Current status of Paragonimus and paragonimiasis in Ecuador

Abstract

A review of national and international publications on paragonimiasis in Ecuador, epidemiological records from the Ministry of Public Health and unpublished research data was conducted to summarise the current status of the parasite/disease. The purpose of the review is to educate physicians, policy-makers and health providers on the status of the disease and to stimulate scientific investigators to conduct further research. Paragonimiasis was first diagnosed in Ecuador 94 years ago and it is endemic to both tropical and subtropical regions in 19 of 24 provinces in the Pacific Coast and Amazon regions. Paragonimus mexicanus is the only known species in the country, with the mollusc Aroapyrgus colombiensis and the crabs Moreirocarcinus emarginatus, Hypolobocera chilensis and Hypolobocera aequatorialis being the primary and secondary intermediate hosts, respectively. Recent studies found P. mexicanus metacercariae in Trichodactylus faxoni crabs of the northern Amazon. Chronic pulmonary paragonimiasis is commonly misdiagnosed and treated as tuberculosis and although studies have demonstrated the efficacy of praziquantel and triclabendazole for the treatment of human infections, neither drug is available in Ecuador. Official data recorded from 1978-2007 indicate an annual incidence of 85.5 cases throughout the 19 provinces, with an estimated 17.2% of the population at risk of infection. There are no current data on the incidence/prevalence of infection, nor is there a national control programme.

Food-borne zoonotic trematodes: devious old flukes in an urbanized, global village

“…Cancer and other non-communicable diseases are a new area of public health concern that are significantly stretching the already fragile situation. Worse still, the ability to diagnose and manage these health problems is still rudimentary or very poor in Africa and most LMICs [42,[53][54][55][56][57][58][59]74] . Liver cancer has been associated with parasitic infections for a long time [53,58,63,[75][76] .…”

“…Worse still, the ability to diagnose and manage these health problems is still rudimentary or very poor in Africa and most LMICs [42,[53][54][55][56][57][58][59]74] . Liver cancer has been associated with parasitic infections for a long time [53,58,63,[75][76] . The risks and possibilities of carcinogenesis due to parasitic trematode infections should be widely broadcast and investigated; the ease of preventing and controlling such a sinister disease source cannot be ignored, especially considering its ramifications [36-37, 51, 64] .…”

“…Non-native species including P. westermani are imported by travelers, vacationers and immigrants [56] . Paragonimiasis in India, Vietnam and Ecuador have been described [9,[57][58] . Consumption of raw crab extract or uncooked crabs is the main source of human infection in India.…”

Hypolobocera guayaquilensis (Decapoda: Pseudothelphusidae): A New Crab Intermediate Host of Paragonimus mexicanus in Manabí Province, Ecuador

“…In Ecuador, P. ecuadoriensis was described as a new species based on the distinct morphology of its ovary and testis in relation to that of P. mexicanus , Paragonimus inca , and Paragonimus peruvianus [ 6 ]. However, further comparative studies revealed that P. ecuadoriensis is a junior synonym of P. mexicanus [ 4 , 7 ]. In Manabí Province, adult parasites obtained from experimentally infected animals showed similar morphological characteristics to P. mexicanus [ 3 ].…”

A tool for mass-screening of paragonimiasis: an enzyme-linked immunosorbent assay with urine samples

“…Paragonimiasis is a parasitic disease caused by several lung fluke species in the genus Paragonimus . Infections of the flukes have been mainly reported from Asian countries [ 1 – 5 ], but emerging cases have also been reported from African [ 6 , 7 ] and American countries [ 8 , 9 ], where people eat the intermediate hosts, fresh water crabs, and crayfish containing metacercariae or meat of the reservoir hosts containing immature flukes. About 23 million people around the world are estimated to be infected with the lung flukes [ 10 ].…”