Implementación de una estrategia de medicamentos en red: el caso de praziquantel / Implementation of a network drug strategy: the case of praziquantel

Resumen Las infecciones parasitarias provocan una enorme carga de enfermedad y constituyen un problema presente para la salud pública. Las enfermedades emergentes o reemergentes se ven influenciadas por fenómenos del mundo actual interconectado producto de la globalización, el desplazamiento de las personas, el comercio, la urbanización descoordinada y el cambio climático, contribuyendo en la transmisión de estas enfermedades. En el año 2021 hubo un aumento de la cantidad de pacientes que han requerido tratamiento para la difilobotriasis en la Región de los Ríos. Se revisan los aspectos relacionados con las redes integradas de servicios de salud para el acceso al tratamiento farmacológico a pacientes con diagnóstico de difilobotriasis, implementado por la Dirección de Servicio de Salud Valdivia, en colaboración con el hospital San José de Osorno, centros de atención primaria y centros privados de la Región de los Ríos.

Abstract Parasitic infections cause a huge burden of disease and are a current public health problem. The category of emerging or re-emerging disease is influenced by phenomena that occur in today's interconnected world because of globalization, the displacement of people, trade, uncoordinated urbanization and climate change, they have a very important influence on transmission of these diseases. In 2021 there was an increase in the number of patients who have required treatment for diphyllobothriasis in the Los Ríos Region. This article reviews aspects related to integrated Health Service networks to provide access to pharmacological treatments to patients diagnosed with diphyllobothriasis (tapeworm infection), implemented by the Valdivia Health Service Department, in collaboration with the San José de Osorno hospital, primary care centers and private centers in the Los Ríos Region.

Molecular Identification of Diphyllobothrium latum from a Pediatric Case in Taiwan

Human diphyllobothriasis is a parasitic disease caused by ingestion of larvae (plerocercoids) in raw or undercooked fish and commonly found in temperate areas. Rare cases were reported in tropical or subtropical areas especially in children. The first documented case of pediatric diphyllobothriasis in Taiwan had been reported 11 years ago. Here, we report another 8-year-old girl case who presented with a live noodle-like worm hanging down from her anus, with no other detectable symptoms. We pulled the worm out and found the strobila being 260 cm in length. Examination of gravid proglottids showed that they were wider than their lengths, containing an ovoid cirrus sac in the anterior side and the rosette-shaped uterus. Eggs extracted from the uterus were ovoid and operculated. Diphyllobothrium latum was confirmed by molecular analysis of the mitochondrial DNA cytochrome c oxidase subunit 1 (cox1) gene. The girl was treated with a single oral dose of praziquantel, and no eggs or proglottids were observed from her stool in the subsequent 3 months. The reemergence of human diphyllobothriasis in non-endemic countries is probably due to prevalent habit of eating imported raw fish from endemic areas. This pediatric case raised our concern that human diphyllobothriasis is likely underestimated because of unremarkable symptoms.

Four Human Cases of Diphyllobothrium nihonkaiense (Eucestoda: Diphyllobothriidae) in China with a Brief Review of Chinese Cases

We described 4 human infection cases of zoonotic fish-tapeworm, Diphyllobothrium nihonkaiense, identified with morphological and molecular characters and briefly reviewed Chinese cases in consideration of it as an emerging parasitic disease in China. The scolex and mature and gravid proglottids of some cases were seen, a rosette-shaped uterus was observed in the middle of the mature and gravid proglottids, and the diphyllobothriid eggs were yellowish-brown in color and displayed a small knob or abopercular protuberance on the opposite end of a lid-like opening. The average size of the eggs was recorded as 62–67×42–45 μm. The parasitic materials gathered from 4 human cases were morphologically identified as belonging to the genera Diphyllobothrium and Adenocephalus. The phylogenetic analysis based on the nucleotide sequences of cytochrome c oxidase subunit 1 gene of the etiologic agents confirmed that the 4 cases were D. nihonkaiense infection. The finding of 4 additional D. nihonkaiense cases suggests that D. nihonkaiense might be a major causative species of human diphyllobothriasis in China. A combined morphological and molecular analysis is the main method to confirm D. nihonkaiense infection.

