AN ASSESSMENT OF RE-INFECTION RATES AND TREATMENT OUTCOMES OF PATIENTS WITH PULMONARY PARAGONIMIASIS
BY: BELIZARIO VY JR. ; DE LEON WU; BUGAYONG MPG; DE GUZMAN AD; VALDERAMA MTG
PULMONARY PARAGONIMIASIS OR LUNG FLUKE INFECTION IS A FOOD-BORNE PARASITOSIS THAT IS ACQUIRED BY INGESTION OF RAW OF INSUFFIENTLY COOKED FRESH WATER CRABS. IF LEFT UNDIAGNOSED AND UNTREATED, THIS CAN LEAD TO A SEVERE AND DISABLING DISEASE THAT REDUCES HUMAN PRODUCTIVITY AND QUALITY OF LIFE. THE PRESENCE OF INTEGRATED TUBERCULOSIS - PARAGONIMIASIS SURVEILLANCE PROGRAM IN THE MUNICIPALITIES OF CASIGURAN AND IROSIN IN SORSOGON MAY NOT BE ENOUGH IN TRYING TO CONTROL THIS PUBLIC HEALTH PROBLEM. DATA ON FINER POINTS SUCH AS RE-INFECTION RATES ARE STILL LACKING. THIS INFORMATION IS ESPECIALLY RELEVANT CONSIDERING THAT PEOPLE LIVING IN ENDEMIC AREAS MAY NOT NECESSARILY ALTER THEIR FOOD PREFERENCES AND EATING HABITS EASILY EVEN WITH A PROVEN BOUT WITH LUNG FLUKE INFECTION. IN ADDITION, THERE ARE NO LOCAL STUDIES ABOUT THE EXTENT OF CLINICAL AND PARASITOLOGICAL RESPONSES TO PRAZIQUANTEL THERAPY, AMIDST REPORTS OF NON-RESPONSE TO TREATMENT. A FOLLOW-UP SURVEY WAS CONDUCTED IN THE MUNICIPALITIES OF IROSIN AND CASIGURAN WHICH GAVE SPECIAL ATTENTION TO THESE ISSUES. RESULTS SHOWED THAT OVERALL INFECTION RATE DID NOT SIGNIFICANTLY DIFFER FORM PREVIOUS LEVELS FOUND IN SURVEYS DONE IN 1997-1998. ALSO, IN PATIENTS WITH PAST HISTORY OF PARAGONIMIASIS, 11.5% WERE AGAIN FOUND POSITIVE FOR LUNG FLUKE OVA. NON-CLEARANCE FOR PARASITE EGGS AFTER TREATMENT WAS ALSO SEEN IN SOME PATIENTS. OUR SURVEY GATHERED VALUABLE DATA THAT MAY HELP JUSTIFY THE NEED FOR FOLLOW-UP AND FOR BETTER HEALTH EDUCATION AND PROMOTION STRATEGIES THAT WILL PREVENT SUBSEQUENT EXPOSURE AND EVENTUAL DISEASE, AND PROBABLY, IN THE EVALUATION OF EXISTING TREATMENT GUIDELINES.
PULMONARY PARAGONIMIASIS OR LUNG FLUKE INFECTION IS A FOOD-BORNE PARASITOSIS THAT IS ACQUIRED BY INGESTION OF RAW OF INSUFFIENTLY COOKED FRESH WATER CRABS. IF LEFT UNDIAGNOSED AND UNTREATED, THIS CAN LEAD TO A SEVERE AND DISABLING DISEASE THAT REDUCES HUMAN PRODUCTIVITY AND QUALITY OF LIFE. THE PRESENCE OF INTEGRATED TUBERCULOSIS - PARAGONIMIASIS SURVEILLANCE PROGRAM IN THE MUNICIPALITIES OF CASIGURAN AND IROSIN IN SORSOGON MAY NOT BE ENOUGH IN TRYING TO CONTROL THIS PUBLIC HEALTH PROBLEM. DATA ON FINER POINTS SUCH AS RE-INFECTION RATES ARE STILL LACKING. THIS INFORMATION IS ESPECIALLY RELEVANT CONSIDERING THAT PEOPLE LIVING IN ENDEMIC AREAS MAY NOT NECESSARILY ALTER THEIR FOOD PREFERENCES AND EATING HABITS EASILY EVEN WITH A PROVEN BOUT WITH LUNG FLUKE INFECTION. IN ADDITION, THERE ARE NO LOCAL STUDIES ABOUT THE EXTENT OF CLINICAL AND PARASITOLOGICAL RESPONSES TO PRAZIQUANTEL THERAPY, AMIDST REPORTS OF NON-RESPONSE TO TREATMENT. A FOLLOW-UP SURVEY WAS CONDUCTED IN THE MUNICIPALITIES OF IROSIN AND CASIGURAN WHICH GAVE SPECIAL ATTENTION TO THESE ISSUES. RESULTS SHOWED THAT OVERALL INFECTION RATE DID NOT SIGNIFICANTLY DIFFER FORM PREVIOUS LEVELS FOUND IN SURVEYS DONE IN 1997-1998. ALSO, IN PATIENTS WITH PAST HISTORY OF PARAGONIMIASIS, 11.5% WERE AGAIN FOUND POSITIVE FOR LUNG FLUKE OVA. NON-CLEARANCE FOR PARASITE EGGS AFTER TREATMENT WAS ALSO SEEN IN SOME PATIENTS. OUR SURVEY GATHERED VALUABLE DATA THAT MAY HELP JUSTIFY THE NEED FOR FOLLOW-UP AND FOR BETTER HEALTH EDUCATION AND PROMOTION STRATEGIES THAT WILL PREVENT SUBSEQUENT EXPOSURE AND EVENTUAL DISEASE, AND PROBABLY, IN THE EVALUATION OF EXISTING TREATMENT GUIDELINES.