The Experts below are selected from a list of 228 Experts worldwide ranked by ideXlab platform
Yukifumi Nawa - One of the best experts on this subject based on the ideXlab platform.
-
molecular and morphological variation of paragonimus westermani in vietnam with records of new second intermediate crab hosts and a new locality in a northern province
Parasitology, 2016Co-Authors: Pham Ngoc Doanh, Luu A Tu, Huynh Thi Thuy Loan, Nariaki Nonaka, Yoichiro Horii, David Blair, Yukifumi NawaAbstract:Paragonimus westermani is one of the most medically important Lung Flukes and is widely distributed in Asia. It exhibits considerable variation in morphological, genetic and biological features. In central provinces of Vietnam, a high prevalence of metacercariae of this species has been reported from the crab intermediate host, Vietopotamon aluoiense. In this study, we detected P. westermani metacercariae in two additional crab hosts, Donopotamon haii in Quang Tri Province, central Vietnam and Indochinamon tannanti in Yen Bai Province in the north. The latter is a new locality for P. westermani in a northern region of Vietnam where P. heterotremus is the only species currently known to cause human paragonimiasis. Paragonimus westermani metacercariae found in Vietnam showed considerable morphological variation but slight genetic variation based on DNA sequences from the nuclear ribosomal ITS2 region and the mitochondrial 16S gene. Co-infection of the same individual crabs with P. westermani and P. heterotremus and/or some other Paragonimus species was found frequently, suggesting potential for co-infection in humans. The findings of the present study emphasize the need for highly specific molecular and immunodiagnostic methods to differentially diagnose between P. westermani and P. heterotremus infections.
-
gene diversity and genetic variation in Lung Flukes genus paragonimus
Transactions of The Royal Society of Tropical Medicine and Hygiene, 2016Co-Authors: David Blair, Makedonka Mitreva, Yukifumi Nawa, Pham Ngoc DoanhAbstract:Paragonimiasis caused by Lung Flukes (genus Paragonimus) is a neglected disease occurring in Asia, Africa and the Americas. The genus is species-rich, ancient and widespread. Genetic diversity is likely to be considerable, but investigation of this remains confined to a few populations of a few species. In recent years, studies of genetic diversity have moved from isoenzyme analysis to molecular phylogenetic analysis based on selected DNA sequences. The former offered better resolution of questions relating to allelic diversity and gene flow, whereas the latter is more suitable for questions relating to molecular taxonomy and phylogeny. A picture is emerging of a highly diverse taxon of parasites, with the greatest diversity found in eastern and southern Asia where ongoing speciation might be indicated by the presence of several species complexes. Diversity of Lung Flukes in Africa and the Americas is very poorly sampled. Functional molecules that might be of value for immunodiagnosis, or as targets for medical intervention, are of great interest. Characterisation of these from Paragonimus species has been ongoing for a number of years. However, the imminent release of genomic and transcriptomic data for several species of Paragonimus will dramatically increase the rate of discovery of such molecules, and illuminate their diversity within and between species.
-
paragonimus westermani and paragonimus species
2014Co-Authors: Yukifumi Nawa, Ngoc P Doanh, Urusa Thaenkham, David BlairAbstract:Paragonimiasis is a zoonotic food-borne Lung disease caused by Lung Flukes of the genus Paragonimus and acquired by consumption of raw/undercooked freshwater crabs/crayfish or wild boar meat. Paragonimus westermani is the best known species to infect humans in Asia, but several other species of human pathogens are also present. Molecular phylogenetic analyses assign most Asian Paragonimus species into four species complexes with some correlation to human pathogenesis. Paragonimus species exploit a range of mammalian definitive hosts and, as intermediate hosts, freshwater snails and crustaceans, eradication of which is not feasible. Avoidance of consumption of raw/undercooked foods and early diagnosis/treatment are recommended for the control of this disease.
