Expected rate of liver fluke-related cholangiocarcinoma in endemic area of liver fluke with antiparasitic drug distribution program for disease control in Thailand.

Abstract

Parasitic-induced cancer is an important problem in tropical oncology. Liver fluke-related biliary tract cancer of cholangiocarcinoma is an important kind of endemic cancer in Southeast Asia. This cancer is related to the liver fluke infection. The local public health policies for disease control include antiparasitic drug, praziquantel, distributing aiming at getting rid of risk factor, and opisthorchiasis. In the present report, the authors reappraise on the local epidemiological data on liver fluke infection among the local people in endemic area Thailand under antiparasitic drug distribution program for further assessment for expected rate of cholangiocarcinoma. The present study is a clinical mathematical modeling study. First, the retrospective reappraisal on the available local data on liver fluke infection among the local people in endemic area of Thailand, a tropical country in Indochina, with a different history of previous exposure to antiparasitic drug is done. Then, a mathematical model based on predictive modeling and probability assignment technique is developed for the assessment of estimated rate of cholangiocarcinoma. According to the present study, the expected rate of liver fluke-related cholangiocarcinoma is equal to 0.0564%. There is a strong relationship between expected rate of liver fluke-related cholangiocarcinoma and number of previous exposure to praziquantel (r = 0.99, P = 0.02). According to the study, the high expected rare of cholangiocarcinoma is observed despite the use of general antiparasitic drug distribution policy. It implies finding for new adjusted public health manipulation for disease prevention and management.