• Title/Summary/Keyword: Praziquantel

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Decrease of Metagonimus yokogawai Endemicity along the Tamjin River Basin

  • Lee, Jin-Ju;Kim, Hyo-Jin;Kim, Min-Jae;Lee, Jo-Woon-Yi;Jung, Bong-Kwang;Lee, Ji-Youn;Shin, Eun-Hee;Kim, Jae-Lip;Chai, Jong-Yil
    • Parasites, Hosts and Diseases
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    • v.46 no.4
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    • pp.289-291
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    • 2008
  • The Tamjin River which flows from Jangheung-gun via Gangjin-gun to the South Sea was reported to be a highly endemic area of Metagonimus yokogawai infection in 1977 and 1985. However, there were no recent studies demonstrating how much change occurred in the endemicity, in terms of prevalence and worm burden, of metagonimiasis in this river basin. Thus, a small-scale epidemiological survey was carried out on some residents along the Tamjin River basin in order to determine the current status of M. yokogawai infection. A total of 48 fecal samples were collected and examined by the Kato-Katz thick smear and formalin-ether sedimentation techniques. The egg positive rate of all helminths was 50.0%, and that of M. yokogawai was 37.5%, followed by C. sinensis 22.9% and G. seoi 4.2%. To obtain the adult flukes of M. yokogawai, 6 egg positive cases were treated with praziquantel 10 mg/kg in a single dose and purged with magnesium sulfate. A total of 5,225 adult flukes (average 871 specimens per person) of M. yokogawai were collected from their diarrheic stools. Compared with the data reported in 1977 and 1985, the individual worm burdens appeared to have decreased remarkably, although the prevalence did not decrease at all. It is suggested that the endemicity of M. yokogawai infection along the Tamjin River has been reduced. To confirm this suggestion, the status of infection in snail and fish intermediate hosts should be investigated.

Echinostoma aegyptica (Trematoda: Echinostomatidae) Infection in Five Riparian People in Savannakhet Province, Lao PDR

  • Chai, Jong-Yil;Jung, Bong-Kwang;Chang, Taehee;Shin, Hyejoo;Sohn, Woon-Mok;Eom, Keeseon S.;Yong, Tai-Soon;Min, Duk-Young;Phammasack, Bounlay;Insisiengmay, Bounnaloth;Rim, Han-Jong
    • Parasites, Hosts and Diseases
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    • v.58 no.1
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    • pp.67-72
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    • 2020
  • Human infection with Echinostoma aegyptica Khalil and Abaza, 1924 (Trematoda: Echinostomatidae) is extremely rare. In this study, we confirmed E. aegyptica infection in 5 riparian residents living along the Mekong River in Savannakhet Province, Lao PDR. The patients revealed eggs of Opisthorchis viverrini/minute intestinal flukes, echinostomes, and other parasites in fecal examinations using the Kato-Katz technique. Following treatment with praziquantel 30-40 mg/kg and pyrantel pamoate 10-15 mg/kg in a single dose and purging with magnesium salts, adult specimens of various helminth species were collected. Among the trematodes, echinostome flukes of 4.5-7.6 mm in length (n = 134; av. 22.3 specimens per case) were of taxonomic interest and subjected in this study. The flukes were morphologically characterized by having total 43-45 collar spines arranged in 2 alternating rows (corner spines usually 5 on each side) and compatible with previous descriptions of E. aegyptica. The patients were mixed-infected with other helminths, so specific clinical manifestations due to this echinostome fluke were difficult to determine. The present paper describes for the first time human E. aegyptica infections in Lao PDR. This is the second report of human infection (2nd-6th cases) with E. aegyptica in the world following the first one from China.

A Study of Clonorchis Sinensis Infection among Factory Workers in Pohang area. (포항지역 공장근로자의 간흡충감염 의식 조사)

