High reinfection rate after preventive chemotherapy for fishborne zoonotic trematodes in Vietnam

PLoS Negl Trop Dis. 2014 Jun 19;8(6):e2958. doi: 10.1371/journal.pntd.0002958. eCollection 2014 Jun.

Abstract

Background: The World Health Organization aims for complete morbidity control of fishborne zoonotic trematodes (FZT) in endemic areas by 2020. The main intervention tool for achieving this goal is regular use of preventive chemotherapy by offering praziquantel to those at risk in endemic areas. The purpose of this study was to investigate the effectiveness of preventive chemotherapy to control FZT in an endemic area in Northern Vietnam.

Methodology and principle findings: We followed a cohort of 396 people who fulfilled the criteria for receiving preventive chemotherapy. Stool samples were examined by Kato-Katz technique for the presence of trematode eggs before, and two, 16, 29 and 60 weeks after preventive chemotherapy. The prevalence of trematode eggs in stool was 40.2% before, 2.3% two weeks after and increased to a cumulative prevalence of 29.8% sixty weeks after preventive chemotherapy.

Conclusions: The effectiveness of preventive chemotherapy as a main component in control of FZT is not well documented in most endemic areas. We found a high reinfection rate within the first year after preventive chemotherapy. Since these trematodes are zoonoses, preventive chemotherapy may not have sufficient impact alone on the transmission to have a lasting effect on the prevalence. Animal reservoirs and farm management practices must be targeted to achieve sustainable control of fishborne zoonotic trematode infections, hence control programs should consider a One Health approach.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Animals
  • Chemoprevention
  • Child
  • Feces / parasitology
  • Female
  • Fishes / parasitology
  • Foodborne Diseases / drug therapy
  • Foodborne Diseases / epidemiology*
  • Foodborne Diseases / parasitology
  • Humans
  • Male
  • Middle Aged
  • Parasite Egg Count
  • Praziquantel / therapeutic use
  • Prevalence
  • Recurrence
  • Trematoda
  • Trematode Infections / drug therapy*
  • Trematode Infections / epidemiology*
  • Vietnam / epidemiology
  • Young Adult
  • Zoonoses / drug therapy
  • Zoonoses / epidemiology*
  • Zoonoses / parasitology

Substances

  • Praziquantel

Grants and funding

The “Fishborne Zoonotic Parasites in Vietnam” (FIBOZOPA), project no 104 Dan-8-L-717-LIFE2, and the Danish International Development Assistance (Danida) are gratefully acknowledged for their financial support of this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.