-
helminth trematode paragonimus westermani and paragonimus species
Reference Module in Food Science#R##N#Encyclopedia of Food Safety, 2014Co-Authors: Yukifumi Nawa, Ngoc P Doanh, Urusa Thaenkham, David BlairAbstract:Paragonimiasis is a zoonotic food-borne Lung disease caused by Lung Flukes of the genus Paragonimus and acquired by consumption of raw/undercooked freshwater crabs/crayfish or wild boar meat. Paragonimus westermani is the best known species to infect humans in Asia, but several other species of human pathogens are also present. Molecular phylogenetic analyses assign most Asian Paragonimus species into four species complexes with some correlation to human pathogenesis. Paragonimus species exploit a range of mammalian definitive hosts and, as intermediate hosts, freshwater snails and crustaceans, eradication of which is not feasible. Avoidance of consumption of raw/undercooked foods and early diagnosis/treatment are recommended for the control of this disease.
-
Paragonimus and Paragonimiasis in Vietnam: an Update
The Korean journal of parasitology, 2013Co-Authors: Pham Ngoc Doanh, Yoichiro Horii, Yukifumi NawaAbstract:Paragonimiasis is a food-borne parasitic zoonosis caused by infection with Lung Flukes of the genus Paragonimus. In Vietnam, research on Paragonimus and paragonimiasis has been conducted in northern and central regions of the country. Using a combination of morphological and molecular methods, 7 Paragonimus species, namely P. heterotremus, P. westermani, P. skrjabini, P. vietnamensis, P. proliferus, P. bangkokenis and P. harinasutai, have been identified in Vietnam. Of these, the first 3, P. heterotremus, P. westermani and P. skrjabini, are known to infect humans in other countries. However, in Vietnam, only P. heterotremus, found in some northern provinces, has been shown to infect humans. Even nowadays, local people in some northern provinces, such as Lai Chau and Yen Bai, are still suffering from P. heterotremus infection. In some provinces of central Vietnam, the prevalence and infection intensity of P. westermani metacercariae in freshwater crabs (the second intermediate hosts) are extremely high, but human cases have not been reported. Likewise, although P. skrjabini was found in Thanh Hoa Province, its pathogenicity to humans in Vietnam still remains uncertain. The results of molecular phylogenetic analyses of Vietnamese Paragonimus species provides new insights on the phylogeny and taxonomy of the genus Paragonimus. Comprehensive molecular epidemiological and geobiological studies on the genus in Vietnam and adjacent countries are needed to clarify the biodiversity and public health significance of the Lung Flukes.
David Blair - One of the best experts on this subject based on the ideXlab platform.
-
molecular and morphological variation of paragonimus westermani in vietnam with records of new second intermediate crab hosts and a new locality in a northern province
Parasitology, 2016Co-Authors: Pham Ngoc Doanh, Luu A Tu, Huynh Thi Thuy Loan, Nariaki Nonaka, Yoichiro Horii, David Blair, Yukifumi NawaAbstract:Paragonimus westermani is one of the most medically important Lung Flukes and is widely distributed in Asia. It exhibits considerable variation in morphological, genetic and biological features. In central provinces of Vietnam, a high prevalence of metacercariae of this species has been reported from the crab intermediate host, Vietopotamon aluoiense. In this study, we detected P. westermani metacercariae in two additional crab hosts, Donopotamon haii in Quang Tri Province, central Vietnam and Indochinamon tannanti in Yen Bai Province in the north. The latter is a new locality for P. westermani in a northern region of Vietnam where P. heterotremus is the only species currently known to cause human paragonimiasis. Paragonimus westermani metacercariae found in Vietnam showed considerable morphological variation but slight genetic variation based on DNA sequences from the nuclear ribosomal ITS2 region and the mitochondrial 16S gene. Co-infection of the same individual crabs with P. westermani and P. heterotremus and/or some other Paragonimus species was found frequently, suggesting potential for co-infection in humans. The findings of the present study emphasize the need for highly specific molecular and immunodiagnostic methods to differentially diagnose between P. westermani and P. heterotremus infections.