  • Han Mi Hyun
    • Journal of Korean Public Health Nursing
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    • v.2 no.2
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    • pp.45-61
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    • 1988
  • Clonorchiasis should be realized as an important public health problems in Korea by their wide distribution, high prevalence rate and heavy infection intensity. This study was designed to obtain the infection rate, contributing factors as well as the behavior of infected persons among the factory workers in Pohang area where that parasite still remains as a problem. Study was undertaken from September '86 to October '87. Clonorchiasis skin test was performed for 3180 factory workers, and stools of skin test positive reactors were examined. Praziquantel was prescribed to stool examination positive persons for clonorchis sinensis ova. After one year. stool examination was repeated for them who received medicine. At the same time. a structured questionnaire was given and the results were analyzed and compared with control group. The results of this study are summarized as follows; 1. The infection rate of Clonorchis sinensis. 1) Clonorchiassis skin test positive rate was $26.2\%$ (834/3180). 2) Stool(Clonorchis sinensis ova) positive rate among skin test positive reactors was $21.6\%$ (129/598) All 129 infected persons were male. 2. Contributing factors of Clonorchis sinensis infection. 1) The chance of infection was higher in low-educated peple(p<0.01) 2) Stool(Clonorchis sinensis ova)positive rate was higher among the persons who reside near the riverside now(p<0.01), or among the persons who long history of riverside residence(p<0.01) 3) The infection rate was higher in thoes who like sliced raw fresh water fishes than in those who like cooked fishes(p<0.05). 4) Correct answering rate for questions about the cause and route of Clonorchis sinensis infection was low in infected persons. 5) The infection rate was lower among those who had experience of previous clonorchiasis test(p<0.01). 6) Family members of infected persons show higher rates of infection(p <0.01). 3. Treatment effect and compliance of infected person to treatment. 1) After one year, negative stool conversion rate was $85.4\%$. 2) $70.8\%$ of infected persons took the medicine; Only $3.1\%$ of them consulted to physician to know the medication effect; As many as $29.4\%$ of them continued to consume raw fresh water fishes. As a conclusion, City of Pohang area, Hyung San River in the center, is an endemic area of clonorchiasis. Current clonorchiasis control system seemed to be ineffective; many of the skin test positive group did not submitted their stool for examination; only $70.8\%$ of infected persons took the medicine even though the drugs were given free of charge; $29.4\%$ continued to consume raw fresh water fishes after taking medicine. Therefore. proper education program should be provided to improve the compliance to treatment. Follow-up for infected cases is mandatory to prevent waste of restricted budget.

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Two endemic foci of heterophyids and other intestinal fluke infections in southern and western coastal areas in Korea (전북 부안군과 경남 사천군 해안지역에서 발견한 이형흡충류 및 기타 장흡충류의 유행지)

  • 채종일;송태의
    • Parasites, Hosts and Diseases
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    • v.36 no.3
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    • pp.155-162
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    • 1998
  • Two endemic foci of heterophyid infections were discovered in coastal villages of Puan-gun. Chollabuk-do, and Sachon-gun. Kyongsangnam-do, Korea. Fecal examina- tions were performed on 153 inhabitants of Puan-gun and 138 of Sachon-gun, using cellophane thick smear and formalin-ether sedimentation technique. The helminth egg and/or protozoan cyst positive rate was 21.5% (33/153) in Puan-gun and 39.1% (54/138) in Sachon-gun. In Puan-fun, the egg Positive rate of heterophyids was the highest, 17.6%, and that of other parasites was 0.7-2.6% by parasite species. In Sachon-gun, that of heterophyids wa's 18.8%, followed by Clonorchis sinensis (12.3%). and other parasites (0.7-5.OBEI . Twenth-two (Puan-gun) and six (Sachon-gun) heterophyid egg Positive cases were treated loth praziquantel, and adult flukes were collected from their diarrheic stools. A total of 3,284 adult flukes of Heterophyes nocens was collected from all of the 22 patients treated in Puan-gun (3-778 individually) , and other trematodes were also collected from 2- 15 patients; Ftgidiopsis sumac, Stellcntchcsmus JcEcctus, Metogoninus Wokogaupci, M. miyntci, Stictodora Juscnta, Heterophwopsis continua, Acnnthopcrwphium kurognmo, and GWmnophaELoines seoi. In Sachon-gun, M. yokognwci (3,007 specimens), H. nocens (120), aud S. falcatus (46) were collected from 5 of 6 treated patients, and H. continuo and 5. tan each from one patient. The present study revealed that heterophyid flukes, especially If. nocens and M. Wokofowai, are prevalent in the southern and western coastal areas of Korea where fresh and/or brackish water fishes are popularly eaten raw.

