RESUMO
A cross sectional study on hepatobiliary abnormalities in opisthorchiasis was performed in 8936 males and females aged from 20 to 60 years from 90 villages of Khon Kaen province, Northeast Thailand. All were stool-examined for Opisthorchis viverrini infection by standard quantitative formalin/ethyl acetate concentration technique. Of these, 3359 participants with stool egg positive underwent ultrasonography of the upper abdomen. The hepatobiliary abnormalities detected by ultrasound are described here. This study found a significantly higher frequency of advanced periductal fibrosis in persons with chronic opisthorchiasis (23.6%), particularly in males. Risks of the fibrosis included intensity of infection, and age younger than 30 years. Height of left lobe of the liver, cross-section of the gallbladder dimensions post fatty meal, sludge, and, interestingly, intrahepatic duct stones were significantly associated with the advanced periductal fibrosis. Eleven suspected cholangiocarcinoma (CCA) cases were observed. This study emphasizes the current status of high O. viverrini infection rate and the existence of hepatobiliary abnormalities including suspected CCA in opisthorchiasis endemic areas of Thailand.
Assuntos
Doenças Biliares/diagnóstico por imagem , Colangiocarcinoma/diagnóstico por imagem , Doenças da Vesícula Biliar/diagnóstico por imagem , Hepatopatias/diagnóstico por imagem , Opistorquíase/diagnóstico por imagem , Adulto , Animais , Sistema Biliar/diagnóstico por imagem , Sistema Biliar/patologia , Doenças Biliares/complicações , Doenças Biliares/epidemiologia , Doenças Biliares/patologia , Colangiocarcinoma/complicações , Colangiocarcinoma/epidemiologia , Colangiocarcinoma/patologia , Estudos Transversais , Fezes/parasitologia , Feminino , Vesícula Biliar/diagnóstico por imagem , Vesícula Biliar/patologia , Doenças da Vesícula Biliar/complicações , Doenças da Vesícula Biliar/epidemiologia , Doenças da Vesícula Biliar/patologia , Humanos , Fígado/diagnóstico por imagem , Fígado/patologia , Hepatopatias/complicações , Hepatopatias/epidemiologia , Hepatopatias/patologia , Masculino , Pessoa de Meia-Idade , Opistorquíase/complicações , Opistorquíase/epidemiologia , Opistorquíase/patologia , Opisthorchis/fisiologia , Prevalência , Fatores de Risco , Tailândia/epidemiologia , Ultrassonografia , Adulto JovemRESUMO
Infection with Opisthorchis viverrini and its associated cholangiocarcinoma (CCA) is an underestimated problem in the Mekong region of Southeast Asia, despite the widespread use of praziquantel and health education measures for parasite control. Although data from Cambodia, Laos and Vietnam are rare, data from Thailand often show wide-ranging variability in epidemiological parameters, including human morbidity and the prevalence and incidence of CCA. The recent discovery of high levels of population genetic variability in O. viverrini in different wetlands in Thailand and Laos, which indicates the presence of sibling species, suggests that we have underestimated the complexity of this epidemiological situation. Future research should determine the relationship between the genetic variability of O. viverrini and patterns of opisthorchiasis-related disease.
