Re-Emergence of Paragonimiasis in Nigeria. A Case Report and Future Challenges.

Abstract

AIM: Imo State of Nigeria was an endemic area for paragonimiasis from 1964 to 1980. A well planned eradication program was put in place and no case was recorded from 1980 to 2007. In October 2007 the first patient with the disease voluntarily reported at the base hospital at 21A Park Road, Aba Nigeria. This case calls to mind a possible re-emergence of the disease–hence this report to alert health stakeholders to initiate and sustain disease eradication program that will give everlasting solution to this disease problem. METHOD: A healthy looking man reported with chronic cough and haemoptysis at the hospital. Ziehl-Neelsen sputum test was done daily for 3 days for acid-fast bacilli. Direct sputum smear microscopy for eggs of paragonimiasis was done. Blood was examined for differential white blood count and direct X-ray chest films were examined also. RESULTS: Sputum was negative for acid-fast mycobacterium organisms. Sputum showed eggs of P. uterobilateralis. Eosinophil count was 15% of the total white blood count. Chest X-ray film showed abnormal soft shadows in one area of the upper left lung field. The patient was diagnosed to have paragonimiasis. CONCLUSION: Eradication program put in place in the endemic paragonimiasis area of Imo State of Nigeria broke the circle of the disease transmission. When the program implementation was relaxed or non-existent the circle closed–hence the re-emergence. It is wise to report this case hoping that the stakeholders will restart the programme continues and sustain it to ensure lasting eradication. This re-emergence could occur anywhere in the world with similar disease transmitting conditions. A lesson learnt here would be of immense benefit to readers especially to health workers.