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Prevalence of Schistosomes and Soil-Transmitted Helminths among Schoolchildren in Lake Victoria Basin, Tanzania

  • Siza, Julius E.;Kaatano, Godfrey M.;Chai, Jong-Yil;Eom, Keeseon S.;Rim, Han-Jong;Yong, Tai-Soon;Min, Duk-Young;Chang, Su Young;Ko, Yunsuk;Changalucha, John M.
    • Parasites, Hosts and Diseases
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    • v.53 no.5
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    • pp.515-524
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    • 2015
  • The objectives of this study was to conduct a survey on schistosomiasis and soil-transmitted helminth (STH) infections in order to come up with feasible control strategies in Lake Victoria basin, Tanzania. Depending on the size of the school, 150-200 schoolchildren were recruited for the study. Duplicate Kato-Katz stool smears were prepared from each child and microscopically examined for Schistosoma mansoni and STHs. Urine specimens were examined for Schistosoma haematobium eggs using the filtration technique. After the survey, mass drug administration was done using praziquantel and albendazole for schistosomiasis and STHs infections, respectively. A total of 5,952 schoolchildren from 36 schools were recruited for the study and had their stool and urine specimens examined. Out of 5,952 schoolchildren, 898 (15.1%) were positive for S. mansoni, 754 (12.6%) for hookworms, 188 (3.2%) for Ascaris lumblicoides, and 5 (0.008%) for Trichuris trichiura. Out of 5,826 schoolchildren who provided urine samples, 519 (8.9%) were positive for S. haematobium eggs. The results revealed that intestinal schistosomiasis, urogenital schistosomiasis, and STH infections are highly prevalent throughought the lake basin. The high prevalence of intestinal and urogenital schistosomisiasis in the study area was a function of the distance from Lake Victoria, the former being more prevalent at localities close to the lake, whilst the latter is more so away from it. Control of schistosomiasis and STHs in the study area requires an integrated strategy that involves provision of health education to communities, regular treatments, and provision of adequate safe water supply and sanitation facilities.

Raw Fish Consuming Behavior Related to Liver Fluke Infection among Populations at Risk of Cholangiocarcinoma in Nakhon Ratchasima Province, Thailand

  • Chavengkun, Wasugree;Kompor, Pontip;Norkaew, Jun;Kujapun, Jirawoot;Pothipim, Mali;Ponphimai, Sukanya;Kaewpitoon, Soraya J;Padchasuwan, Natnapa;Kaewpitoon, Natthawut
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2761-2765
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    • 2016
  • Opisthorchiasis is a health problem in rural communities of Thailand, particularly in the northeast and north regions. Therefore, this study aimed to investigate raw fish consuming behavior related to liver fluke infection among the population at risk for opisthorchiasis and cholangiocarcinoma (CCA). A cross-sectional descriptive study was conducted in Meuang Yang district, Nakhon Ratchasima province, northeast Thailand, between June and October 2015. Participants were screened for CCA, and samples who had a high score of CCA risk were purposively selected. A predesigned questionnaire was utilized to collect the data from all participants. $X^2-test$ was used for analysis of associations between demographic data and raw fish consumption. The results revealed that participants had past histories of stool examination (33.0%), liver fluke infection (21.0%), praziquantel use (24.0%), raw fish consumption (78.0%), relatives family consuming raw fish (73.0%), and relatives family with CCA (3.0%). Participants consumed several dished related to liver fluke infection, mainly raw fermented fish (13.0%), under smoked catfish (5.00%), raw pickled fish (4.00%), and raw spicy minced fish salad (3.00%). The most common types of cyprinoid fish were Barbodes gonionotus (39%), Hampala dispar (38%), Puntius brevis (37%), Cyclocheilichthys armatus (33%), Puntioplites proctozysron (32%), and Luciosoma bleekeri (30%), respectively. Participants had a low level of knowledge (mean=3.79, SD=0.74), moderate attitude (mean=7.31, SD=7.31) and practice (mean=38.64, SD=6.95) regarding liver fluke prevention and control. Demographic variables like age (>36 years old; $X^2-test=17.794$, p-value=0.001), education (primary school; $X^2-test=18.952$, p-value=0.001), marital status (married; $X^2-test=12.399$, p-value=0.002), and income (<5,000 baht; $X^2-test=27.757$, p-value=0.015) were significantly associated with raw fish consumption. This result indicates that the population had risk consumption for liver fluke infection particularly of various cyprinoid fishes that are $2^{nd}$ intermediate hosts. Therefore, health education is required to improve their behavior.

