kasus parasitologi

7/23/2019 kasus parasitologi

http://slidepdf.com/reader/full/kasus-parasitologi 1/18

Am. J. Trop. Med. Hyg., 81(1), 2009, pp. 152–155

Copyright © 2009 by The American Society o Tropica! "e#icine an# $ygiene

%nci#ence an# &i' actor' o Opisthorchis viverrini %nection' in a &*ra! Comm*nity in Thai!an#

&am &ang'in,+ "athir*t "*ngthin, aan-it Taama'ri, Somporn "ong!on, ote Aimp*n,

Taee /aag!or, an# Saoaanee ee!ayooa

Department of Military and Community Medicine, and Department of Parasitology, Phramongutlao College of Medicine, !ango, Thailand

A"stract. Opisthorchis viverrini inection i' one o the ma-or p*b!ic hea!th prob!em' in Thai!an#. A!tho*gh inormation abo*t

tran'mi''ion o thi' para'ite to h*man' i' e!! e'tab!i'he#, inection' are 'ti!! prea!ent in the northern an# northea'tern Thai!an#. Th*',

pro'pectie epi#emio!ogic inormation i' nee#e# or #ee!oping more eectie p*b!ic hea!th interention'. A cohort 't*#y to i#entiy

inci#ence an# ri' actor' o O. viverrini inection a' con#*cte# in a r*ra! comm*nity in Thai!an# #*ring 3ecember 2002–ebr*ary

2004. The inci#ence rate o opi'thorchia'i' a' 21.6100 per'onyear'. The in#epen#ent actor' a''ociate# ith opi'thorchia'i' ere an

age > 0 year' an# con'*ming choppe# ra i'h 'a!a# ( #oi pla). Th*', aoi#ing thi' ra i'h 'a!a# 'ho*!# be empha'i7e# in the nationa!

contro! program.

%/T&3CT%/

$*man !ier !*e inection', opi'thorchia'i' i' ca*'e# by

Opisthorchis viverrini an# O. felineus. C!onorchia'i' i' an

inection ith Clonorchis sinensis. The'e !ier !*e inection'

remain a ma-or p*b!ic hea!th prob!em in #ierent area'.

Opisthorchis viverrini inection i' en#emic in So*thea't A'ia,

e'pecia!!y in Thai!an#, ao 3&, :ietnam, an# Cambo#ia; O.

felineus inection i' prea!ent in ea'tern <*rope. Co*ntrie' in

ea'tern A'ia inc!*#ing China, =apan, >orea, Taian, an# northern

:ietnam are the en#emic area' o C. sinensis.

1,2

%n Thai!an#,appro?imate!y 'i? mi!!ion per'on' harboring O. viverrini !ie in

the northern an# northea'tern region'. @ Clonorchis sinensis

inection a' recent!y reporte# in centra! Thai!an#.4 Chronic

inection o O. viverrini may !ea# to cho!angiocarcinoma.5 The

reporte# inci#ence o cho!angiocarcinoma range# rom [email protected] to

@1. per 100,000 per'onyear' in >hon >aen in northea'tern

Thai!an#, the area in hich O. viverrini inection i' en#emic. An

epi#emio!ogic '*rey in Thai!an# 'hoe# that the aerage

prea!ence o opi'thorchia'i' in 2001 a' re!atie!y high,

ranging rom 9.B to 19.@B. %n a##ition, a 't*#y con#*cte# in

2004 'hoe# that the aerage prea!ence o O. viverrini inection

a' 24.5B, ranging rom 2.1B to 0.8B in ario*' #i'trict' o

>hon >aen.

er'on' in the'e area' hae con'*me# *n#ercooe# or ra

anima! pro#*ct', in partic*!ar re'hater i'h.

–9

A!tho*ghinormation abo*t i'hborne tran'mi''ion o O. viverrini i' e!!

e'tab!i'he#, the o*tcome o p*b!ic hea!th preention an# contro!

