Abstract
Intestinal parasitic infections (IPIs) are still important to the health of Thai rural residents. IPIs are the cause of many chronic diseases with, for example, opisthorchiasis resulting in progression to cholangiocarcinoma (CCA). This cross-sectional study in a prospective cohort study aimed to examine the prevalence and co- infection of intestinal parasites among Northeastern Thai rural residents, recruited into the Khon Kaen Cohort Study (KKCS), and who were residing in areas of high-risk for developing CCA. On recruitment, subjects had completed questionnaires and provided fecal samples for IPI testing using the formalin ethyl acetate concentration technique. Data on selected general characteristics and the results of the fecal tests were analysed. IPI test results were available for 18,900 of cohort subjects, and 38.50% were found to be positive for one or more types of intestinal parasite. The prevalence of Opisthorchis viverrini (O. viverrini) infection was the highest (45.7%), followed by intestinal flukes (31.9%), intestinal nematodes (17.7%), intestinal protozoa (3.02%), and intestinal cestodes (1.69%). The pattern of different infections was similar in all age groups. According to a mapping analysis, a higher CCA burden was correlated with a higher prevalence of O. viverrini and intestinal flukes and a greater intensity of O. viverrini. Both prevention and control programs against liver fluke and other intestinal parasites are needed and should be delivered simultaneously. We can anticipate that the design of future control and prevention programmes will accommodate a more community-orientated and participatory approach.
Highlights
Intestinal parasitic infections (IPIs) are globally endemic and have been described as constituting the greatest single worldwide cause of illness and disease (Curtale et al, 1998; Steketee, 2003)
Intestinal parasitic infections, including protozoal infections, remain a major threat to their health. These infections cause chronic conditions, which may progress to serious diseases. This is especially true of opisthorchiasis, which is due to infection by 2SLVWKRUFKLV YLYHUULQL 2 YLYHUULQL, and can result in cholangiocarcinoma (CCA), the commonest form of cancer in the northeast region (Vatanasapt et al, 1990; Parkin et al, 1993; Sriamporn et al, 2004; Sripa et al, 2007)
The presence of IPIs was analyzed according to five parasite groups: (1) intestinal protozoa, comprising of (QWDPRHED FROL ( FROL, (QWDPRHEDKLVWRO\WLFD (KLVWRO\WLFD and *LDUGLD ODPEOLD *ODPEOLD LQWHVWLQDOÁXNHVFRPSULVLQJRI (FKLQRVWRPDVSSDQGPLQXWHLQWHVWLQDOÁXNHV OLYHU ÁXNHFRPSULVLQJRI2YLYHUULQL, (4) intestinal cestodes, comprising +\PHQROHSLV GLPLQXWD + GLPLQXWD, +\PHQROHSLV QDQD + QDQD, and 7DHQLD spp. and (5) intestinal nematodes, comprising of $VFDULVOXPEULFRLGHV $ OXPEULFRLGHV, Hookworms, 6 VWHUFRUDOLV and 7ULFKXULVWULFKLXUD 7WULFKLXUD
Summary
Intestinal parasitic infections (IPIs) are globally endemic and have been described as constituting the greatest single worldwide cause of illness and disease (Curtale et al, 1998; Steketee, 2003). The northeast region of Thailand is a mostly dry geographical area and, in socioeconomic terms, has been the most impoverished part of the country for decades. Intestinal parasitic infections, including protozoal infections, remain a major threat to their health. These infections cause chronic conditions, which may progress to serious diseases. This is especially true of opisthorchiasis, which is due to infection by 2SLVWKRUFKLV YLYHUULQL 2 YLYHUULQL , and can result in cholangiocarcinoma (CCA), the commonest form of cancer in the northeast region (Vatanasapt et al, 1990; Parkin et al, 1993; Sriamporn et al, 2004; Sripa et al, 2007)
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