-
gene diversity and genetic variation in Lung Flukes genus paragonimus
Transactions of The Royal Society of Tropical Medicine and Hygiene, 2016Co-Authors: David Blair, Makedonka Mitreva, Yukifumi Nawa, Pham Ngoc DoanhAbstract:Paragonimiasis caused by Lung Flukes (genus Paragonimus) is a neglected disease occurring in Asia, Africa and the Americas. The genus is species-rich, ancient and widespread. Genetic diversity is likely to be considerable, but investigation of this remains confined to a few populations of a few species. In recent years, studies of genetic diversity have moved from isoenzyme analysis to molecular phylogenetic analysis based on selected DNA sequences. The former offered better resolution of questions relating to allelic diversity and gene flow, whereas the latter is more suitable for questions relating to molecular taxonomy and phylogeny. A picture is emerging of a highly diverse taxon of parasites, with the greatest diversity found in eastern and southern Asia where ongoing speciation might be indicated by the presence of several species complexes. Diversity of Lung Flukes in Africa and the Americas is very poorly sampled. Functional molecules that might be of value for immunodiagnosis, or as targets for medical intervention, are of great interest. Characterisation of these from Paragonimus species has been ongoing for a number of years. However, the imminent release of genomic and transcriptomic data for several species of Paragonimus will dramatically increase the rate of discovery of such molecules, and illuminate their diversity within and between species.
-
paragonimus westermani and paragonimus species
2014Co-Authors: Yukifumi Nawa, Ngoc P Doanh, Urusa Thaenkham, David BlairAbstract:Paragonimiasis is a zoonotic food-borne Lung disease caused by Lung Flukes of the genus Paragonimus and acquired by consumption of raw/undercooked freshwater crabs/crayfish or wild boar meat. Paragonimus westermani is the best known species to infect humans in Asia, but several other species of human pathogens are also present. Molecular phylogenetic analyses assign most Asian Paragonimus species into four species complexes with some correlation to human pathogenesis. Paragonimus species exploit a range of mammalian definitive hosts and, as intermediate hosts, freshwater snails and crustaceans, eradication of which is not feasible. Avoidance of consumption of raw/undercooked foods and early diagnosis/treatment are recommended for the control of this disease.
-
helminth trematode paragonimus westermani and paragonimus species
Reference Module in Food Science#R##N#Encyclopedia of Food Safety, 2014Co-Authors: Yukifumi Nawa, Ngoc P Doanh, Urusa Thaenkham, David BlairAbstract:Paragonimiasis is a zoonotic food-borne Lung disease caused by Lung Flukes of the genus Paragonimus and acquired by consumption of raw/undercooked freshwater crabs/crayfish or wild boar meat. Paragonimus westermani is the best known species to infect humans in Asia, but several other species of human pathogens are also present. Molecular phylogenetic analyses assign most Asian Paragonimus species into four species complexes with some correlation to human pathogenesis. Paragonimus species exploit a range of mammalian definitive hosts and, as intermediate hosts, freshwater snails and crustaceans, eradication of which is not feasible. Avoidance of consumption of raw/undercooked foods and early diagnosis/treatment are recommended for the control of this disease.
-
molecular variation in the paragonimus heterotremus complex in thailand and myanmar
Korean Journal of Parasitology, 2013Co-Authors: Oranuch Sanpool, David Blair, Yukifumi Nawa, Pewpan M. Intapan, Penchom Janwan, Tongjit Thanchomnang, Wanchai MaleewongAbstract:Paragonimiasis is an important food-borne parasitic zoonosis caused by infection with Lung Flukes of the genus Paragonimus. Of the 7 members of the genus known in Thailand until recently, only P. heterotremus has been confirmed as causing human disease. An 8th species, P. pseudoheterotremus, has recently been proposed from Thailand, and has been found in humans. Molecular data place this species as a sister species to P. heterotremus, and it is likely that P. pseudoheterotremus is not specifically distinct from P. heterotremus. In this study, we collected metacercariae of both nominal species (identification based on metacercarial morphology) from freshwater crabs from Phetchabun Province in northern Thailand, Saraburi Province in central Thailand, and Surat Thani Province in southern Thailand. In addition, we purchased freshwater crabs imported from Myanmar at Myawaddy Province, western Thailand, close to the Myanmar-Thailand border. The DNAs extracted from excysted metacercariae were PCR-amplified and sequenced for ITS2 and cox1 genes. The ITS2 sequences were nearly identical among all samples (99-100%). Phylogenies inferred from all available partial cox1 sequences contained several clusters. Sequences from Indian P. heterotremus formed a sister group to sequences from P. pseudoheterotremus-type metacercariae. Sequences of P. heterotremus from Thailand, Vietnam, and China formed a separate distinct clade. One metacercaria from Phitsanulok Province was distinct from all others. There is clearly considerable genetic variation in the P. heterotremus complex in Thailand and the form referred to as P. pseudoheterotremus is widely distributed in Thailand and the Thai-Myanmar border region.