program' or opi'thorchia'i' #*ring the pa't #eca#e ha' not been

'*cce'*!. pi'thorchia'i' preention campaign' oc*'ing on

aoi#ing the con'*mption o *n#ercooe# or ra re'hater i'h

may not be '*'tainab!y eectie in Thai!an#. rea!ence' hae

not been '*b'tantia!!y re#*ce# in high!y en#emic area'. Changing

oo# con'*mption behaior' among the atri' pop*!ation i' a

#iic*!t ta' in p*b!ic hea!th interention'. Seera! *n#ercooe#

i'h oo#' are 'ti!! common among pop*!ation' in northern an#

northea'tern Thai!an#. Seera! reporte# ri' actor' 'hoe# a

'igniicant a''ociation o non'peciic *n#ercooe# i'h oo#'

an# ac*iring O. viverrini inection. To #ee!op more eectieinterention 'trategie',

+ A##re'' corre'pon#ence to &am &ang'in, 3epartment o "i!itary an#

Comm*nity "e#icine, hramong*t!ao Co!!ege o "e#icine, @15

&atchaithi &oa#, &atchathei, Dango 10400 Thai!an#. <mai!E

rrang'inFpm.ac.th



inormation re!ate# to 'peciic oo# con'*mption habit' that

increa'e the ri' o ac*iring opi'thorchia'i' i' re*ire#.

"o't 't*#ie' o opi'thorchia'i' in Thai!an# ere con#*cte# *'ing

a cro'''ectiona! 't*#y #e'ign, hich may p!ace !imitation' on

obtaining *nbia'e# ri' actor'. To obtain the inci#ence an#

a''ociate# ri' actor' o opi'thorchia'i' in thi' comm*nity, e

con#*cte# a cohort 't*#y a' perorme# #*ring 3ecember

2002–ebr*ary 2004. The p*rpo'e o thi' 't*#y a' to obtain

inormation on ri'' a''ociate# ith opi'thorchia'i', inc!*#ing'ocia! behaior o peop!e in the #i'ea'een#emic area.

"AT<&%AS A/3 "<T$3S

Study area and population. The 't*#y a' con#*cte# at Daan

/ayao i!!age in a r*ra! area o Chacheong'ao roince,

Thai!an#, 228 m ea't o Dango. The pop*!ation o the 't*#yarea a' 1,524 in 2004. The i!!age i' '*rro*n#e# by pon#' an#

re'eroir', hich harbor 'nai! an# i'h interme#iate ho't' o O.

viverrini. "o't o the pop*!ation migrate# rom northea'tern

Thai!an# an# ha' !ie# in thi' area or more than @0 year'. They

hae maintaine# their northea'tern'ty!e habit' o eating

*n#ercooe# an# ra re'hater i'h.

The ba'e!ine '*rey o O. viverrini inection a' carrie# o*t in

3ecember 2002. 8 'too! 'pecimen', 142 (21.@B) ere

po'itie or O. viverrini inection. Tho'e per'on' ho ere

negatie or O. viverrini (n G 52, 8.B) by 'too! e?amination

ere inite# to be enro!!e# into a o!!o*p '*rey in ebr*ary

2004 to i#entiy inci#ence an# ri' actor' o

O. viverrini inection.

Stool collection and examination. At the ba'e!ine an# o!!o*p

'*rey', a 'too! 'pecimen rom each participant a' e?amine#

or inte'tina! para'ite' ithin ho*r' ater co!!ection in the ie!#

*'ing norma! 'a!ine et preparation an# >ato thic 'mear

metho#.10 Stoo! 'pecimen' ere then e?amine# *n#er a !ight

micro'cope or inte'tina! para'ite', ith an empha'i' on O.

viverrini. The'e 'pecimen' ere then tran'porte# to the

3epartment o ara'ito!ogy, hramong*t!ao Co!!ege o

"e#icine, Dango, or the conirmation o O. viverrini inection

by e?perience# technician' *'ing orma!inethy! acetate

concentration techni*e.11 Opisthorchis viverrini po'itiity a'

#eine# a' the pre'ence o O. viverrini egg' in the 'too! 'pecimen

e?amine# by at !ea't one o three metho#'E norma! 'a!ine et

preparation, >ato thic 'mear, an# orma!inethy! acetate

concentration techni*e.