Epidemiological Studios on Clonorchis sinensis Infection along the Nam-river in Gyeongnam Province, Korea (남강유역 간흡충감염의 역학적 조사연구)

  • 배경훈;안영겸
    • Parasites, Hosts and Diseases
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    • v.21 no.2
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    • pp.116-186
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    • 1983
  • An epidemiological study on Clonorchis sinensis infection along the Nam-river (total length ; 186km) flowing in Gyeongsang-nam-do, southern part of Korea, was carried out. Formalin-ether concentration technique and Stoll's egg counting method were employed to figure out the prevalence of C. sinensis infection. For the detection of cercariae from Parafossarulus sp., the snail host of C. sinensis, each snail was placed in aerated tap water, and examined for expelled cercariae. For observing the metacercariae the fresh water fish favorably eaten in raw conditions wore prepared by means of pressing the muscles between two slide glasses and/or by digesting them with artificial gastric juice. The fresh water fish were fed to the rabbits to get the worms and to identify the morphology of adult C. sinensis. The results are summarized as follows: 1. Overall Prevalence of C. sinensis infection was 38.75 from 5,291 examinees; 44.15 (1,408 out of 3,196) in male and 30.4% (637 out of 2,095) in female. 2. The prevalence rates were 42.0% at the upper stream, 41.2% around the vicinity of Jinyanglake, 34.2% at Jinju city, 34.2% at middle stream and 40.3% at down stream regions, respectively. 3. By age, the highest positive rate (53.4∼54.3%) was observed in 30 to 59 years of age. In this age group, the rate in males was 59.7∼62.2%, and in females 42.2∼44.4%, In the age group of less than 19 years it was 7.5∼20.9%. 4. By social strata, the positive rate was 16.5% in the primary school children, 22.6% in school students, 46.2% in teachers and local officers and 49.6% in the general inhabitants. 5. The quantitative examinations with the stool collected from clonorchiasis cases revealed that the light infection (less than 4,000/EPG) was 53.6%, moderate infection (4,001∼10,000 /EPG) 30.3% and heavy infection (more than 10,001/EPG) 16.1%, respectively. More than half of total cases examined were light infection, and 73.2% of female examinees were lightly infected with this cuke. 6. The average value of EPG was 4,963 (male, 6,057; female, 2,557 and the highest value was obtained from the age group of 30 to 59 years (5,240∼6,454). 7. The prevalence of Metagonimus yokogawai infection in humans was 5.5%, and 89.8% of metagonimiasis cases wore double-infected arith C. sinensis. The highest prevalence rate was observed in Jinju city (11.2%). 8. Total of 5,005 Parafossarulus sp., the snail intermediate host of C. sinensis, were examined for the detection of cercariae. The cercarial expulsion rate was 0.34%, and the snails collected in Jin-yang-lake side and in the down stream expelled mainly the cercariae of C, sinensis. 9. About 788 cercariaejday (range: 127∼1,503) were expelled daily from a snail naturally infected with C. sinensis. The snails which released more than 1,000 cercariae/day were 30.8% out of total collected. A snail uniquely released 5,840 cercariae/day in this study. 10. The other trematode cercariae besides C. sinensis were also detected, and the rates out of total snails were the cercariae of Losogenes liberum 6.71%, Cyathocotyle orientalis 0.26%, Notocotylus attenuatus 2.52% and Mucobucaris 0.54%, 11. Ten out of 18 species of fresh water fish caught along the river harbored the metacercariae of C, sinensis. The highest rate of metacercarial infection in fish was detected in Pseudorasbora larva (85.9%). The fish mainly eaten by the inhabitants along the Nam-river, and the metacercarial infection rates were: Zacco platypus 8.0%, Hemibarbus sp. 18.2∼26.7%, Gnathepcgcn sp. 37.5%, Ischikauia steenackeri 42.9% and Pseudogobio esocinus 16.7%. 12. Out of 36 P. larva, the number of metacercariae were about 109 (ranEe; 18∼446) per fish and 27 per gram of flesh. The fish caught in spring harbored the highest number of metacercariae. As indicated above, the prevalence of C. sinensis infection in the inhabitants residing around the Nam-river was relatively high. The farther toward the upper stream areas, the higher was the positive rate of C. sinensis infection, and most of clonorchiasis cases were lightly infected. The snail hosts of C. sinensis distributed all around the Nam-river. Several species of freshwater fish were infected with the metacercariae of C. sinensis and the infection rates were relatively high. To prevent C. sinensis infection in the endemic areas, the effective health education system is suggested as a control measure, although mass treatment is also expected to be useful, using chemotherapeutic agents such as "praziquantel", a recently developed anthelminthic for C. sinensis inftraction.

