• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2565-2571
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• 2016

A cross-sectional survey was conducted among 730 participants from 4 rural districts of Nakhon Ratchasima province, Thailand, with a reported high incidence of liver fluke infection. This study was aimed to examine and evaluate the nutritional status in relation to Opisthorchis viverrini infection. Participants were purposive selected from Chum Phuang, Mueang Yang, Bua Yai, and Kaeng Sanam Nang districts. Stool samples were prepared by Kato Katz technique and then assessed by microscopy. Anthropometry was evaluated according to the body mass index from weight and height. Descriptive statistics and Spearman rank correlation coefficients were used to evaluate the association between the nutritional status and O. viverrini infection. Of 1.64% infected with O. viverrini the highest proportions were found in age groups ${\geq}61$ and 41-50 years old, Mueang Yang district. The majorities of participants had normal weight (32.2%), followed by class II obesity (28.1 %), class I obesity (21.8%), underweight (10.3%), and class III obesity (8.63%). Nutritional status with class II obesity (rS=0.639, p<0.01) and class I obesity (rS=0.582, p<0.05), had moderately statistical significant correlations with O. viverrini infection. Meanwhile, normal weight (rS=0.437, p<0.05) and class III obesity (rS=0.384, p<0.05) demonstrated lower statistical significance. These findings raise the possibility that infection with O. viverrini may contribute to fat deposition and thereby have long-term consequences on human health. Further studies are needed to better understand whether O. viverrini contributes directly to fat deposition and possible mechanisms.

• YAKHAK HOEJI
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• v.30 no.5
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• pp.253-265
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• 1986

Among 230 species of herbal drugs screened, thirty one show the anthelmintic activities in vitro against Clonorchis sinensis, the chinese liver fluke. The active substances have been isolated and their structures identified. Some of the active substances and their derivatives have been synthesized, followed by anthelmintic activity tests. The extracts from the active drugs cause damages in organs of the adult worm in the hepatic duct of rabbit. Some fresh water fish, which function as bad hosts for the fluke, excrete defense substances against the cercaria of the fluke. The defense substances have been isolated from Cyprinus carpio and Cyprinus carpio nudus, followed by structural identification. The results are summarized as follows: l) The bark of Machilus thunbergii as well as the seed of Schizandra chinensis contain meso-dihydro-guaiaretic acid as the anthelmintic component. Among derivatives synthesized, 4-phenyl-1-((3, 4-dihydroxyphenyl)-, 4-phenyl-1-(3-hydroxy-4-methoxy phenyl)-and 4-phenyl-1-(4-hydroxy-3-methoxy phenyl)-2, 3-dimethyl butanes show considerable activities. Administration of the bark extract mainly damages the bladder of the adult worm. 2) The active substance from the roasted fruit of Prunus mume is 2-hydroxymethylfurfural. This substance is produced during the roasting process. Administration of the fruitextract causes a damage of the bladder of the adult worm. 3) The active substance from the root of Scutellaria baicalensis is 5.2'-dihydroxy-6, 7, 8, 6'-tetramethoxyflavone. 4) Beside alantolactone, a very strong anthelmintic component is contained in the root of Inula helenium. Administration of the root extract causes irreversible damage on the worm, affecting mainly the reproductive organs. 5) The cercaricidal substances from the epidermis of C. carpio and C. carpio nudus are ethyl linoleate and linoleic acid, respertively. 6) The cercaricidal substances from various kinds of fresh water fish have different $R_f$ values, implying that the defense substances are species-specific. Unexpectedly, the fish with good host function, for example Pseudorasbora parva, excrete the defense substances, too. The defense substances are possibly organ-specific in individual species; the organs essenstial for the existence of the species excrete the defense substances, allowing other parts to be invaded by the cercaria. 7) The cercaricidal fraction of Carassius carassius is detected only in the fish which have been collected during the summer time from May to September, Its secretion is not dependent on water temperature. Thus, it seems to be possible that the secretion of the defense substance would be stimulated through a contact between the fish and cercaria.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9511-9515
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• 2014