152



%/C%3</C< A/3 &%S> ACT&S %ST$&C$%AS%S

15@

Questionnaires. <nro!!e# participant' ere

interiee# *'ing 'tan#ar#i7e#

*e'tionnaire' to i#entiy the ri' actor' or

O. viverrini inection. The *e'tionnaire

coere# #emographic #ata, 'ocioeconomiccon#ition', 'anitary behaior, inc!*#ing

cooing an# eating habit' o 'eera!

tra#itiona! i'h #i'he' #*ring the pa't 12

month', 'o*rce' o i'h or oo# preparation,

'o*rce' an# treatment metho#' o #rining

ater, an# a hi'tory o anima!' contact. The

*e'tionnaire a' a!'o #e'igne# to coer

tra#itiona! i'h oo# item', hich ere

gro*pe# into three categorie'E *ncooe# i'h,

i.e., choppe# ra i'h 'a!a# ( #oi pla);

mo#erate!y ermente# i'h, i.e., brie!y

ermente# i'h ( Pla som) an# brie!y

ermente# i'h 't*e# ith rice ( Pla faa );an# comp!ete!y ermente# i'h in a high!y

concentrate# 'a!t 'o!*tion, i.e., ra ermente#

i'h ( Pla ra). The i!!ager'H interie

'e''ion' ere con#*cte# a' a proce'' o the

*e'tionnaire #ee!opment to en'*re the

a!i#ity o the *e'tion' a'e#. The

*e'tionnaire ha' been prete'te# an# *'e# in

the other preio*' '*rey' an# a' o*n# to

be re!iab!e in i#entiying the potentia! oo#

con'*mption e?po'*re'.

Statistical analysis. %nci#ence rate per 100

per'onyear' o ob'eration ere ca!c*!ate#

or each category o #emographic an#

potentia! ri' actor ariab!e'. The

a''ociation beteen potentia! ri' actor' an#

O. viverrini inection ere a''e''e# *'ing

ear'onH' chi'*are te't or categorica!

ariab!e'. A 0.05 c*to point a' *'e# or

the P a!*e an# app!ie# in a!! 'tati'tica!

ana!y'i'. Cr*#e re!atie ri' (&&) an# 95B

coni#ence intera!' (C%') ere ca!c*!ate#

or O. viverrini inection an# each o the

other ariab!e' in a biariate ana!y'i'.

"*!tiariate oi''on regre''ion ana!y'i' a'

perorme# to obtain a#-*'te# && an# 95B

C%'. A!! ana!y'e' ere con#*cte# *'ing

STATA6 S< or Iin#o' er'ion 9.2

(StataCorp , Co!!ege Station, TJ).

Ethical consideration and treatment. The

re'earch protoco! a' reiee# an#

approe# by <thica! Committee o the

"e#ica! 3epartment o the &oya! Thai Army.

Iritten inorme# con'ent' ere obtaine#

rom the enro!!e# participant' or their parent'

or chi!#ren participant' ater they rea# the

inormation 'heet an# con'ent orm. ree

proper anthe!minthic treatment an# hea!th

e#*cation ere proi#e# or tho'e ho ha#

inte'tina! para'itic inection'. Opisthorchisviverrini –inecte# ca'e' ere treate# ith a

'ing!e #o'e o pra7i*ante! (40 mg6g).

&<STS

Study population. 52 enro!!e# O.

viverrininegatie participant', 258 (49.0B)

ere ma!e'. Agric*!t*re (80.0B) a' the

main occ*pation. A tota! o 5B ha#e#*cation !ee!' !e'' than primary 'choo!.

Ann*a! ho*'eho!# income a' obtaine#

rom each ami!y in Thai baht an# conerte#

to .S. #o!!ar at the rate o 40 baht6.S.

#o!!ar. "ore than 9 o 10 't*#y participant'

ha# an ann*a! ho*'eho!# income be!o the

nationa! aerage. The proportion o ra or

*n#ercooe# re'hater i'h eating habit'

ere a' o!!o'E con'*mption o brie!y

ermente# i'h (.5B), ra ermente# i'h

(.@B), choppe# ra i'h 'a!a# (52.4B),

an# brie!y ermente# i'h 't*e# ith rice

(1.8B).

Incidence of opisthorchiasis. 52

participant' ho ere negatie or O.

viverrini inection at the ba'e!ine '*rey in

3ecember 2002, @1 (0.@B) ere enro!!e#

in a o!!o*p ea!*ation in ebr*ary 2004.

Opisthorchis egg' ere i#entiie# in 8@

(2.2B) per'on'. The >ato thic 'mear

metho# #etecte# O. viverrini egg in 8

'pecimen', an# the orma!inethy! acetate

concentration techni*e i#entiie# a##itiona!15 ca'e'. The inci#ence rate o

opi'thorchia'i' a' 21.6100 per'onyear'.

