Chapter 11 - Food-Borne Trematodiases in Southeast Asia: Epidemiology, Pathology, Clinical Manifestation and Control
Introduction
Food-borne trematodiases are one major group of the so-called neglected tropical diseases (NTDs) worldwide with more than 40 million people infected and 750 million (> 10% of the world's population) at risk (Hotez et al., 2008, Keiser & Utzinger, 2005). Over 100 species of food-borne trematodes are known to infect humans. These infections usually occur focally, are still endemic in many parts of the world, particularly Southeast Asia (Graczyk and Fried, 2007). Common clinical important trematodes in this region include Opisthorchis viverrini, Clonorchis sinensis, Fasciola spp., Paragonimus spp. and intestinal flukes (Table 11.1) (WHO, 2002). Most trematodiases affect the poor and poorest people in rural areas. Many factors contribute to the high prevalence of these infections, including lack of education, poor recognition of the trematode infections because of their asymptomatic clinical presentation, poverty, malnutrition, a lack of food inspection and poor sanitation (Graczyk and Fried, 2007).
This review highlights on the life cycles, epidemiology, clinical manifestations, pathology and pathogenesis, diagnosis, and prevention and control of the most important trematodiases in Southeast Asia, particularly opisthorchiasis and clonorchiasis. Fascioliasis, one of the clinically important trematodiasis in the region, has been extensively updated in this journal recently (Mas-Coma et al., 2009a). For detailed biology of other trematodes, several recent in-depth reviews are recommended, that is Dorny et al., 2009, Keiser & Utzinger, 2009.
Section snippets
Opisthorchiasis and Clonorchiasis
The human liver flukes, O. viverrini, O. felineus and C. sinensis remain important public health problems in many parts of the world (Fig. 11.1). C. sinensis is widespread in the People's Republic of China (P.R. China), Korea and north Vietnam, while O. viverrini is endemic in Southeast Asia, including Thailand, Lao People's Democratic Republic (Lao PDR), Cambodia and central Vietnam. Human infection follows the consumption of raw or undercooked cyprinoid (freshwater) fish habouring infective
Fascioliasis
There are an estimated 2.4–17 million people worldwide, including Asia, infected with one or both species of the liver fluke Fasciola, namely F. hepatica and F. gigantica, often causing serious acute and chronic morbidity (Mas-Coma et al., 2005, Mas-Coma et al., 2009a). The estimated at-risk population is 80 million (Keiser and Utzinger, 2005). In the past, Fasciola infections were limited to specific and typical geographical areas, but more recently, this liver fluke has spread throughout the
Paragonimiasis
Paragonimus spp., the lung flukes, represent one of the most injurious of the food-borne helminths. These flukes cause paragonimiasis in people and other crab-eating mammals in Asia, parts of West Africa, and South and Central America. About 20 million people are infected with lung flukes (WHO, 1995) and an estimated 293 million people are at-risk (Keiser and Utzinger, 2005). There are about 15 species of Paragonimus known to infect humans. P. westermani infection is the most common elsewhere,
Intestinal Flukes
The intestinal fluke category comprises a large assemblage of trematode species that induce food-borne parasitic zoonoses. Collectively, these parasites have a major impact on the health and economy in developing countries of the tropics and sub-tropics in Asia, Africa, Europe and the Americas.
Conclusions and Research Implications
The food-borne trematodiases not only remain major NTDs in South East Asia and sub-Saharan Africa, throughout much of the developing world, they are emerging and re-emerging, including developed regions, such as O. felineus in Western Europe (Armignacco et al., 2008), P. westermani in Miyazaki prefecture, Japan (Nakano et al., 2009) and fascioliasis in the Bolivian Altiplano (Parkinson et al., 2007).
There is a need to undertake risk mapping using geographical information systems (GIS) and
Acknowledgements
We gratefully acknowledge support from award number UO1AI065871 from the National Institute of Allergy and Infectious Diseases (NIAID), the Thailand Research Fund (grant no. BRG4580016) and the Thailand-Tropical Diseases Research Programme (T-2, grant number ID 02-2-HEL-05-054). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NIAID or the National Institutes of Health (NIH).
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