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KMID : 0378019830260120155
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New Medical Journal
1983 Volume.26 No. 12 p.155 ~ p.172
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CURRENT RESULTS ON CHEMOTHERAPY OF CLONORCHIASIS AND PARAGONIMIASIS
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Rim Han-Jong
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Abstract
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Human trematode infections are largely confined to the tropical and oriental countries. Especially schistosomiasis, the liver, lung and intestinal trematodes are major public health problems in certain countries. Among these diseases, the infections of Clonorchis sinensis and Paragonimus westermani are the most common species of trematodes of medical importance in Korea. These parasitic infections mediated by snails can produce an endemic focus. The habits of the human populations in endemic foci not only are responsible for their own infections but also are frequently the essential factors in propagating the diseases. Eating raw or undercooked fish, crabs or crayfish containing infectious metacercariae constitute the source for a large portion of human infections. Sanitary disposal of human feces and sputum provides the source of pollution of water, from which the intermediate hosts become infected. In most trematode infections which are present in large numbers of the human population, man is principally responsible for the propagation of the organism. Therefore, for control measures, a practical way is to destroy the adult worms in human host by chemotherapy.
For a long time, only a limited progress in the chemotherapy of trematode infections has been achieved in comparison to that observed for other helminthic diseases. The compound so far used for the treatment of those trematode infections in man has not been satisfactory because of their poor tolerability and/or their limited anthelmintic efficacy. Since 1961 bithionol has been used extensively for the treatment of paragonimiasis westermani and it was proved as a drug of choice for the paragonimiasis caused by all kinds of Paragonimus, but the multiple doses and its side effects are hampered in mass treatment with bithionol in the field. However, still there is no drug of choice for the treatment of clonorchiasis.
Recently a newly developed praziquantel (Embay 8440; Biltricide® ) proved to be safe and effective against a broad spectrum of trematode and cestode infections in man and animals. It was proved that praziquantel is the drug of choice for all species of Schistosoma, liver flukes, lung flukes and intestinal flukes pathogenic to man.
In this present review, the drug used for clonorchiasis and paragonimiasis in the past, current results on the experimental and clinical therapeutic effects and mode of action of praziquantel against C. sinensis and P. westermani infections have been discussed.
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