Riskfactorsforopisthorchiasis.The

prea!ence o O. viverrini inection a'

'igniicant!y #ierent hen ana!y7e# by age

gro*p ( P < 0.001), e#*cation !ee! ( P G

0.04), an# occ*pation ( P < 0.001). There

a' no 'igniicant #ierence beteen 'e?

an# #ierent ho*'eho!# income gro*p'



(Tab!e 1). niariate ana!y'i' 'hoe# that

tho'e ho con'*me# choppe# ra i'h 'a!a#

(&& G 2.0, 95B C% G 1.@1–@.28) an# brie!y

ermente# i'h 't*e# ith rice (&& G 1.8,

95B C% G 1.0@–2.9) ha# a higher ri' o

ac*iring the inection (Tab!e 2). %n contra't,

con'*ming ra ermente# i'h ( Pla ra) a'

not a''ociate# ith opi'thorchia'i' (&& G

0.9, 95B C% G 0.1–1.59).

"*!tiariate oi''on regre''ion ana!y'i'

'hoe# that age an# choppe# ra i'h 'a!a#

con'*mption ere in#epen#ent!y a''ociate#

ith opi'thorchia'i' (Tab!e 2). The

participant' ho ere in 20–@9, 40–59, an#

greater than 0 year' o age ere @.1 (95B

C% G 1.1–8.2), 2. (95B C% G 1.0–.4), an#

4.1 (95B C% G 1.5–11.8) time' at greater ri'

o ac*iring the inection compare# ith

tho'e o !e'' than 20 year' o age. %n

a##ition, tho'e ho con'*me# choppe# ra

i'h 'a!a# ha# a 1.9 time' higher ri' o

ac*iring opi'thorchia'i' (95B C% G 1.1–@.@)

than tho'e ho #i# not con'*me choppe#

ra i'h 'a!a# ater a#-*'ting or 'e?, age,

e#*cation !ee!, occ*pation, an# a hi'tory o

con'*ming other i'h oo# item'. There a'

no 'igniicant a''ociation ith other

tra#itiona! re'hater i'h oo#.

3%SCSS%/

*r 't*#y 'hoe# a re!atie!y high inci#ence

rate o O. viver$rini inection o 21.6100

per'onyear' in the 't*#y comm*nity. The

inection rate a' 'imi!ar to that reporte# in

>hon >aen roince (24B), an area in

northea'tern Thai!an# in hich

opi'thorchia'i' i' high!y en#emic. ,,12 Ie

*'e# the orma!inethy! acetate concentration

techni*e, hich i' con'i#ere# to be the mo't

'en'itie an# re!iab!e metho# or #etection o

O. viverrini egg' in conirming the re'*!t' o

the norma! 'a!ine et preparation an# the

>ato thic 'mear metho# in the ba'e!ine an#

o!!o*p '*rey'.1@ $oeer, e e?amine#

on!y a 'ing!e 'too! 'amp!e or each

participant. Th*', tho'e per'on' ith !ight

inection inten'itie' might be mi''e#. Thi'

in#ing might hae aecte# the inci#ence

rate. Another !imitation o thi' 't*#y might

be the re!atie!y !o o!!o*p rate (0.@B)

among tho'e ho ha# negatie 'too!

e?amination re'*!t' or O. viverrini #*r

TAD< 1

%nci#ence o Opisthorchis viverriniinecte#

per'on' an# characteri'tic' o enro!!e# '*b-ect',

Thai!an#

Characteri'tic

/o. enro!!e#

/o. (B) inecte#

P

Se?

"a!e

141

4@

(@0.5)

ema!e

1

40



(22.)

0.125

Age gro*p, year'

0–19

104

8

(8.0)

20–@9

54

1

(@1.5)

40–59

108

@5

(@2.4)

< 0.001

≥ 0

51

2@

(45.1)

<#*cation !ee!

rimary 'choo!

24

1

(28.9)

Aboe primary 'choo!

0

12

(1.1)

0.04

ami!y income (SK6year')

0–500

158

55

(@4.8)

> 500

5



20

(2.)

0.2@@

cc*pation

Agric*!t*re

14

59

(@.0)

ther'

11@

24

(15.)

L 0.001



154

&A/MS%/ A/3 T$<&S

TAD< 2

niariate an# m*!tiariate ana!y'i' o ri' actor' or ac*iring Opisthorchis viverrini inection, Thai!an#+

er'onyear' o

%nci#ence rate6

Characteri'tic

/o. inecte#



o!!o*p

100 per'onyear'

Cr*#e && (95B C%)

A#-*'te# && (95B C%)

Se?

ema!e

40

214.1

25.2

1

1

"a!e

4@

10.9

18.

