A comparison was made of a new serological method, thin layer immunoassay (TIA), and an established method, enzyme-linked immunosorbent assay (ELISA), in the detection and quantiacation of antibodies in clonorchiasis. Saline extract of Iyophilized Clonorchis sinensis adult worm was used as antigen, and TIA by the method of Elwing et at. (1976) and ELISA by Voller et at. (1974) were performed. Using sera from known clonorchiasis cases,100% of the sera tested were Positive by TIA and 88.35 by ELISA. TIA produced false positive results in 14 out of 36 cases, which were 10 amoebiasis cases, 16 paragonimiasis cases and 10 healthy controls. ELISA. however, produced a small number of false positives, 7 out of 55 cases. There was correlation between Immunoglobulin G level in sera and ELISA value (correlation coefficient, 0.69), whereas no correlation between Immunoglobulin G level and TIA result. The Performance of TIA and ELISA was not correlated in the results using homologous antigen.
This study was performed to evaluate diagnostic sensitivity and specificity of sonography on clonorchiasis. During the 9 months from March to November 1994, sonography skin test, stool examination, and medical examination were performed to 609 volunteers of Pohang which is located along the Hyongsan-gang (Rivers and is one of well-known endemic areas of clonorchiasis. The sensitivity of sonography was either 21% if the intrahepatic ducts dilatation was assumed to be the only positive anding or 52% if the periductal echogenicity was also included as one of positive findings. The sensitivity of skin test was 62%. The sensitivity was 46% if the diagnostic criteria were arbitrarily assumed as being positive in skin test and having either sonographic findings. The sonographic finding of fusiform, non-shadowing, weakly echogenic foci in gallbladder or in billiaiy tree indicating the flukes or aggregates of flukes was not obvious in this study. The specificity of sonography was either 95% if the intrahepatic ducts dilatation was assumed to be the only positive finding or 82% if the periductal echogenicity was also included as one of positive findings. The specificity of skin test was 52%. The specificity was 90% if the diagnostic criteria was arbitrarily assumed as being positive in skin test and having either sonographic findings.
The endemic status of clonorchiasis and metagonimiasis along the Geum gang (River) in Okcheon-gun (County) in Korea was examined. From February to December 7000, stools of total 1,081 inhabitants living in 5 villages were examined. Each stool specimen was examined by both the cellophane thick smear method and the formalin-ether sedimentation technique. Egg-positive cases were further analyzed by Stoll's egg-counting technique. and praziquantel was administered to positive cases. The egg-positive rates for Clonorchis sinensis and Metafonimus species were 9.3% and 5.5%, respectively, and the double infection rate was 3.5%. The numbers of eggs per gram (EPG) of feces of C. sinensis and Metafoninus sp. were $918{\pm}1,463$ and $711{\pm}947$, respectively. The egg-positive rates for C. sinensis and Metagoninus sp. in the riverside area were 14.2% and 8.4%, respectively, which were significantly higher than those of the inland area (3.2% and 1.7%. respectively). The egg-positive rates of C. sinensis and Metagoninus sp. in males (16.7% and 10.0%) were significantly higher than those of females (3.5% and 1.8%) However, there were no significant differences of EPG values between localities and sexes. The prevalence of clonorchiasis and metagonimiasis in this survey was significantly lower than that in the previous reports. However. there is still a high prevalence of infection with C. sinensis and Metagoninus sp. in this region. especially in the riverside area.