Jennifer Keiser - One of the best experts on this subject based on the ideXlab platform.
-
trematode infections liver and Lung Flukes
Infectious Disease Clinics of North America, 2012Co-Authors: Thomas Furst, Urs Duthaler, Banchop Sripa, Jurg Utzinger, Jennifer KeiserAbstract:Food-borne trematodiases are an emerging public health problem in Southeast Asia and Latin America and of growing importance for travel clinics in Europe and North America. The disease is caused by chronic infections with liver, Lung, and intestinal Flukes. This article focuses on the most important liver and Lung Flukes that parasitize man, namely Clonorchis sinensis, Fasciola gigantica, Fasciola hepatica, Opisthorchis felineus, Opisthorchis viverrini, and Paragonimus spp. The article describes the epidemiology of major liver and Lung fluke infections, including current distribution, burden, life cycle, clinical signs and symptoms, diagnostic approaches, and current tools for prevention, treatment, and control
-
Triclabendazole for the treatment of fascioliasis and paragonimiasis.
Expert opinion on investigational drugs, 2005Co-Authors: Jennifer Keiser, Dirk Engels, Gottfried Büscher, Jurg UtzingerAbstract:Fascioliasis and paragonimiasis, which are caused by liver Flukes (Fasciola) and Lung Flukes (Paragonimus), are emerging public health problems. Several hundred millions of people are at risk of the two diseases that cause considerable morbidity and delay socio-economic development. Triclabendazole, a benzimidazole derivative, has been routinely used since 1983 in veterinary medicine to control infections with Fasciola spp. in domestic herbivorous animals. In 1986, a veterinary formulation of triclabendazole was first administered to two human patients with fascioliasis. Clinical data obtained thus far suggest that triclabendazole is the most efficacious and best tolerated drug for the treatment of fascioliasis. Moreover, the drug holds promise as a useful therapeutic alternative to praziquantel in the treatment of paragonimiasis. This review of triclabendazole includes an overview of the pharmacodynamics and pharmacokinetics, toxicology and efficacy against the major food-borne trematodes in laboratory animals. Data from case reports and clinical trials in humans infected with Fasciola spp. and Paragonimus spp. are summarised and the current state of triclabendazole regarding treatment of human fascioliasis and paragonimiasis is described. Efforts to facilitate broader registration of this drug should go hand-in-hand with research and development on novel drugs against food-borne trematodiasis, better access to improved sanitation, sound health education and the development of new technologies for assuring food safety.
Wanchai Maleewong - One of the best experts on this subject based on the ideXlab platform.
-
Comparative genomics and transcriptomics of 4 Paragonimus species provide insights into Lung fluke parasitism and pathogenesis.
