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Lancet. 2016 Feb 20;387(10020):800-10. doi: 10.1016/S0140-6736(15)60313-0. Epub 2015 Aug 21.

Clonorchiasis.

Author information

1
National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China; World Health Organization Collaborating Center for Tropical Diseases, Shanghai, China.
2
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland.
3
Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland.
4
National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China; World Health Organization Collaborating Center for Tropical Diseases, Shanghai, China. Electronic address: ipdzhouxn@sh163.net.

Abstract

On Aug 21, 1875, James McConnell published in The Lancet his findings from a post-mortem examination of a 20-year-old Chinese man--undertaken at the Medical College Hospital in Calcutta, India--in whom he found Clonorchis sinensis in the bile ducts. Now, exactly 140 years later, we have a sound understanding of the lifecycle of this liver fluke, including key clinical, diagnostic, and epidemiological features. Developments in the so-called -omics sciences have not only advanced our knowledge of the biology and pathology of the parasite, but also led to the discovery of new diagnostic, drug, and vaccine targets. C sinensis infection is primarily related to liver and biliary disorders, especially cholangiocarcinoma. Clonorchiasis mainly occurs in east Asia, as a result of the region's social-ecological systems and deeply rooted cultural habit of consuming raw freshwater fish. The Kato-Katz technique, applied on fresh stool samples, is the most widely used diagnostic approach. Praziquantel is the treatment of choice and has been considered for preventive chemotherapy. Tribendimidine showed good safety and therapeutic profiles in phase 2 trials and warrants further investigation. Still today, the precise distribution, the exact number of infected people, subtle morbidities and pathogenesis, and the global burden of clonorchiasis are unknown. Integrated control strategies, consisting of preventive chemotherapy; information, education, and communication; environmental management; and capacity building through intersectoral collaboration should be advocated.

PMID:
26299184
DOI:
10.1016/S0140-6736(15)60313-0
[Indexed for MEDLINE]

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