Kim, Chung-Hyeon;Choi, Min-Ho;Chae, Jong-Il;Shin, Eun-Hee;Hong, Sung-Tae
Molecular & Cellular Toxicology
/
v.3
no.3
/
pp.195-197
/
2007
Currently praziquantel is used for treatment of not only clonorchiasis but also other trematodes and cestodes. But cure rate of praziquantel is just 60-80% for most trematodes. It needs for the treatment-failed patients to have more drugs. The cause of failure of treatment is not studied. We just know that the blood level of praziquantel is severely different among the people. We guess that this factor may influence the results of treatment. In an endemic area of human clonorchiasis in Heilongjiang Providence, China, 78 subjects were selected for the study. Three doses of 25 mg/kg (total 75 mg/kg) of praziquantel were administered to 78 clonorchiasis patients. After three weeks of treatment, stool examination was undertaken once again to confirm the cured and uncured subjects. To analyze SNP (single nucleotide polymorphism) of CYP3A5 PS2-1, CYP3A5 PS2-2, and CYP3A5*6, PCR method was done with specifically designed primers. The mutation rates of all sites were not significant statistically. The number of subjects was too small, so we need more subjects and other delivery proteins of bile ducts (ex. MRP etc.) were also considered for effects of praziquantel. We analyzed, for the first time, the entire CYP3A5 gene in a French population, using a polymerase chain reaction- single strand conformational polymorphism (PCR-SSCP) strategy.
We measured changes in sonographic findings of patients with clonorchiasis after a treatment in a highly endemic area. A total of 347 residents showed positive stool results for Clonorchis sinensis eggs in a village in northeastern China, and were treated with praziquantel. Of them, 132 patients underwent abdominal sonography both before and 1 year after treatment, and the changes in sonographic findings of 83 cured subjects were compared. Diffuse dilatation of intrahepatic bile ducts (DDIHD) was found in 82 patients (98.2%) before and 80 (96.4%) after treatment, which was improved in 3, aggravated in 1, and unchanged in 79 patients. Increased periductal echogenicity (IPDE) as observed in 42 patients (50.6%) before and 45 (54.2%) after treatment, which was improved in 5, aggravated in 8, and unchanged in 70 patients. Floating echogenic foci in the gallbladder (FEFGB) was detected in 32 patients (38.6%) before and 17 (20.5%) after treatment, which was improved in 20, aggravated in 5, and unchanged in 58 patients. Improvement of FEFGB only was statistically significantly (P = 0.004). The present results confirm that DDIHD and IPDE persist but FEFGB decreases significantly at 1 year after treatment. In a heavy endemic area, the sonographic finding of FEFGB may suggest active clonorchiasis 1 year after treatment.
Journal of agricultural medicine and community health
/
v.29
no.1
/
pp.163-175
/
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.
The present pilot project was executed to recommend a strategy of clonorchiasis control in China. The pilot area of this project was Zhaoyuan, Hailin, and Ningan, Heiloagjiang province. A baseline survey subjecting 4,865 residents in Heilongjiang confirmed Zhaoyuan asa high endemic area and Hailin and Ningan as moderate endemic areas. Six different control strategies were implemented in Zhaoyuan, two were in Hailin, and one was in Ningan. Including the baseline survey and project programs from 2000 to 2004, total 63,274subject-times were examined of their feces for Clonorchiseggs, 26,680 were treated, 10,082 were screened by ELISA, and 6,130 subjects were examined of their liver by sonography. The egg Positive rates in 6 villages of Zhaoyuan were as high as 44.8% 70,0%. Following the protocolof each strategy, the subjected residents were examined of their feces and treated with 25 mg/kg praziquantel, 3 times. Except the control group, all of the villages showed 72.8% to 92.0% reduction of their original egg Positive rates at Zhaoyuan. Mass treatments of all subjected residents in 2001 and 2003 reduced the egg rate from 68.8% to18.7% and 4 annual mass treatments reduced the rate from 44.8% in 2001 to 8.7% in 2004.Selective annual treatments of egg positive subjects reduced the egg rates from 50.8% in2001 to 13.8% in 2004 or from 70.0% in 2001 to 11.6% in 2004, and two treatments in a year reduced the rate from 57.6% in 2001 to 4.6% in 2004. According to repeated treatments, EPG counts decreased remarkably. In moderate endemic areas, the original egg rates were 22.6% and 28.3% in 2001 but were 1.7% and 1.1% after 2 or 3 selective treatments. The present findings of the chemotherapeutic control of clonorchiasis prove that repeated medication is important. The reduction is directly correlated with dose of praziquantel but not with mass or selective treatments. Chemotherapeutic control of reservoirhosts has little effect on reinfection of clonorchiasis because the field along the Songhua-jiang is too wide to be impacted. ELISA confirmed many serologically positive cases to Clonorchisantigen but only a few cases were positive to other antigens (Paragonimus, cysticercus, sparganum). The abdominal soaography visualized intrahepatic bile duct dilatation and periductal echo in 2,002 of 6,070 examined subjects. In addition to these examinations and treatment, health education supplemented tㅗe control activities. The present findings prove clonorchiasis is very widely prevalent and heavily endemic along the rivers in Heiloagjiang. The results suggest that group chemotherapy with praziquantel is effective to reduce endemicity of clonorchiasis. Mass treatment without individual fecal examination is recommended in heavy endemic areas where the egg rate is over 40% while one selective treatment is effective enough in moderate endemic areas.