GigaScience, 2020Co-Authors: Bruce A Rosa, Pham Ngoc Doanh, Samantha N Mcnulty, Young Jun Choi, Hyeim Jung, John Martin, Takeshi Agatsuma, Hiromu Sugiyama, Wanchai MaleewongAbstract:Background Paragonimus spp. (Lung Flukes) are among the most injurious foodborne helminths, infecting ∼23 million people and subjecting ∼292 million to infection risk. Paragonimiasis is acquired from infected undercooked crustaceans and primarily affects the Lungs but often causes lesions elsewhere including the brain. The disease is easily mistaken for tuberculosis owing to similar pulmonary symptoms, and accordingly, diagnostics are in demand. Results We assembled, annotated, and compared draft genomes of 4 prevalent and distinct Paragonimus species: Paragonimus miyazakii, Paragonimus westermani, Paragonimus kellicotti, and Paragonimus heterotremus. Genomes ranged from 697 to 923 Mb, included 12,072-12,853 genes, and were 71.6-90.1% complete according to BUSCO. Orthologous group analysis spanning 21 species (Lung, liver, and blood Flukes, additional platyhelminths, and hosts) provided insights into Lung fluke biology. We identified 256 Lung fluke-specific and conserved orthologous groups with consistent transcriptional adult-stage Paragonimus expression profiles and enriched for iron acquisition, immune modulation, and other parasite functions. Previously identified Paragonimus diagnostic antigens were matched to genes, providing an opportunity to optimize and ensure pan-Paragonimus reactivity for diagnostic assays. Conclusions This report provides advances in molecular understanding of Paragonimus and underpins future studies into the biology, evolution, and pathogenesis of Paragonimus and related foodborne Flukes. We anticipate that these novel genomic and transcriptomic resources will be invaluable for future Lung fluke research.
-
Evaluation of IgG4 Subclass Antibody Detection by Peptide-Based ELISA for the Diagnosis of Human
2016Co-Authors: Paragonimiasis Heterotrema, Yoon Kong, Pewpan M. Intapan, Penchom Janwan, Oranuch Sanpool, Porntip Laummaunwai, Nimit Morakote, Wanchai MaleewongAbstract:The Lung Flukes, Paragonimus species, cause paragonimiasis in humans and animals [1-3]. It is estimated that over 20 mil-lion people are infected worldwide [4] and approximately 292.8 million people are at risk of infection [5]. While Paragonimus westermani is the most important human pathogen in China, Korea, and Japan [1-3,6], Paragonimus heterotremus is the main etiological agent of human paragonimiasis in southern China, Southeast Asia (including Thailand and Vietnam), and India [1-3]. Diagnosis of paragonimiasis relies on demonstration of Par-agonimus eggs in the feces, sputum, or both [3]. However, mi-croscopic detection of Paragonimus eggs is not very sensitive because of irregular egg production and difficulties of process-ing sputum and fecal specimens and requirement for experi-enced microscopists. Furthermore, eggs are not detectable i
-
molecular variation in the paragonimus heterotremus complex in thailand and myanmar
Korean Journal of Parasitology, 2013Co-Authors: Oranuch Sanpool, David Blair, Yukifumi Nawa, Pewpan M. Intapan, Penchom Janwan, Tongjit Thanchomnang, Wanchai MaleewongAbstract:Paragonimiasis is an important food-borne parasitic zoonosis caused by infection with Lung Flukes of the genus Paragonimus. Of the 7 members of the genus known in Thailand until recently, only P. heterotremus has been confirmed as causing human disease. An 8th species, P. pseudoheterotremus, has recently been proposed from Thailand, and has been found in humans. Molecular data place this species as a sister species to P. heterotremus, and it is likely that P. pseudoheterotremus is not specifically distinct from P. heterotremus. In this study, we collected metacercariae of both nominal species (identification based on metacercarial morphology) from freshwater crabs from Phetchabun Province in northern Thailand, Saraburi Province in central Thailand, and Surat Thani Province in southern Thailand. In addition, we purchased freshwater crabs imported from Myanmar at Myawaddy Province, western Thailand, close to the Myanmar-Thailand border. The DNAs extracted from excysted metacercariae were PCR-amplified and sequenced for ITS2 and cox1 genes. The ITS2 sequences were nearly identical among all samples (99-100%). Phylogenies inferred from all available partial cox1 sequences contained several clusters. Sequences from Indian P. heterotremus formed a sister group to sequences from P. pseudoheterotremus-type metacercariae. Sequences of P. heterotremus from Thailand, Vietnam, and China formed a separate distinct clade. One metacercaria from Phitsanulok Province was distinct from all others. There is clearly considerable genetic variation in the P. heterotremus complex in Thailand and the form referred to as P. pseudoheterotremus is widely distributed in Thailand and the Thai-Myanmar border region.