Cholangiocarcinoma (CCA) is a cancer of the bile duct epithelial cells. The highest incidence rate of CCA with a poor prognosis and poor response to chemotherapy is found in Southeast Asian countries, especially in northeastern Thailand and Lao PDR. Cathepsin B is a lysosomal cysteine protease which is regulated by cysteine proteinase inhibitors such as cystatin C. Elevation of cathepsin B levels in biological fluid has been observed in patients with inflammatory diseases and many cancers. We aimed to investigate the serum cathepsin B and cystatin C levels of CCA patients to evaluate the feasibility of using cathepsin B and cystatin C as markers for the diagnosis of CCA. Fifty-six sera from CCA patients, 17 with benign biliary diseases (BBD) and 13 from controls were collected and the cathepsin B and cystatin C levels were determined. In addition, cathepsin B expression was investigated immunohistochemically for 9 matched-pairs of cancerous and adjacent tissues of CCA patients. Serum cathepsin B, but not cystatin C, was significantly higher in CCA and BBD patient groups compared to that in the control group. Consistently, all cancerous tissues strongly expressed cathepsin B while adjacent tissues were negative in 7 out of 9 cases. In contrast, serum cystatin C levels were comparable between CCA and control groups, although serum cystatin C levels in the BBD group was higher than that in the control or CCA groups. When the serum cathepsin B to cystatin C ratio was calculated, that of the CCA group was significantly higher than that of the control group, and, although statistically not significant, the ratio of CCA group showed a trend to be higher than that of the BBD group. Thus, the cathepsin B to cystatin C ratio might be used as an alternative marker for aiding diagnosis of CCA.

• Parasites, Hosts and Diseases
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• v.45 no.3
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• pp.213-218
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• 2007

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.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1111-1114
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• 2016

Opisthorchiasis is a major problem in Thailand particularly in northeast region which also has a high incidence of cholangiocarcinomas. Since health modification is needed, this quasi-experimental study aimed to assess the effectiveness of a health education program based on self-efficacy and social support in Tha Tum district, Surin province, Thailand. A total of 70 participants were purposive selected with a history of opisthorchiasis. Participants were divided into experimental and control groups, each with 35 subjects. The experimental group received a health education program composed of: (1) knowledge improvement, lectured with multimedia, demonstration, brochure, and handbook; (2) group discussion about their health beliefs, sharing their ideas and experience; and (3) social support from village health volunteers (VHV), heads of villages (HV), friends, and members of families, and public health officer (PHO). Follow-up was by PHO/VHV/HV, with provision of certificates and flasg for household that did not eat raw fish. Data were collected by predesigned questionnaires after implementation of the program for 3 months. Comparative data was analyzed by paired simple t-test and independent t-test. The results revealed that the experimental group had mean score of knowledge higher more than before the experiment (mean difference=3.1, t=3.915, 95%CI-3.3, -1.8 p-value=0.001), and the control group (mean difference=2.5, t=4.196, 95%CI=1.4, 3.6, p-value=0.001) with statistical significance. The mean scores of practice were higher than before the experiment (mean difference=4.6, t=4.331, 95%CI-5.3, -3.1, p-value=0.001), and control group (mean difference=4.4, t=6.142, 95%CI=4.2, 7.9, p-value=0.001). The mean scores of perceived susceptibility and perceived severity of opisthorchiasis, al well as perceived benefits and perceived barriers to prevention of opisthorchiasis, were also higher than before the experiment and in the control group (p-value <0.001). In conclusion, this was a successful health education program for liver fluke avoidance. Therefore, it may useful for further behavior modification in the other epidemic areas.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7789-7794
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• 2015