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Control of Human Clonorchiasis at Gokseong-gun and Sunchang-gun near the Sumjin River in Korea (섬진강 유역 곡성군, 순창군 지역 주민의 간흡충증 관리)

  • Kim, Suk-Il;Yun, Woo-Sang
    • Journal of agricultural medicine and community health
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    • v.29 no.1
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    • pp.163-175
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    • 2004
  • Objectives: This study was carried out to decrease the prevalence of human clonorchiasis and to evaluate the control effect in two Clonorchis sinensis-endemic area of Gokseong-gun and Sunchang-gun adjacent to the Sumjin River in Korea. Methods: The formalin-ether concentration method for stool egg examination or ELISA was applied for the diagnosis of clonorchiasis. As a primary survey, according to the non-probability sampling, a total of 1,2.13 inhabitants at Gokseong-gun were screened through the stool examination, and 1,004 inhabitants at Sunchang-gun were screened through the ELISA. The humans infected with C. sinensis were medicated with praziquantel and educated for the prevention of reinfection with the fluke. After 9 months, as a secondary survey, each prevalence of 616 inhabitants at Gokseong-gun and 2.637 inhabitants at Sunchang-gun was followed-up for the decrease of human clonorchiasis. Results: The prevalence before the mass control was 39.0% at Gokseong-gun and 30.1% at Sunchang-gun in average from 61.5% to 8.9% according to the villages (Myeon) of the survey. In the riverside villages to the Sumjin River the prevalences were higher than other villages located far from the river. The prevalence after the control was decreased to the level of 22.4% at Gokseong-gun(P<0.0001) and 16,3% at Sunchang-gun (P<0.0001). Conclusions: These results suggested that human clonorchiasis was still highly endemic in riverside area of the Sumjin River and could be decreased through the control activities such as diagnosis, medication and education. It was highly recommended that a integrated control such as those of the present study must be adopted in other localities along the Sumjin River for the eradication of human clonorchiasis.

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Studies on the Epidemiological Change of Clonorchiasis After Mass Chemotherapy in Highly endemic Areas (집단치료사업에 따른 간흡충증의 역학적 변동에 관한 조사)