-
Molecular identification of a case of Paragonimus pseudoheterotremus infection in Thailand.
The American journal of tropical medicine and hygiene, 2012Co-Authors: Pewpan M. Intapan, Yukifumi Nawa, Oranuch Sanpool, Kanokwan Imtawil, Tongjit Thanchomnang, Chatlert Pongchaiyakul, Wanchai MaleewongAbstract:Paragonimiasis is an important food-borne parasitic zoonosis caused by infection with Lung Flukes of the genus Paragonimus. In Southeast Asia, Paragonimus heterotremus is the only proven causative pathogen. Recently, a new Paragonimus species, P. pseudoheterotremus, was found in Thailand. This species is genetically similar to P. heterotremus and is considered as a sister species. However, infectivity or pathogenicity of P. pseudoheterotremus to humans remains unclear. We report the first confirmed human pulmonary paragonimiasis case caused by P. pseudoheterotremus infection. After polymerase chain reaction/sequencing of the DNA extracted from Paragonimus eggs in the sputum of the patient, partial internal transcribed spacer 2 and cytochrome c oxidase subunit 1 sequences were approximately identical (98–100%) with those of P. pseudoheterotremus. For P. heterotremus, the partial internal transcribed spacer 2 sequence was approximately identical (99–100%), but the partial mitochondrial cytochrome c oxidase subunit 1 sequence showed a similarity of 90–95%.
-
Short Report: Molecular Identification of a Case of Paragonimus pseudoheterotremus Infection in Thailand
2012Co-Authors: Pewpan M. Intapan, Yukifumi Nawa, Oranuch Sanpool, Kanokwan Imtawil, Wanchai MaleewongAbstract:Paragonimiasis is an important food-borne parasitic zoonosis caused by infection with Lung Flukes of the genus Paragonimus. In Southeast Asia, Paragonimus heterotremus is the only proven causative pathogen. Recently, a new Paragonimus species, P. pseudoheterotremus, was found in Thailand. This species is genetically similar to P. heterotremus and is considered as a sister species. However, infectivity or pathogenicity of P. pseudoheterotremus to humans remains unclear. We report the first confirmed human pulmonary paragonimiasis case caused by P. pseudo- heterotremus infection. After polymerase chain reaction/sequencing of the DNA extracted from Paragonimus eggs in the sputum of the patient, partial internal transcribed spacer 2 and cytochrome c oxidase subunit 1 sequences were approx- imately identical (98-100%) with those of P. pseudoheterotremus. For P. heterotremus, the partial internal transcribed spacer 2 sequence was approximately identical (99-100%), but the partial mitochondrial cytochrome c oxidase subunit 1 sequence showed a similarity of 90-95%. Paragonimiasis is a food-borne zoonosis caused by infection with Lung Flukes of the genus Paragonimus .O nly 7o f approxi- mately 40 species can infect humans: 2 species (Paragonimus kelikotti and P. mexicanus) in the Western Hemisphere, 2( P. africanus and P. uterobilateralis )i n Africa, and 3( P. westeremani, P. skrjabini ,a ndP. heterotremus )i n Asia. 1-3
Jurg Utzinger - One of the best experts on this subject based on the ideXlab platform.