Background: This study aimed to evaluate the impact of a community-based health education and communication programme on reducing liver fluke infections caused by the consumption of uncooked fish among people in a high-risk area of Thailand. Materials and Methods: The study was quasi-experimental in nature, with three-stages. Stage 1 involved a situational and capacity analysis of designated communities in Khon Kaen province. This was followed by the development of a model for community-based health education and communication to prevent liver fluke infections among high-risk people, and, lastly, implementation and evaluation of the model were performed. Data were collected using both qualitative and quantitative methods. In total, 390 people were surveyed, and quasi-experimental and comparison groups, each with 90 people, were assessed between May 2011 and April 2012. Analysis was using statistical OR, 95 % CI, the Willcoxon matched pairs signed ranks test, the chi-square test, and the Mann-Whitney U test. Results: The findings showed that most respondents had a high level of knowledge and understanding of liver fluke disease (89.5%, 95% CI:86.0-92.4), and positive attitudes toward the prevention of the disease (94.4%, 95% CI:91.6-96.4). However, with regard to changes in consumption of uncooked fish, most respondents were still in the pre-contemplation phase (55.1%, 95% CI:50.0-60.1), followed by the contemplation phase, 22.6%. Furthermore, four factors were found to be associated with the consumption of uncooked fish - the consumption of alcohol (OR 4.16, 95% CI:1.79-9.65), gender (OR 3.17, 95% CI:1.53-6.54), smoking (OR 3.03, 95% CI:1.31-7.05), and age 40 years and above (OR 2.68, 95% CI:1.02-7.05). After nine months of the health education and communication programme using local media based on local wisdom, culture and persons, the results showed that, compared to the control group, members of the experimental group had a higher level of knowledge, a better attitude and lower levels of ill-advised consumption behaviour. Also, it was found that consumption of uncooked fish, by an assessment of the level of stage of change, was reduced. (p-value 0.002). Conclusions: The health education and communication programme developed as part of the study was effective in changing the consumption of uncooked fish. Therefore, this approach should be promoted in other high-risk areas in Thailand in the future.

• Journal of agricultural medicine and community health
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• v.22 no.2
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• pp.239-252
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• 1997

A questionnaire survey including stool examination for the parasite ova, skin test, and enzyme-linked immunosorbent assay (ELISA) of the liver fluke to find the factors related with the prevalence of the parasite infestation was done toward 118 residents living in three villages of Song-jung, Yi-jung, and Chim-gok of Okok-myun, Goksung County, South Cholla Province. The results are as follows : 1. The prevalence of Clonorchis sinensis ova by the stool examination was 46.6%. The sensitivity and specificity of skin test to egg-positive cases were 63.5% and 68.9%. The sensitivity and specificity of ELISA to egg-positive clonorchiasis were 100% and 34.9%. 2. The prevalence of Clonchiasis was higher in male than in female. 45~64 year old group was the highest among age groups, and the longer the duration of living in the present residence was, the higher the prevalence was shown statistically significantly (p<0.01). 3. The present drinker had higher prevalence of Clonorchiasis significantly than the past drinker or non-drinker, and the more the frequency of drinking the higher the prevalence was shown significantly (p<0.05). 4. Those who took raw fish had significantly higher than persons who didn't take it or take cooked fish(p<0.05) and prevalence showed the tendency to be increased as the frequency to take raw fishes increased significantly(p<0.05). 5. Those who had taken a raw sweet fish(Plecoglossus altivelis) or snake-headed fish(Ophicephalus argus) showed significantly higher prevalence of infection with liver fluke than persons who didn't take the raw fish. 6. While 56.4% of persons infected with Clonorchiasis answered that they were healthy, only 13.0% of the subjects were careful for their health, and 41.8% experienced tests to diagnose liver flukes before they were examined by this survey. 7. While 56.4% of infected persons thought the prevalence was high in their community, 54.0% were afraid to be infected, 47.1% thought the infection might destroy their health, 25.5% took treatment drugs, and 18.2% took raw fish continuously after treatment. The above results confirmed that Goksung area was highly prevalent in Clonorchiasis, so it was necessary to push effective preventive program against liver fluke infection together with the program to diagnose and treat existing infected persons.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.177-181
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• 2016