This study was conducted to evaluate the current endemicity and the transition mode of the Clonorchis infection in Sanchong-gun Kyongsangnam-do. The areas of investigation, villages and schools surveyed, method and techniques used in this study were the same as in 1984. The egg positive rate of clonorchiasis in the general population of Sanchong-gun was 37.6% out of 837 exanuned persons. In the schoolchildren. the rate was 9.7% out of 145 persons examined. In the Intensity of the infEction among the cases. the mean EPG (Egg Per gram of feces) in the inhabitants and schoolchildren were 3, 310 (male 4, 221, female 1, 978) and 711 tamale 620. female 8331, respectively. Of the inhabitants with clonorchiasis, the cases of light infection (EPG < 1, 000) and moderate infection (1.000 < EPG < 10, 000) were 93.9%. The proportion with experience of eating raw freshwater-fish was 90.5% among the infecters. Out of 138 Inhabitants examined in both 1984 and 1992, the number of the positives by both examinations was 31 (22.5%), positive to negative conversion was 35 (25.4%), negative to positive conversion was 22(15.9%). The present results reveal that there are no chanties of the e99 Positive rate of clonorchiasis among inhabitants in Sanchong and the eating habit of raw freshwater-fish persists there. In this community, the eating habit Is the most important problem to be solved for control of this endemic diease.
Sustained-releasing praziquantel (SRP) tablet was designed for single dose treatment regimen of clonorchiasis. A previous pre-clinical study confirmed its sustained-releasing characteristics and a better cure rate than conventional praziquantel (PZQ). In this clinical study, the pharmacokinetics of this SRP tablet were investigated in human volunteers (phase 1; 12 volunteers), and its curative efficacy was examined in clonorchiasis patients (phase 2; 20 volunteers). In the phase 1 clinical study, blood concentrations of both tablets showed wide individual variation. The $AUC_{last}$ of SRP was $497.9{\pm}519.0ng{\cdot}hr/ml\;(mean{\pm}SD)$ and PZQ of $628.6{\pm}695.5\;ng{\cdot}hr/ml$, and the $AUC_{inf}$ of SRP was $776.0{\pm}538.5\;ng{\cdot}hr/ml$ and of PZQ $658.6{\pm}709.9\;ng{\cdot}hr/ml$. $C_{max}$ values of SRP and PZQ were $90.7{\pm}82.2ng/ml\;and\;214.9{\pm}251.9\;ng/ml$, and $T_{max}$ values were $3.42{\pm}1.43\;hr\;and\;1.96{\pm}1.23\;hr$, respectively. SRP tablets showed similar AUC values, but lower $C_{max}$ and longer $T_{max}$ values than PZQ. In the phase 2 study, SRP at 30 mg/kg (single dose) achieved a 60% cure rate and a 95.5% egg reduction rate. The cure rate of a single dose SRP was unsatisfactory compared with that of the conventional PZQ dose, but much better than that achieved by a single dose PZQ.
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