Opisthorchiasis caused by Opisthorchis viverrini remains a major public health problem in many parts of Southeast Asia, including Thailand, Lao PDR, Vietnam and Cambodia. The infection is associated with a number of hepatobiliary diseases, including cholangitis, obstructive jaundice, hepatomegaly, cholecystitis and cholelithiasis. Multi-factorial etiology of cholangiocarcinoma, mechanical damage, parasite secretions, and immunopathology may enhance cholangiocarcinogenesis. Moreover, both experimental and epidemiological evidences strongly implicate liver fluke infection as the major risk factor in cholangiocarcinoma, cancer of the bile ducts. The liver fluke infection is induced by eating raw or uncooked fish products that is the tradition and popular in the northeastern and northern region, particularly in rural areas, of Thailand. The health education programs to prevent and control opisthorchiasis are still required in the high-risk areas.
Opisthorchiasis caused by Opisthorchis viverrini (O. viverrini ) remains a major public health problem in many parts of Southeast Asia including Thailand, Lao PDR, Vietnam and Cambodia. The infection is associated with a number of hepatobiliary diseases, including cholangitis, obstructive jaundice, hepatomegaly, cholecystitis, cholelithiasis and cholangiocarcinoma. The liver fluke infection was induced by eating raw or uncooked fish products that is the tradition and popular in the northeastern and northern region, particularly in rural areas of Thailand. Health education programs to prevent and control opisthorchiasis are still required in high-risk areas.
Background: Helicobacter pylori infection and premalignant gastric mucosa can be reliably identified using conventional narrow band imaging (C-NBI) gastroscopy. The aim of our study was to compare standard biopsy with site specific biopsy for diagnosis of H. pylori infection and premalignant gastric mucosa in daily clinical practice. Materials and Methods: Of a total of 500 patients who underwent gastroscopy for investigation of dyspeptic symptoms, 250 patients underwent site specific biopsy using C-NBI (Group 1) and 250 standard biopsy (Group 2). Sensitivity, specificity, and positive and negative predictive values were assessed. The efficacy of detecting H. pylori associated gastritis and premalignant gastric mucosa according to the updated Sydney classification was also compared. Results: In group 1 the sensitivity, specificity, positive and negative predictive values for predicting H. pylori positivity were 95.4%, 97.3%, 98.8% and 90.0% respectively, compared to 92.9%, 88.6%, 83.2% and 76.1% in group 2. Site specific biopsy was more effective than standard biopsy in terms of both H. pylori infection status and premalignant gastric mucosa detection (P<0.01). Conclusions: Site specific biopsy using C-NBI can improve detection of H. pylori infection and premalignant gastric mucosa in daily clinical practice.
Background: Opisthorchis viverrini infection is a serious public-health problem in Southeast Asia especially in Lao PDR and Thailand. It is associated with a number of hepatobiliary diseases and the evidence strongly indicates that liver fluke infection is the major etiology of cholangiocarcinoma. Objectives: This study aimed to determine actual levels of Opisthorchis viverrini infection in Nakhon Ratchasima province, Northeast Thailand. Methods: A cross-sectional survey was conducted during a one year period from October 2010 to September 2011. O. viverrini infection was determined using a modified Kato's thick smear technique and socio-demographic data were collected using predesigned semi-structured questionnaires. Results: A total of 1,168 stool samples were obtained from 516 males and 652 females, aged 5-90 years. Stool examination showed that 2.48% were infected with O. viverrini. Males were slightly more likely to be infected than females, but the different was not statistically significant. O. viverrini infection was most frequent in the 51-60 year age group and was found to be positively associated with education and occupation. Positive results were evident in 16 of 32 districts, the highest prevalence being found in Non Daeng with 16.7%, followed by Pra Thai with 11.1%, Kaeng Sanam Nang with 8.33%, and Lam Ta Men Chai (8.33%) districts. Conclusion: This study indicates that O viverrini is still a problem in some areas of Nakhon Ratchasima, the patients in this study bing suitable for the purpose of monitoring projects.
Background: Colorectal polyps are common in Thailand, particularly in the northeastern region. The present study aimed to determine any correlation between Helicobacter pylori-associated gastritis and colorectal polyps in the Thai population. Materials and Methods: A total of 303 patients undergoing esophagogastroduodenoscopy with colonoscopy for investigation of chronic abdominal pain participated in this study from November 2014 to October 2015. A diagnosis of Helicobacter pylori associated gastritis was made if the bacteria were seen on histopathological examination and a rapid urease test was positive. Colorectal polyps were confirmed by histological examination of colorectal biopsies. Patient demographic data were analyzed for correlations. Results: The prevalence of colorectal polyps was 77 (25.4%), lesions being found more frequently in Helicobacter pylori infected patients than non-infected subjects [38.4% vs. 12.5%; Odds Ratio (OR) (95% CI): 2.26 (1.32 -3.86), p < 0.01]. Patients with Helicobacter pylori -associated gastritis were at high risk of having adenomas featuring dysplasia [OR (95% CI): 1.15 (1.16 -7.99); P = 0.02]. There was no varaition in location of polyps, age group, sex and gastric lesions with respect to Helicobacter pylori status. Conclusions: This study showed that Helicobacter pylori associated gastritis is associated with an increased risk of colorectal polyps, especially adenomas with dysplasia in the Thai population. Patients with Helicobacter pylori-associated gastritis may benefit from concurrent colonoscopy for diagnosis of colorectal polyps as a preventive and early treatment for colorectal cancer.
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