1.4

(0.9–2.1)

1.2 (0.8–1.9)

Age gro*p, year'



0–19

8

12.

.@

1

1

20–@9

1

.@

25.

4.1

(1.–11.0)

@.1 (1.1–8.2)

40–59

@5

[email protected]

2.8

4.@

(2.0–10.)

2. (1.0–.4)

≥ 0

2@

0.

@.9

5.0

(2.N15.)

4.1 (1.45–11.8)



<#*cation !ee!

$igher than primary 'choo!

12

8.8

[email protected]

1

1

rimary 'choo!

1

298.2

[email protected]

1.A

(0.9–@.5)

0.9 (0.4–1.8)

ami!y income (SK6year')

> 500

20

91.

21.8

1



0–500

55

191.9

28.

1.@

(0.8–2.@)

cc*pation

ther'

24

18.0

12.9

1

1

Agric*!t*re

59

199.1

29.

2.@

(1.41–@.9)

0.9 (0.5–1.)

i'h men*'



Choppe# ra i'h 'a!a# ( #oi pla)

/o

@9

[email protected]

1.9

1

1

Oe'

4@

122.5

@5.1

2.1

(1.@–@.@)

1.9 (1.1–@.@)

Drie!y ermente# i'h ( Pla som)



/o

2

14.0

18.5

1

1

Oe'

5

212.8

2.@

1.4

(0.9–2.@)

1.0 (0.–1.)

&a ermente# i'h ( Pla ra)

/o

28

118.

2@.

1

Oe'

55

240.2

22.9

1.0



(0.–1.)

Drie!y ermente# i'h 't*e# ith rice ( Pla faa )

/o

0

29.9

20.2

1

1

Oe'

21

58.4

@.0

1.8

(1.0–@.0)

1.4 (0.8–2.@)

+ 3ata ere a#-*'te# or 'e?, e#*cation !ee!, an# occ*pation. && G re!atie ri'; C% G coni#ence intera!.

ing the 2002 't*#y. The oera!! inci#ence rate might be oere'

timate# to 'ome e?tent beca*'e the inci#ence' o O. viverrini

inection ere increa'e# in the o!#er age gro*p. $oeer, mo't

per'on' ho #i# not participate in the o!!o*p '*rey in 2004

ere yo*ng a#*!t' ho temporari!y moe# o*t o the i!!age to

in# -ob' #*ring the #ry 'ea'on. $oeer, the in#ing' regar#ing

ri' actor' o*!# not be aecte# beca*'e the rea'on' or not

participating in the 't*#y ere *n!ie!y to be re!ate# to oo#

con'*mption behaior an# O. viverrini inection.

Another potentia! bia' might be re!ate# to the re!atie!y !ong reca!!

perio# (one year) o the oo# con'*mption hi'tory. ther preio*''t*#ie' *'ing *e'tionnaire' or rapi# i#entiication o

'chi'to'omia'i' in Arica an# or ri' actor' o he!minthic

inection' in China *'e# a m*ch 'horter reca!! perio#, *'*a!!y

abo*t o*r ee'.14,15 %n o*r 't*#y, hoeer, e note# a high

'ea'ona! ariation in con'*mption o *ncooe# oo# in thi'

comm*nity, e'pecia!!y or choppe# ra i'h 'a!a# con'*mption

that *'*a!!y tae p!ace #*ring the #ry 'ea'on. The *e'tionnaire

a' #e'igne# to coer the oo# con'*mption oer the ho!e

preio*' year. %n a##ition, beca*'e e co!!ecte# the e?po'*re

inormation at the 'ame time o 'too! 'pecimen co!!ection', o*r

in#ing' on ri' actor' ere not !ie!y to be compromi'e# by

inormation bia'.