-
trematode infections liver and Lung Flukes
Infectious Disease Clinics of North America, 2012Co-Authors: Thomas Furst, Urs Duthaler, Banchop Sripa, Jurg Utzinger, Jennifer KeiserAbstract:Food-borne trematodiases are an emerging public health problem in Southeast Asia and Latin America and of growing importance for travel clinics in Europe and North America. The disease is caused by chronic infections with liver, Lung, and intestinal Flukes. This article focuses on the most important liver and Lung Flukes that parasitize man, namely Clonorchis sinensis, Fasciola gigantica, Fasciola hepatica, Opisthorchis felineus, Opisthorchis viverrini, and Paragonimus spp. The article describes the epidemiology of major liver and Lung fluke infections, including current distribution, burden, life cycle, clinical signs and symptoms, diagnostic approaches, and current tools for prevention, treatment, and control
-
no paragonimus in high risk groups in cote d ivoire but considerable prevalence of helminths and intestinal protozoon infections
Parasites & Vectors, 2011Co-Authors: Sylvain G Traore, Jurg Utzinger, Peter Odermatt, Bassirou Bonfoh, Nda D Aka, Koffi D Adoubryn, Aka Assoumou, Gilles DreyfussAbstract:Background Paragonimiasis is a neglected tropical disease caused by an infection with Lung Flukes that is transmitted through the consumption of undercooked crabs. The disease is often confused with tuberculosis. Paragonimiasis is thought to be endemic in south-western Cote d'Ivoire.
-
towards improved diagnosis of zoonotic trematode infections in southeast asia
Advances in Parasitology, 2010Co-Authors: Maria Vang Johansen, Jurg Utzinger, Paiboon Sithithaworn, Robert BergquistAbstract:Humans in Southeast Asia are at risk for at least 70 species of food-borne and water-borne trematodes, including blood Flukes, intestinal Flukes, liver Flukes and Lung Flukes, which are shared with a great variety of animals. Co-infection with several other zoonotic trematodes is pervasive, and hence differential diagnosis represents a major challenge. Many zoonotic trematodes are commonly overlooked, leading to unreliable prevalence data, underappreciation of their veterinary and public health burden and impact, and general neglect with respect to treatment and control. Additionally, many eggs are indistinguishable by microscopy. For example, failure to address this diagnostic dilemma has resulted in overestimation of Clonorchis sinensis prevalence and underestimation of minute intestinal Flukes. Test insensitivity is becoming a problem of prime interest as surveillance is gaining in importance and various control programmes now regularly register progress. Hence, the likelihood of underestimating the true burden of disease is growing in well-controlled areas when the faecal egg excretion among infected individuals approaches zero. While antibody testing has ultimate sensitivity, its use as a test of cure remains contentious. On the other hand, employing faecal egg detection as the diagnostic 'gold' standard makes many positive antibody test results (incorrectly) appear false. Polymerase chain reaction (PCR)-based diagnostics could solve this dilemma, but more experience is needed and costs must be brought down to permit large-scale use of this approach. The future development of virtual microscopy to be used for diagnosis of parasitic infections in the field could make ordinary microscopy obsolete by electronically capturing specimens at point-of-contact in remote areas.
-
Triclabendazole for the treatment of fascioliasis and paragonimiasis.
Expert opinion on investigational drugs, 2005Co-Authors: Jennifer Keiser, Dirk Engels, Gottfried Büscher, Jurg UtzingerAbstract:Fascioliasis and paragonimiasis, which are caused by liver Flukes (Fasciola) and Lung Flukes (Paragonimus), are emerging public health problems. Several hundred millions of people are at risk of the two diseases that cause considerable morbidity and delay socio-economic development. Triclabendazole, a benzimidazole derivative, has been routinely used since 1983 in veterinary medicine to control infections with Fasciola spp. in domestic herbivorous animals. In 1986, a veterinary formulation of triclabendazole was first administered to two human patients with fascioliasis. Clinical data obtained thus far suggest that triclabendazole is the most efficacious and best tolerated drug for the treatment of fascioliasis. Moreover, the drug holds promise as a useful therapeutic alternative to praziquantel in the treatment of paragonimiasis. This review of triclabendazole includes an overview of the pharmacodynamics and pharmacokinetics, toxicology and efficacy against the major food-borne trematodes in laboratory animals. Data from case reports and clinical trials in humans infected with Fasciola spp. and Paragonimus spp. are summarised and the current state of triclabendazole regarding treatment of human fascioliasis and paragonimiasis is described. Efforts to facilitate broader registration of this drug should go hand-in-hand with research and development on novel drugs against food-borne trematodiasis, better access to improved sanitation, sound health education and the development of new technologies for assuring food safety.