This cross-sectional descriptive and qualitative study was aimed to study the people participation and their approaches toward the human carcinogenic liver fluke, Opisthorchis viverrini, prevention and control in Ban Chaun sub-district administrative organization (BCSAO) and Bamnet Narong sub-district municipality (BNSM), Bamnet Narong district, Chaiyaphum Province, Thailand between June 2013 and February 2014. Participants were purposive selected, included chiefs of sub-district administrative organizations, sub-district municipalities, sub-district health promotion hospitals (SHPHs), heads of village, and a further sample was selected with a multi-stage random sampling for public health volunteers, and villagers. The pre-designed questionnaire contained items for individualized status and the participatory steps of sharing ideas, decision-making, and planning, procession, evaluation, and mutual benefit, for the project O. viverrini prevention and control (POPC). In-depth interviews were used for collection of need approaches to POPC. With 375 participants who completed the questionnaire, it was found that people had a high level regarding to participate in the POPC, particularly in the process stage ($\bar{X}=3.78$, S.D. = 0.56), but the lowest level was found in sharing ideas, decision making, and planning step ($\bar{X}=3.65$, S.D. = 0.63). By comparison, participant status and organization did not significantly differ with people participation. In each step, Ban Chaun sub-district had a high level of participation in the step of sharing ideas, decision making, and planning toward POPC, more than Bamnet Narong sub-district municipality (t=2.20, p=0.028). Approaches for POPC in Ban Chaun sub-district and Bamnet Narong sub-district municipality included requirements for budget support, annual campaigns for liver fluke prevention and control, campaign promotion, risk group observation, home visiting, community rules regarding reducing raw fish consumption in their communities, and a professional public health officer for working in their communities, BCSAO, BNSM, and SHPH, for O. viverrini prevention and control. This study indicates that people realize that eradication of the liver fluke needs a continuous people participation for O. viverrini prevention and control in their communities.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1367-1370
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• 2015

Diagnosis of cholangiocarcinoma (CCA) is difficult when patients do not show jaundice. The aim of this study was to examine the feasibility of using the total serum bile acid (TSBA) level as an aid for the diagnosis of CCA in patients without jaundice. For this purpose, TSBA of the following groups were measured using a Beckman Synchron CX4 clinical chemistry analyzer: 60 cases of CCA with total serum bilirubin ${\leq}2mg/dL$ (low total bilirubin group, LTB); 32 cases of CCA with total serum bilirubin >2 mg/dL (high total bilirubin group, HTB); and 115 healthy controls. Liver function parameters such as serum cholesterol, albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were also examined. The results showed that the TSBA of both LTB and HTB groups of the CCA patients were significantly higher than that of the healthy controls. Also, significant correlation was observed between TSBA and total bilirubin levels in the HTB group of CCA patients. However, no such correlation was seen in the LTB group. The cut-off value of TSBA was determined for the LTB group of CCA patients using the receiver operating characteristic curve analysis, and it was $6.05{\mu}mol/L$ with the sensitivity and specificity of 46.7% and 84.4%, respectively. In addition, the ALP level was correlated well with the TSBA level and ALP in HTB group was significantly higher than that of LTB group. Moreover, the combination of high TSBA and high ALP levels gave higher specificity up to 97.4%. TSBA might be useful for the diagnosis of CCA patients without jaundice.

• Parasites, Hosts and Diseases
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• v.50 no.1
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• pp.45-51
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• 2012

Fascioliasis is one of the public health problems in the world. Cysteine proteinases (CP) released by $Fasciola$ $gigantica$ play a key role in parasite feeding, migration through host tissues, and in immune evasion. There has been some evidence from several parasite systems that proteinases might have potential as protective antigens against parasitic infections. Cysteine proteinases were purified and tested in vaccine trials of sheep infected with the liver fluke. Multiple doses (2 mg of CP in Freund's adjuvant followed by 3 booster doses 1 mg each at 4 week intervals) were injected intramuscularly into sheep 1 week prior to infect orally with 300 $F.$ $gigantica$ metacercariae. All the sheep were humanely slaughtered 12 weeks after the first immunization. Changes in the worm burden, ova count, and humoral and cellular responses were evaluated. Significant reduction was observed in the worm burden (56.9%), bile egg count (70.7%), and fecel egg count (75.2%). Immunization with CP was also found to be associated with increases of total IgG, $IgG_1$, and $IgG_2$ ($P$<0.05). Data showed that the serum cytokine levels of pro-inflammatory cytokines, IL-12, IFN-${\gamma}$, and TNF-${\alpha}$, revealed significant decreases ($P$<0.05). However, the anti-inflammatory cytokine levels, IL-10, TGF-${\beta}$, and IL-6, showed significant increases ($P$<0.05). In conclusion, it has been found that CP released by $F.$ $gigantica$ are highly important candidates for a vaccine antigen because of their role in the fluke biology and host-parasite relationships.