%n o*r 't*#y, the inci#ence o opi'thorchia'i' a' not 'ig

niicant!y #ierent beteen 'e?e' b*t a' #ierent among age

gro*p'. The higher inci#ence' ere o*n# in the o!#er age gro*p'

compare# ith tho'e !e'' than 19 year' o age. 'ing a

m*!tiariate oi''on regre''ion mo#e!, e o*n# that tho'e ho

ere greater than 0 year' o age ha# an appro?imate!y o*r

time' greater ri' o ac*iring opi'thorchia'i'. Thi' in#ing i' in

agreement ith tho'e o preio*' report'.,8

A!tho*gh hea!th e#*cation to aoi# a!! in# o ra or *n#er

cooe# i'h oo# ha' been imp!emente# in the 't*#y area, the

o!#er pop*!ation 'ti!! maintaine# their habit' o eating *n#er

cooe# i'h. %t i' apparent that recommen#ation' that the p*b!ic

aoi# non'peciic *n#ercooe# i'h #i'he' hae not been

achiee#, e'pecia!!y among the e!#er!y. ther rea'on' might be

that aecte# peop!e ee! !e'' concerne# abo*t the inection

beca*'e it i' a'ymptomatic an# an eectie treatment again't the

para'ite' (pra7i*ante!) i' aai!ab!e. %t ha' been #emon'trate# that

there i' an a''ociation beteen chronic inection ith O.

viverrini an# cho!angiocarcinoma. er'on' 5–9 year' o age

ith chronic inection' ith opi'thorchia'i' ere 2.5 time' more

!ie!y to 'ho #ee!opment o cho!angiocarcinoma than other

age gro*p'. Th*', hea!th e#*cation regar#ing the threat o chronic

opi'thorchia'i' nee#' to be contin*o*'!y comm*nicate# to

aecte# peop!e. Deca*'e the o!#er pop*!ation 'eeme# to hae

#iic*!tie' in changing it' eating habit', hea!th e#*cation

program' to aoi# ra an# *n#ercooe# i'h oo#' 'ho*!# be

oc*'e# on yo*ng per'on' ho o*!# be more !ie!y to change

their behaior.

'ing a cro'''ectiona! approach, patham an# other' o*n# that

more than 90B o heai!y inecte# per'on' ha# a hi'tory o eating

choppe# ra i'h 'a!a# compare# ith 19B o *ninecte#

per'on'.8 &ecent!y, a 't*#y o opi'thorchia'i' in ao 3& a!'o

'hoe# that per'on' con'*ming ra or *n#ercooe# i'h ha# a 2.@

time' greater ri' o ac*iring the inection. 1 rom the'e 't*#ie',

it a' conc!*#e# that eating preerence, e'pecia!!y ra or

*n#ercooe# i'h #i'he', enhance' the ri' o being inecte# ith

O. viverrini. $oeer, eating *n#ercooe# i'h an# act*a! ri'' o

ac*iring the inection ere not #emon'trate# in thi' 't*#y. *r

't*#y a' the ir't cohort 't*#y o



%/C%3</C< A/3 &%S> ACT&S %ST$&C$%AS%S

155

O. viverrini inection con#*cte# in Thai!an#

that i#entiie# the ri'' or O. viverrini

inection.

There are at !ea't 15 'pecie' o 'ma!! an#

me#i*m'i7e# cyprinoi# i'h that nat*ra!!y

harbor the inectie metacercariae, an# the'e

i'h being the 'o*rce o inection.1,18 "ore

than 10 pop*!ar ra or *n#ercooe# i'h

#i'he' ha# been prepare# an# con'*me#

thro*gho*t the year by !oca! per'on' at the

't*#y 'ite. the o*r aorite #i'he' o

re'hater i'h, m*!tiariate oi''on

regre''ion ana!y'i' conirme# that on!y

choppe# ra i'h 'a!a# con'*mption a'

'igniicant!y a''ociate# ith opi'thorchia'i';

the other' ere not. er'on' ho con'*me#choppe# ra i'h 'a!a# ha# a 1.9 time'

greater ri' o ac*iring the inection than

tho'e ho #i# eat thi' 'a!a# ater a#-*'ting

or 'e?, age, e#*cation !ee!, occ*pation, an#

a hi'tory o con'*ming other i'h oo# item'.

n the ba'i' o inorma! interie' ith

i!!ager', re*encie' o eating choppe# ra

i'h 'a!a# hae been #ecrea'e# an#

con'*mption genera!!y a' conine# to

'pecia! 'ocia! occa'ion' in thi' comm*nity,'*ch a' the i'h catching 'ea'on in '*mmer.

