The role of evolutionary biology in research and control of liver flukes in Southeast Asia

Abstract

Stimulated largely by the availability of new technology, biomedical research at the molecular-level and chemical-based control approaches arguably dominate the field of infectious diseases. Along with this, the proximate view of disease etiology predominates to the exclusion of the ultimate, evolutionary biology-based, causation perspective. Yet, historically and up to today, research in evolutionary biology has provided much of the foundation for understanding the mechanisms underlying disease transmission dynamics, virulence, and the design of effective integrated control strategies. Here we review the state of knowledge regarding the biology of Asian liver Fluke-host relationship, parasitology, phylodynamics, drug-based interventions and liver Fluke-related cancer etiology from an evolutionary biology perspective. We consider how evolutionary principles, mechanisms and research methods could help refine our understanding of clinical disease associated with infection by Liver Flukes as well as their transmission dynamics. We identify a series of questions for an evolutionary biology research agenda for the liver Fluke that should contribute to an increased understanding of liver Fluke-associated diseases. Finally, we describe an integrative evolutionary medicine approach to liver Fluke prevention and control highlighting the need to better contextualize interventions within a broader human health and sustainable development framework.

Experimental and modelling investigations of Opisthorchis viverrini miracidia transmission over time and across temperatures: implications for control

“…The relevance of this amended conceptual and methodological framework for an improved understanding of O. viverrini transmission dynamics aligns with recent propositions advocating the development of interdisciplinary research agendas and transdisciplinary actions for more sustainable disease control (Echaubard et al, 2015, 2016; Ziegler et al, 2016, Wilcox and Echaubard, in press).…”

Life by the river: neglected worm infection in Western Siberia and pitfalls of a one-size-fits-all control approach

“…For example, in a recent publication, Wilcox and Echaubard (2017) argue, '[s]erious hepatobiliary disease associated with liver fluke infection is observed only in cases of heavy infection' , concluding that in the case of opisthorchiasis, infection is indeed not equivalent to disease. In terms of control strategies, this opens up the possibility of employing infection intensity rather than infection prevalence to guide intervention strategy (see also Echaubard, Sripa, Mallory, & Wilcox, 2016). The perceptions of Siberians reported here regarding 'regular' and 'too high' 'worm load' , then, can be usefully employed as a foundation rather than an obstacle for control efforts.…”

Prospects and Challenges towards Sustainable Liver Fluke Control

“…However, it can also be argued that the clinical benefits associated with infection prevalence reduction may be limited [48] and that current interventions procedures (e.g. mass drug administration, behavioral change campaigns) may also incur hidden health costs when considering the whole social-ecological system, its dynamics, and its emergent properties, including communities’ resilience [6].…”

“…These observations have been argued to warrant a refined interpretation of the nature of the interaction between flukes and humans [48]. This may range from parasitic to mutualistic, the latter particularly in endemic areas where people have been persistently exposed to helminthes and other infectious agents.…”