Consistency of Fecal Egg Output in Patients with Opisthochiasis Viverrini

Kurathong, S; Brockelman, Warren Y.; Lerdverasirikul, P; Wongpaitoon, Virasak; Kanjanapitak, A; Varavithya, W; Upatham, E. S.; Viyanant, Vithoon

doi:10.4269/ajtmh.1984.33.73

Cited by 8 publications

(6 citation statements)

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“…Previous autopsy studies in Schistosoma mansoni also demonstrated a positive correlation between faecal egg count and the number of worms recovered from mesenteric veins (Cheever, 1968;Cheever et al 1977). Our results, together with the report that Opisthorchis epg is relatively consistent in stools passed at different times (Kurathong et al 1984), indicate that worm burden can be predicted from egg counts with a reasonable degree of accuracy. This contrasts with egg counts for intestinal nematodes, where correlation coefficients between the two measurements are much lower (Elkins & Haswell-Elkins, personal communication) and therefore prediction of worm burden based on egg count is highly inaccurate.…”

Section: Discussionsupporting

confidence: 78%

Relationship between faecal egg count and worm burden of Opisthorchis viverrini in human autopsy cases

et al. 1991

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The relationship between faecal examination for egg output and worm burden of Opisthorchis viverrini in man of 181 autopsy cases from Northeast Thailand is described. Diagnosis of the parasite infection by stool examination for the presence of eggs was less sensitive than the worm recovery technique. Using Stoll's dilution and formalin-ether technique, no eggs were detected in the faeces of 20 cases harbouring low worm burdens (less than 20 worms). The quantitative faecal egg count by Stoll's dilution technique showed a strikingly close positive correlation with the number of worms recovered (r = 0.96, P less than 0.001) indicating a strong linear association between eggs per gram of faeces (epg) and worm burden. The number of epg per worm was inversely correlated to the worm burden (P less than 0.001), suggesting that density-dependent constraints on fecundity could operate to restrict egg output in heavy infections. The accuracy of egg counts for estimating worm burden and its relevance to parasite epidemiological research are discussed.

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Section: Discussionsupporting

confidence: 78%

Relationship between faecal egg count and worm burden of Opisthorchis viverrini in human autopsy cases

et al. 1991

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“…Important day-to-day variation in egg output has been thoroughly documented for S. mansoni and S. japonicum [19], [21], [22], [35]. By contrast, O. viverrini egg output was found to be relatively consistent over a period of several days in hospitalized patients [41]. Of note, Schistosoma egg shedding dynamics are additionally affected by retention of eggs in intestinal and liver tissues and the lower fecundity of female worms.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Praziquantel against Schistosoma mekongi and Opisthorchis viverrini: A Randomized, Single-Blinded Dose-Comparison Trial

et al. 2012

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BackgroundSchistosomiasis and opisthorchiasis are of public health importance in Southeast Asia. Praziquantel (PZQ) is the drug of choice for morbidity control but few dose comparisons have been made.MethodologyNinety-three schoolchildren were enrolled in an area of Lao PDR where Schistosoma mekongi and Opisthorchis viverrini coexist for a PZQ dose-comparison trial. Prevalence and intensity of infections were determined by a rigorous diagnostic effort (3 stool specimens, each examined with triplicate Kato-Katz) before and 28–30 days after treatment. Ninety children with full baseline data were randomized to receive PZQ: the 40 mg/kg standard single dose (n = 45) or a 75 mg/kg total dose (50 mg/kg+25 mg/kg, 4 hours apart; n = 45). Adverse events were assessed at 3 and 24 hours posttreatment.Principal FindingsBaseline infection prevalence of S. mekongi and O. viverrini were 87.8% and 98.9%, respectively. S. mekongi cure rates were 75.0% (95% confidence interval (CI): 56.6–88.5%) and 80.8% (95% CI: 60.6–93.4%) for 40 mg/kg and 75 mg/kg PZQ, respectively (P = 0.60). O. viverrini cure rates were significantly different at 71.4% (95% CI: 53.4–84.4%) and 96.6% (95% CI: not defined), respectively (P = 0.009). Egg reduction rates (ERRs) against O. viverrini were very high for both doses (>99%), but slightly lower for S. mekongi at 40 mg/kg (96.4% vs. 98.1%) and not influenced by increasing diagnostic effort. O. viverrini cure rates would have been overestimated and no statistical difference between doses found if efficacy was based on a minimum sampling effort (single Kato-Katz before and after treatment). Adverse events were common (96%), mainly mild with no significant differences between the two treatment groups.Conclusions/SignificanceCure rate from the 75 mg/kg PZQ dose was more efficacious than 40 mg/kg against O. viverrini but not against S. mekongi infections, while ERRs were similar for both doses.Trial RegistrationControlled-Trials.com ISRCTN57714676

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“…In most helminth infections, egg counts are highly variable with time, subject to measurement error and inaccurate in estimating worm burden. However, Kurathong et al (1984) demonstrated little variation in fluke egg output with time, and Ramsey et al (1989) reported a strong correlation between egg counts and worms recovered after treatment. T h e latter report also indicated that fecundity is negatively associated with worm load, suggesting densitydependent constraints on egg production.…”

Section: Introductionmentioning

confidence: 95%

“…Less severe manifestations include cholangitis, chronic cholecystitis and cholelithiasis (Harinasuta, Riganti & Bunnag, 1984). Recent community-based studies demonstrate relationships between severity of hepatobiliary disease and both intensity of infection (Upatham et al 1984;Elkins et al 1990) and parasite-specific IgG levels (Haswell-Elkins et al unpublished observations).…”

Section: Introductionmentioning

confidence: 98%

Opisthorchis viverrini: relationships between egg counts, worms recovered and antibody levels within an endemic community in Northeast Thailand

et al. 1991

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Three techniques for estimating the intensity of Opisthorchis viverrini infection in individuals from a Northeast Thai community are compared. Egg counts were determined using a quantitative formalin/ethyl acetate technique, worm burdens were estimated by expulsion chemotherapy and antibody levels were measured by ELISA. Log-transformed worm and egg counts were closely correlated (r = 0.80), suggesting that both measurements provide good assessments of relative intensity of infection. However, no Opisthorchis worms were recovered from 34 people with high egg counts; probably due to problems with the expulsion technique in some individuals. Examination of egg production per fluke indicated that each fluke contributed an average of 180 eggs per gram (epg) of faeces and fecundity was negatively associated with total worm burden. Serum IgG levels correlated significantly with Opisthorchis egg count (r = 0.61) at two independent assessments. Although significant associations were observed between antibody levels and echinostome infection, analysis suggested that these reflected independent associations between these two variables and Opisthorchis infection and age. We conclude that all three measurements are useful for epidemiological studies.

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Consistency of Fecal Egg Output in Patients with Opisthochiasis Viverrini

Cited by 8 publications

References 0 publications

Relationship between faecal egg count and worm burden of Opisthorchis viverrini in human autopsy cases

Relationship between faecal egg count and worm burden of Opisthorchis viverrini in human autopsy cases

Efficacy of Praziquantel against Schistosoma mekongi and Opisthorchis viverrini: A Randomized, Single-Blinded Dose-Comparison Trial

Opisthorchis viverrini: relationships between egg counts, worms recovered and antibody levels within an endemic community in Northeast Thailand

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