3*ring thi' 'ea'on, choppe# ra i'h 'a!a#

a' re'h!y prepare#, an# then imme#iate!y

con'*me# near the pon#'. Thi' inormation

a' a!'o reporte# in other 't*#ie'.1 %n thi'

comm*nity, *!!y pre'ere# i'h, i.e., ra

ermente# i'h, a' reg*!ar!y con'*me#

'eera! time' a ee a!! year ro*n#. Thi'

pre'ere# i'h a' a!'o con'*me# #ai!y by

mo't peop!e in opi'thorchia'i'en#emic

area' in northea't Thai!an#.19 /eerthe!e'',

e o*n# that ra ermente# i'h ere not

a''ociate# ith opi'thorchia'i'. reparation

o ra ermente# i'h a' *ni*e beca*'e it

a' ept ermente# in a high!y 'a!te#

con#ition or at !ea't @– month'. S*ria! o

metacercaria #epen#' on the concentration o

'a!t an# #*ration o ermentation.20

S*ontha'on an# other' reporte# that

metacercariae in brie!y ermente# i'h ere

#egenerate# ater the 'econ# #ay.21 *r

interie' 'hoe# that ra ermente# i'h

a' prepare# by !oca! peop!e an# ept at

!ea't 'i? month'. Th*', it i' mo't !ie!y that

metacercariae in ra ermente# i'h ere

nonpathogenic to h*man'. The pre'ent #ata

'hoe# that ra ermente# i'h a' 'ae to

con'*me beca*'e it a' not the potentia! ri'

o O. viverrini inection in thi' comm*nity.

%n conc!*'ion, the nationa! opi'thorchia'i'

contro! program in Thai!an# 'ho*!# c!ear!y

a##re'' the threat o choppe# ra i'h 'a!a#

con'*mption in ac*iring O. viverrini

inection. Strategic approache' or the

opi'thorchia'i' contro! program 'ho*!#

inc!*#e 'too! e?amination an# treatment o

para'itepo'itie ca'e' ith pra7i*ante! to

e!iminate h*man ho't re'eroir'. $ea!th

e#*cation that empha'i7e' aoi#ing rare'hater i'h con'*mption, e'pecia!!y

choppe# ra i'h 'a!a#, or preenting O.

viverrini inection 'ho*!# be imp!emente#.

&eceie# A*g*'t @, 2008. Accepte# or p*b!ication

"arch 1, 2009.

Acno!e#gment'E Ie than the a*thoritie' o

roincia! $ea!th, 3i'trict $ea!th, hea# o the

i!!age, an# a!! participant' or their participation

in thi' 't*#y.

inancia! '*pportE Thi' 't*#y a' '*pporte# by

The Thai $ea!th romotion o*n#ation an#

hramong*t!ao &e'earch *n#.

A*thor'H a##re''e'E &am &ang'in, Somporn

"ong!on, an# ote Aimp*n, 3epartment o

"i!itary an# Comm*nity "e#icine,

hramong*t!ao Co!!ege o "e#icine @15

&atchaithi &oa#, &atchathei, Dango 10400

Thai!an#. "athir*t "*ngthin, aan-it Taama'ri,

Taee /aag!or, an# Saoanee ee!ayooa,

3epartment o ara'ito!ogy, hramong*t!ao

Co!!ege o "e#icine, @15 &atchaithi &oa#,

&atchathei, Dango 10400 Thai!an#.

&<<&</C<S



Sithithaorn , $a'e!!<!in' ", 200@.

<pi#emio!ogy o

Opisthorchis viverrini. Acta Trop %%& 18–194.

>ei'er =, t7inger =, 2005. <merging oo#borne

tremato#ia'i'.

'merg (nfect Dis ))& 150–1514.

>aepitoon /, >aepitoon S=, eng'aa , 2008.

pi'thorchia'i' in Thai!an#E reie an# c*rrent

'tat*'. *orld J +astroenterol )& 229–2@02.

4. Tra*b &=, "acarana' =, "*ngthin ",

ee!ayooa S, Cribb T, "*rre!! >3, Thomp'on

&C, 2009. A ne C&ba'e# approach in#icate'

the range o Clonorchis sinensis no e?ten#' to

centra! Thai!an#. P-o /egl Trop Dis 0& e@.

Sripa D, >aee' S, Sithithaorn , "airiang <,

aha T, Smo*t ", airo-*! C, Dh*#hi'aa'#i :,

Te'ana S, Thinamrop D, Dethony =", o*a' A,

Drin#!ey =, 200. ier !*e in#*ce' cho!ang

iocarcinoma. P-o Med & e201.

