Phupiewkham Weeraya, Rodpai Rutchanee, Inthavongsack Somchith, Laymanivong Sakhone, Thanchomnang Tongjit, Sadaow Lakkhana, Boonroumkaew Patcharaporn, Sanpool Oranuch, Janwan Penchom, Intapan Pewpan M, Maleewong Wanchai
D epart ment of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
Excellence in Medical Innovation, and Technology Research Group, Faculty of Medicine and Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen 40002, Thailand.
Trans R Soc Trop Med Hyg. 2021 Dec 2;115(12):1403-1409. doi: 10.1093/trstmh/trab066.
Human opisthorchiasis, caused by Opisthorchis viverrini, is a public health problem in Southeast Asia and a major risk factor for cholangiocarcinoma. In Lao PDR, seroprevalence and the relationship between the number of O. viverrini eggs in infected people and specific antibody responses are still unknown. We evaluated and compared parasitological and serological screening methods in the community in an endemic area of opisthorchiasis in Lao PDR.
Seroprevalence of O. viverrini-specific total IgG and IgG4 antibodies and their relationships with O. viverrini egg intensities were evaluated in Khammouane Province, central Lao PDR, using ELISA and a modified formalin ethyl-acetate concentration technique (FECT).
FECT stool examination revealed O. viverrini eggs in 70.3% (90/128) of individuals (95% CI 61.6 to 78.1%) while ELISA (based on total IgG and on IgG4 antibodies to O. viverrini) found 98.4% (95% CI 94.5 to 99.8%) and 89.8% (95% CI 83.3 to 94.5%) of sera, respectively. There was a positive and significant correlation between numbers of O. viverrini eggs per gram and levels of both IgG (R2=0.168, p<0.001) and IgG4 (R2=0.219, p<0.001) antibodies.
A high prevalence of human opisthorchiasis in Lao PDR was found using a new platform, serological screening in the community. This points to a need for sustainable control of this liver fluke infection.
由麝猫后睾吸虫引起的人体后睾吸虫病是东南亚的一个公共卫生问题，也是胆管癌的主要危险因素。在老挝人民民主共和国，麝猫后睾吸虫的血清流行率以及感染者体内该吸虫卵数量与特异性抗体反应之间的关系仍不清楚。我们在老挝人民民主共和国后睾吸虫病流行地区的社区中评估并比较了寄生虫学和血清学筛查方法。
在老挝人民民主共和国中部的甘蒙省，采用酶联免疫吸附测定（ELISA）和改良的福尔马林-乙酸乙酯浓缩技术（FECT），评估了麝猫后睾吸虫特异性总IgG和IgG4抗体的血清流行率及其与麝猫后睾吸虫卵强度的关系。
FECT粪便检查显示，70.3%（90/128）的个体粪便中有麝猫后睾吸虫卵（95%置信区间61.6%至78.1%），而ELISA（基于总IgG和针对麝猫后睾吸虫的IgG4抗体）分别在98.4%（95%置信区间94.5%至99.8%）和89.8%（95%置信区间83.3%至94.5%）的血清中检测到阳性。每克粪便中麝猫后睾吸虫卵的数量与IgG（R2 = 0.168，p < 0.001）和IgG4（R2 = 0.219，p < 0.001）抗体水平均呈正相关且具有显著性。
通过在社区中进行血清学筛查这一新平台，发现老挝人民民主共和国人体后睾吸虫病的患病率很高。这表明需要对这种肝吸虫感染进行可持续控制。