  • Joo, Kyoung-Hwan;Chu, Paul B.;Rim, Han-Jong;Lee, Joon-Sang
    • Journal of agricultural medicine and community health
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    • v.12 no.1
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    • pp.80-93
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    • 1987
  • Mass chemotherapy of Clonorchis sinensis infection in Korea was started in 1982 with 40mg/kg body weight single dose administration scheme of praziquantel. The purpose of this study was to investigate the efficiency of current mass chemotherapy project and compare the epidemiological changes in endemic area of Ckmorchis sinensis. This study was performed at Kimhae-city and Samrangjin-eup of Miryang-gun, Kyongnam province, highly endemic area of C. sinensis located southeastern part of Korea from July to October of 1986. The therapy project of Kimhae area was performed in 1984, whereas that of Samrangjin was done in 1985 by stool examination of the Korea Association for Parasite Eradication(KAPE) and drug administration of local health centre. The results obtained were as follows; 1) As a results of stool examination from 234 specimens obtained in Kimhae area, the infection rate has decreased to 34.2%from 45.6p in 1983, but the infection rate of C. sinensis from 341 specimens obtained in Samrangjin area did not decrease (58.1%in 1986 490%in 1983). 2) The study in Kimhae area showed that the average EPG decreased remarkably from 4,858 to 1,340 and those classified above the category of heavy infection decreased also from 14.0pp to 1.7%. The study in Samrangjin area showed that the average EPG did decrease drastically from 9,597 to 6,498 and those classified above the category of heavy infection did not go down drastically from 25.2% to 14.2%. 3) The study in Kimhae area showed decrease of Cs.$D._{50}$ in comparison to that in 1983, wheareas Cs.$D._{50}$ in Samrangjin area showed no much difference compared to that in 1983. The intensities of endemicity were represented with the regression equation calculated with the cumulative percentages of EPG count. Regression equation was Y=4.49+1.19 log x in Kimhae area and Y=3.66+127 log x in Samrangjin area. 4) The two stage catalytic model was applied and the calculation lead to the equation $Y=5.33(e^{-0.018t}-e^{-0.016t})$ in Kimhae area and $Y=1.25(e^{-0.010t}-e^{-0.018t})$ in Kimhae area and $Y=125(e^{-0.010t}-e^{-0.050t})$ in Samrangjin area 5) The infection rate of cercaria in P.manchouric-us studied in Kimhae area showed 1.25% which is not much different from that in previous years, wheareas the infection rate of metacercaria in P. parva studied in the same area this year showed 2.5-20.2/gm of flesh in comparison to 64/gm of flesh in 1983. 6) Data of C. sinensis infection on the reservoir host in Kimhae area showed 4 out of 18 dogs, 1 out of 18 rats and that in Samrangjin area showed 2 out of 18 dogs respectively. 7) Among the inhabitants who were under mass chemotherapy in Kimhae area, 71out of them, upon stool examination, showed infection rate of 66.2% and those classified above the category of heavy infection, 2.4%. In comparison to infection rate of 33.7% and those classified above the category of heavy infection, which is 1.0%, obtained from those not under mass chemotherapy showed higher infection rate and somewhat equal distribution of intensity of infection. The above statements reflect the fact that individual therapy besides mass chemotherapy was prevalent in that area. 8) On the other side, the studies in Samrangjin area showed infection rate of 68.7% and those above the category of heavy infection, which is 6.1%, in comparison to infection rate of 58.3% and those above the category of heavy infection, which is 16.5%, in those not under mass chemotherapy. the above reflects that although a good deal of inhabit-ants were classified under light or moderate infection category, those above the category of heavy infection, yet, numbered a lot, and individual chemotherapy has not been going on. In conclusion, it was suggested that the number of reinfected inhabitants among those under mass chemotherapy were numerous. Accordingly, the reinforcement of health education should be followed with mass chemotherapy. The facts of high infection rate exemplified by 65% and high number of those above the category of heavy infection in Samrangjin area say that reevaluation of dosage, number of medication and intervals should be necessarily made.

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Epidemiological Studies of Clonorchiasis - II. Current Status and Natural Transition of the Endemicity of Clonorchis sinensis in Goyang Gun, a Low Endemic Area in Korea (간흡충증(肝吸虫症) 역학(疫學) - II. 저도유행지(低度流行地) 고양지방(高陽地方)에 있어서의 간흡충감염(肝吸虫感染)의 현황(現況)과 자연추이(自然推移))

