULTS: Of the 149 subjects, 58 participants (38.9%) were positive by UM, 119 (79.9%) were positive by ELISA and 82 (55.0%) showed consistently positive or negative results by both methods. The diagnostic sensitivity of ELISA was 94.8% and specificity was 29.7% based on UM results. The ELISA positive serum samples also cross-reacted with egg antigens of Schistosoma mansoni and Schistosoma japonicum. CONCLUSION: We have established in-house ELISA for screening serum immunoglobulin (Ig) G antibodies by employing soluble egg antigen of S. haematobium for diagnosis of UGS with 94.8% sensitivity and 29.7% specificity. The ELISA system can supplement the conventional diagnosis by UM.
Antibodies ; Diagnosis* ; Enzyme-Linked Immunosorbent Assay* ; Immunoglobulins ; Mass Screening ; Methods ; Microscopy* ; Ovum ; Parasites ; Schistosoma haematobium* ; Schistosoma japonicum ; Schistosoma mansoni ; Schistosoma* ; Schistosomiasis haematobia ; Sensitivity and Specificity ; Sudan

OBJECTIVETo describe the characteristic magnetic resonance imaging (MRI) appearance of cerebral schistosomiasis.

METHODSTwenty-five patients whose diagnosis of central nervous system (CNS) schistosomiasis had been pathologically (n = 8) and clinically (n = 17) confirmed were randomly selected. MRI was performed on a Signal 1. 5T MRI scanner before and after the intravenous administration of gadopentetate dimeglumine constrast medium. We reviewed the MRI studies obtained at the time of initial presentation, as well as follow-up studies obtained during and after medical treatment.

RESULTSImmunological tests in 15 patients indicated schistosomiasis haematobium. Contrast-enhanced T1-weighted images in 22 cases showed central linear enhancement surrounded by multiple enhancing punctate nodules, which appeared "arborized". Through operation and pathological examination, 8 cases had the granuloma formation of schistosomal eggs extensive surrounded by inflammation and venous congestion. And 17 cases were treated with praziquantel and corticosteroid therapy. And they were followed up for 2 months by taking MRI, which turned out to be complete resolution of the enhancing structure and edema. At follow-up, all the patients' initial symptoms also resolved.

CONCLUSIONThe specified MRI enhancement pattern of cerebral schistosomiasis is common in most cases of CNS schistosomiasis, so it should be taken account into the diagnosis of cerebral schistosomiasis.

Adolescent ; Adult ; Aged ; Brain ; pathology ; Brain Diseases ; diagnosis ; pathology ; Child ; Contrast Media ; Female ; Follow-Up Studies ; Gadolinium DTPA ; Humans ; Image Enhancement ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Neuroschistosomiasis ; diagnosis ; pathology ; Schistosomiasis haematobia ; diagnosis ; pathology

Polypeptide antigen as isolated from adult worms of Clonorchis sinensis by means of diluted HCl-extraction method. Preliminary intradermal examination with those polypeptide antigen(CPT) were performed on patients of clonorchiasis, paragonimiasis and metagonimiasis and the result of the intradermal test with CPT antigen were compared with those of Clonorchis protein fraction(CPF) and Veronal buffer saline extraction (VBS) antigen. The result of the examination were summerized as follows: When 0.05 ml (1 microgram) of CPT was injected intradermally, the positive intradermal reaction appeared in 42.7 per cent (37 of 82) on the patients of clonorchiasis. The sizes of the wheal and erythema with CPT antigen was smaller than that of CPF and VBS antigen. Intradermal reaction with CPT antigen was carried out for other parasitic diseases, such as paragonimiasis and metagonimiasis. The result indicated that CPT antigen may be showed no cross reactions. Clonorchiasis pateints who with negative reaction to CPT antigen, reacted negatively to CPF and VBS antigens.
parastiology-helminth-trenmatoda ; Paragonimus ; Clonorchis sinensis ; Metagonimus ; clonorchiasis ; paragonimiasis ; metagonimiasis ; immunology ; skin test ; erythema ; Clonorchis protein fraction ; Veronal buffer saline extraction ; antigen