Sriamporn S, i'ani , ipitgoo! :,

S*anr*ngr*ang >, >am'aar# S, arin 3",

2004. rea!ence o Opisthorchis viverrini

inection an# inci#ence o cho!angiocarcinoma in

>hon >aen, /orthea't Thai!an#. Trop Med (nt

Health 1& 588–594.

=ong'*'*ntig*! , %m'omboon T, 200@.

pi'thorchia'i' contro! in Thai!an#. Acta Trop %%&

229–2@2.

patham <S, :iyanant :, >*rathong S,

&o-boronitaya =, Droce!man IO,

Ar#'*ngnoen S, ee , :a-ra'thira S, 1984.

&e!ation'hip beteen prea!ence an# inten'ity o

Opisthorchis viverrini inection, an# c!inica!

'ymptom' an# 'ign' in a r*ra! comm*nity in north

ea't Thai!an#. !ull *orld Health Organ 23& 451–

41.

>*rathong S, er#era'iri*! , Iongpaitoon :,

ramoo!'in'ap C, patham <S, 198.

Opisthorchis viverrini inection in r*ra! an# *rban

comm*nitie' in northea't Thai!an#. Trans 4 oc

Trop Med Hyg %)& 411–414.

>ato >, "i*ra ", 1954. Comparatie

e?amination'. Jap J Parasitol 0& @5.

Tr*ant A, <!!iott S$, >e!!y "T, Smith =$, 1981.

Compari'on o orma!inethy! ether 'e#imentation,

orma!inethy! acetate 'e#imentation, an# 7inc

'*!ate !otation techni*e' or #etection o

inte'tina! para'ite'. J Clin Micro"iol )0& 882–884.

=ong'*'*ntig*! , %m'omboon T, 199. The

impact o a #eca#e !ong opi'thorchia'i' contro!

program in northea'tern Thai!an#.

outheast Asian J Trop Med Pu"lic Health 3%&

551–55.

Sithithaorn , Oonganit , Te'ana S, airo-*!

C, 200. ier !*e'. "*rre!! >3, rie# D, e#'.

5ood !orne Parasitic 6oonoses& 5ish and Plant$

!orne Parasites. /e OorE Springer, @–52.

enge!er C, t7inger =, Tanner ", 2002.

P*e'tionnaire' or rapi# 'creening o

'chi'to'omia'i' in '*bSaharan Arica. !ull *orld

Health Organ %7& 2@5–242.

Steinmann , Qho* J/, i O, i $=, Chen S&,

Oang Q, an I, =ia TI, i $, :o*nat'o* ,

t7inger =, 200. $e!minth inection' an# ri'

actor ana!y'i' among re'i#ent' in <ry*an co*nty,

O*nnan proince, China. Acta Trop )7& @8–51.

Saya'one S, #ermatt , ho*min#r /,

:ong'araane J, Sen'ombath :, het'o*anh &,

Cho*!amany J, Strobe! ", 200. <pi#emio!ogy o

Opisthorchis viverrini in a r*ra! #i'trict o

So*thern ao 3&. Trans 4 oc Trop Med Hyg

)7)& 40–4.

:icha'ri S, :iyanant :, patham <S, 1982.

Opisthorchis viverrini inten'ity an# rate' o

inection in cyprinoi# i'h rom an en#emic oc*'

in northea't Thai!an#. outheast Asian J Trop Med

Pu"lic Health )0& 1@8–141.



Ior!# $ea!th rgani7ation, 1995. Contro! o

oo#borne tremato#e inection'. &eport o a I$

St*#y Mro*p. *orld Health Organ Tech 4ep er

%1& 1–15.

"iga'ena , 1982. ier !*e' re!ation'hip to

#ietary habit' an# #ee!opment program' in

Thai!an#. atrice =e!!ie <, =e!!ie 3D, e#'.

Adverse 'ffects of 5oods. /e OorE !en*m

re'', @0–@11.

>r*atrach*e ", Chitramong O, patham <S,

:icha'ri S, :iyanant :, 1982. <ect' o phy'ico

chemica! actor' on the inection o ham'ter' by

metacercariae o Opisthorchis viverrini. outheast

Asian J Trop Med Pu"lic Health )0& 14–1.

S*onta'on >, "ethanitiorn &, iang-ai S,

Choochote I, 1998. :iabi!ity o metacercariae in

northern Thai tra#itiona! oo#'.

outheast Asian J Trop Med Pu"lic Health 31&

14–1.

kasus parasitologi

Documents

Transcript of kasus parasitologi