  • Kim, D.C.;Lee, O.Y.;Lee, J.S.;Ahn, J.S.;Chang, Y.M.;Son, S.C.;See, S.H.
    • Journal of agricultural medicine and community health
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    • v.8 no.1
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    • pp.66-80
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    • 1983
  • As a part of the epidemiological studies of clonorchiasis in Korea, this study was conducted to evaluate the current endemicity and the natural transition of the Clonorchis infection in Goyang Gun a low endemic area in recent years, prior to the introduction of praziquantel which will eventually influence to the status of the prevalence. The data obtained in this study in 1983 were evaluated for natural transition of the infection in comparison with those obtained 16 years ago in 1967 by the author (Kim, 1974). The areas of investigation, villages and schools surveyed, methods and techniques used in this study were the same as in 1967, except for the contents of the questionnaire for raw freshwater fish consumption by the local inhabitants. 1) The current prevalence rate of Clonorchis infection among the inhabitants was 7.5% on the average out of a total of 479 persons examined. The prevalence rate was 9.0% in the riverside area and 4.2% in the inland area. Among the schoolchildren, the prevalence rate was 1.1% out of a total of 1 319 examined. By area, it was 1.4% in the riverside area and 0.7% in the inland area. By sex, the prevalence rate was 13.3% in the male and 1.3% in the female in the inhabitants and no difference was seen in the schoolchildren. 2) In the natural transition of the infection, the prevalence rate in the inhabitants has decreased from 22.5% in 1967 to 7.5% in 1983, and in the schoolchildren, from 9.5% in 1967 to 1.1% in 1983. The reduction rate was higher in the riverside area than in the inland area. 3) In the prevalence rate by age, 1.2% was seen in the 10-14 age group and gradually increased to 8.1% in the 30-39 age group and reached peak 18.1% in the 40-49 age group. By sex, in the male, the prevalence rates have increased to 31.9% and 33.3% in the 40-49 and 50-59 age groups, respectively and decreased thereafter. In the female, the prevalence rate less than 5% was seen only in between the 10-14 and 30-39 age groups. 4) In the natural transition of the prevalence rate by age, sharp decrease was seen in the male from around 50% in 1967 between 15-19 and 30-39 age groups. The generation over 40s showed less decrease. In the female, the prevalence rate has decreased from 13% in 1967 to 5% in 1983 in the middle age groups and dropped to 0% in the rest of the age groups. 5) The intensity of the infection among clonorchiasis cases by mean EPmg (number of eggs per mg feces) value was 1.4. In the inhabitants, the value was 2.0 in the riverside area and 0.4 in the inland area. While in the schoolchildren, the value was 0.2 in both riverside and inland areas. 6) In the transition of the intensity of the infection, EPmg among the inhabitants has decreased from 3.9 in 1967 to 2.0 in 1983 in the riverside area, and from 2.9 to 0.4 in the inland area. In the schoolchildren, the reduction was similar in both riverside and inland areas resulting from 1.0-1.1 in 1967 to 0.2 in 1983. 7) In the intensity of the infection by age, EPmg 3.4 was peak at the 40-49 age group and 0.2-1.0 was seen in the rest of the age groups. The mean value was 1.5 in the male and 0.6 in the female. 8) In the natural transition of the intensity of the infection, the EPmg has decreased from 2.7 in 1967 to 1.4 in 1983. By age, reduction was seen in all of the age groups, particularly in the young and the old age groups of 50s and over, except in the 40-49 age group in which reverse phenomenon was seen. By sex, it has decreased from 3.5 in 1967 to 1.5 in 1983 in the male and from 1.0 to 0.6 in the female. 9) In the distribution of the clonorchiasis cases by the range of EPmg value, 70.3% of the cases were placed in the range of 0.1-0.9 as the most and 16.2% in 1.0-4.9 as the next. With such figures, those included in the range less than 0.9 as light infection were 78.4% and under 5.0-9.9 up to moderate infection 99.3% of the cases were covered. The cases were distributed up to 20.0-39.9 in the male and to 1.0-4.9 in the female. 10) In the transition of the distribution of the clonorchiasis cases by EPmg, the highest intensity reached up to 60.0-79.9 in 1967 and to 20.0-39.9 in 1983. In the range of light infection, under 0.1-0.9, the distribution in rate was 64.5% in 1967 and 78.4% in 1983. Up to the range of moderate infection, under 5.0-9.9, 91.7% in 1967 and 97.3% in 1983 were seen respectively. 11) In a survey for raw freshwater fish consumption among the local inhabitants,78.3 of the clonorchiasis cases interviewed admitted their experience of the raw consumption. However, those who practised in the past two years were 34.8% 55.6% of those who have such experience in the past professed that they did not practise raw freshwater fish consumption in the past two years. 12) The major cause of the reduction of the raw freshwater fish consumption among the inhabitants were the wide spread water pollution in the locality. The most common reason professed for stopping raw freshwater fish consumption among the inhabitants was the risk of the fluke infection. 13) In animal survey, 3.1% of dogs were found infected with Clonorchis, decreasing from 21.6% in 1967. 14) The distribution of the first intermediate host, Parafossarulus manchouricus has greatly diminished in this locality and found only in two localized ponds. No Clonorchis infection was found from the snails examined. 15) The second intermediate freshwater fish host has been further limited by extended water pollution. No susceptible fish host could be examined. 16) In conclusion, the endemicity of Clonorchis infection in Croyang Gun, low endemic area, has significantly decreased during the past 16 years. The major cause of the regressive transition of the infection was the water pollution of the freshwater system of this locality. This has upset the ecosystems of the intermediate host of Clonorchis sinensis in many areas of waterbodies and further discouraged to a significant extent the local inhabitants from raw freshwater fish consumption.

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