Fish-borne Parasitic Diseases / 한양의대학술지

Parasites transmitted by fish (=fish-borne parasites) and the diseases caused by them are briefly reviewed. The fish-borne parasites known to occur in the Republic of Korea are taxonomically classified as 23 helminth species, which include 5 species of nematodes, 16 species of trematodes, and 2 species of cestodes. Among them, Anisakis simplex, Clonorchis sinensis, Metagonimus yokogawai, Heterophyes nocens, Echinostoma hortense, and Diphyllobothrium latum are the most important species in public health points of view. The kinds of fish responsible for human infections include various species of fresh water fish, brackish water fish, and marine fish. Pathogenicity and clinical manifestations are variable according to different parasite species and immune status of the host. For prevention of these infections, avoidance of consuming raw or improperly cooked fish is important.

Diphyllobothrium latum infection in a non-endemic country: case report / Infecção pelo Diphyllobothrium latum em país não endêmico: relato de caso

Diphyllobothriasis, which is rarely described in Brazil, was reported initially as a travelers’ disease and as an accidental infection in individuals who ate raw freshwater fish. This report aims to present the case of a 20-year-old patient with confirmed Diphyllobothrium latum infection.

A difilobotríase, raramente descrita no Brasil, foi referida inicialmente como doença de viajantes e como infecção acidental em indivíduos que se alimentam com peixe cru de água doce. Este relato objetiva apresentar o caso de uma paciente de 20 anos com infecção confirmada pelo Diphyllobothrium latum.

Acuicultura y salud pública: La expansión de la difilobotriasis en Chile y el mundo / Aquaculture and public health: The emergence of diphyllobothriasis in Chileand the world

Recent clinical and epidemiológica! information, an analysis of the literature, and study of the technical aspects of Chilean salmon aquaculture indicate that this activity has the ability to expand the range of diphyllobothriasis caused by the fish tapeworm Diphyllobothrium latum. Evidence for expansion of the range of the fish tapeworm includes the emergences of clinical cases in Brazil related to consumption of salmon produced in Chile. Expansion of the range of this parasite is also suggested by an increase of its geographical range in Chile, beyond its previously endemic foci in the lakes of Regions IX and X. Prevention of further dissemination of this parasitic disease rests on an improvement of sanitation and sewage disposal around the lakes of Regions IX, X and XI in Chile, improvement in aquaculture methods including curtailing the use offish tapeworm-contaminated lakes to grow juveniles forms ofsalmonids and more measures to decrease the number of salmonid escapees from marine pens to prevent their return to rivers and lakes carrying the infestation. Moreover, tracking the origin ofjuveniies in marketed salmon, determining the presence of plerocercoids in them, and increased education of the public regarding the potential dangers of eating raw fish should also be implemented. Only by stimulating the dialogue between the industry, consumers and state regulators will it be possible to implement appropriate measures to prevent further expansion of this parasitic disease by salmon aquaculture.

Diphyllobothriasis and sparganosis in Indonesia

Food-borne zoonotic cestode infections by <I>Diphyllobothrium</I> spp. and <I>Spirometra</I> spp. are relatively uncommon in Indonesia. So far, only one case of diphyllobothriasis was confirmed in 2004 in Jakarta, whereas there were 4 sparganosis cases in Indonesia. Morphology of eggs and gravid proglottids revealed the first case to be caused by <I>Diphyllobothrium</I> species. However, molecular identification of the species was not successful. Sparganosis may not be particularly rare in Indonesia, since <I>Spirometra</I> species have often been found in cats and other animals. These topics in Indonesia are briefly overviewed with reference to historical records and socio-cultural background information.