Long-term Persistence of Opisthorchis viverrini Antigen in Urine: A Prospective Study in Northeast Thailand

Worasith, Chanika; Wongphutorn, Phattharaphon; Kopolrat, Kulthida; Homwong, Chutima; Techasen, Anchalee; Thanan, Raynoo; Wangboon, Chompunoot; Eamudomkarn, Chatanun; Sithithaworn, Jiraporn; Crellen, Thomas; Sithithaworn, Paiboon

doi:10.4269/ajtmh.22-0478

Cited by 4 publications

(1 citation statement)

References 11 publications

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“… 14 , 19 , 20 Persistency of antigen in urine over a period of 10 months indicated the reliability of antigen detection in diagnosis of opisthorchiasis. 22 In this study, based on the standard FECT protocol (two-drop examination), egg detections were negative in 57 of 176 individuals (32.3%) in antigen-positive groups (groups 1 and 2). Within O. viverrini egg-negative but antigen-positive individuals, the positive rates of O. viverrini in both the optimization and validation studies were similar (about 30%) by the optimized FECT protocol.…”

Section: Discussionmentioning

confidence: 57%

Comparison of a Urine Antigen Assay and Multiple Examinations with the Formalin-Ethyl Acetate Concentration Technique for Diagnosis of Opisthorchiasis

Worasith

Techasen

Duenngai

et al. 2023

The American Journal of Tropical Medicine and Hygiene

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Detection of worm antigen in urine is a sensitive diagnostic method for opisthorchiasis, particularly for light-intensity infections; however, the presence of eggs in feces is essential for validating results from the antigen assay. To address the issue of low sensitivity of fecal examination, we modified the protocol for the formalin-ethyl acetate concentration technique (FECT) and compared it against urine antigen measurements for detection of the parasite Opisthorchis viverrini. First, we optimized the FECT protocol by increasing the number of drops for examinations from the standard two drops to a maximum of eight. We were able to detect additional cases after examination of ≥ 3 drops, and the prevalence of O. viverrini saturated after examination of ≥ 5 drops. We then compared the optimized FECT protocol (examining five drops of suspension) against urine antigen detection for the diagnosis of opisthorchiasis in field-collected samples. The optimized FECT protocol detected O. viverrini eggs in 25 of 82 individuals (30.5%) who had positive urine antigen tests but were fecal egg negative by the standard FECT protocol. The optimized protocol also retrieved O. viverrini eggs in 2 of 80 antigen-negative cases (2.5%). In comparison with the composite reference standard (combined FECT and urine antigen detection), the diagnostic sensitivity of examining two and five drops of FECT and the urine assay was 58.2, 67, and 98.8%, respectively. Our results show that multiple examinations of fecal sediment increase the diagnostic sensitivity of FECT and thus provide further support for the reliability and utility of the antigen assay for diagnosis and screening of opisthorchiasis.

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Section: Discussionmentioning

confidence: 57%

Comparison of a Urine Antigen Assay and Multiple Examinations with the Formalin-Ethyl Acetate Concentration Technique for Diagnosis of Opisthorchiasis

Worasith

Techasen

Duenngai

et al. 2023

The American Journal of Tropical Medicine and Hygiene

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Epidemiology of Strongyloides stercoralis and Opisthorchis viverrini infections in northern and northeastern Thailand: Insights from urine-ELISA surveys

Wiraphongthongchai,

Sithithaworn,

Thinkhamrop

et al. 2024

Parasitol Res

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Clonorchiasis and opisthorchiasis: epidemiology, transmission, clinical features, morbidity, diagnosis, treatment, and control

Qian,

Keiser,

Utzinger

et al. 2024

Clin Microbiol Rev

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SUMMARY Clonorchis sinensis , Opisthorchis viverrini , and Opisthorchis felineus are important liver flukes that cause a considerable public health burden in eastern Asia, southeastern Asia, and eastern Europe, respectively. The life cycles are complex, involving humans, animal reservoirs, and two kinds of intermediate hosts. An interplay of biological, cultural, ecological, economic, and social factors drives transmission. Chronic infections are associated with liver and biliary complications, most importantly cholangiocarcinoma. With regard to diagnosis, stool microscopy is widely used in epidemiologic surveys and for individual diagnosis. Immunologic techniques are employed for screening purposes, and molecular techniques facilitate species differentiation in reference laboratories. The mainstay of control is preventive chemotherapy with praziquantel, usually combined with behavioral change through information, education and communication, and environmental control. Tribendimidine, a drug registered in the People’s Republic of China for soil-transmitted helminth infections, shows potential against both C. sinensis and O. viverrini and, hence, warrants further clinical development. Novel control approaches include fish vaccine and biological control. Considerable advances have been made using multi-omics which may trigger the development of new interventions. Pressing research needs include mapping the current distribution, disentangling the transmission, accurately estimating the disease burden, and developing new diagnostic and treatment tools, which would aid to optimize control and elimination measures.

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Long-term Persistence of Opisthorchis viverrini Antigen in Urine: A Prospective Study in Northeast Thailand

Cited by 4 publications

References 11 publications

Comparison of a Urine Antigen Assay and Multiple Examinations with the Formalin-Ethyl Acetate Concentration Technique for Diagnosis of Opisthorchiasis

Comparison of a Urine Antigen Assay and Multiple Examinations with the Formalin-Ethyl Acetate Concentration Technique for Diagnosis of Opisthorchiasis

Epidemiology of Strongyloides stercoralis and Opisthorchis viverrini infections in northern and northeastern Thailand: Insights from urine-ELISA surveys

Clonorchiasis and opisthorchiasis: epidemiology, transmission, clinical features, morbidity, diagnosis, treatment, and control

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