Paiboon Sithithaworn
Khon Kaen and Mahasarakham University, Thailand
Title: New diagnostic tool for control and elimination of opisthorchiasis : community-based application of urine antigen assay for diagnosis and evaluation of curative treatment.
Biography
Biography: Paiboon Sithithaworn
Abstract
Opisthorchiasis and cholangiocarcinoma (CCA) remain important health problems in Southeast Asia and in Thailand alone an estimated death is up to 20,000 per year. Screening of opisthorchiasis by an accurate diagnosis and treatment with praziquantel (PZQ) is a prerequisite for reduction and control of CCA. Since standard parasitological diagnosis of Opisthorchis viverrini infection is insensitive and antigen detection in urine has been suggested as an alternative method. Our recent field testing in Thailand demonstrated that urine antigen assay correlated well with copro-antigen detection and had superior diagnostic performance than fecal examination. In addition to screening and prevalence mapping, we applied this new antigen assay to monitor the status of opisthorchiasis after chemotherapeutic control in endemic community in Thailand. A period of curative treatment can be assessed at 4 weeks after praziquantel treatment. In a post treatment follow up study for 52 weeks, emergence of reinfection can be detected by urine antigen assay and greater reinfection rates were obtained compring to fecal examination. Due to the ease and noninvasiveness of sample collection, the urine assay has high potential for clinical diagnosis as well as population screening in the program for the control and elimination of opisthorchiasis.