Introduction:
Fasciolopsiasis, also known as intestinal fluke infection. It is a parasitic disease caused by the trematode Fasciolopsis buski. This fluke is found primarily in Southeast Asia and parts of China. Fasciolopsiasis is a neglected tropical disease that primarily affects people in low- and middle-income countries and is often overlooked by the global health community. As such, resources for diagnosis, treatment, and prevention may be limited in affected areas. It is primarily contracted by consuming infected freshwater snails or aquatic plants. Fasciolopsiasis is a zoonotic disease that can be transmitted between animals and humans. It may significantly impact the livelihoods of communities that rely on farming and fishing.
What Are the Causes of Fasciolopsiasis?
Fasciolopsiasis is caused by the intestinal fluke Fasciolopsis buski. The infection is acquired through the consumption of freshwater snails or aquatic plants infected by the fluke. The life cycle of F. buski begins with the release of eggs into freshwater, where they hatch into miracidia. The miracidia then infect freshwater snails and cercariae. Finally, the cercariae are released into the water and can infect aquatic plants. The consumption of these infected snails or aquatic plants is the primary means of contracting fasciolopsiasis. However, the infection can also be acquired by accidentally ingesting the fluke's metacercariae on raw or undercooked aquatic plants.
What Are the Symptoms of Fasciolopsiasis?
The symptoms of fasciolopsiasis can vary depending on the severity of the infection. In mild cases, individuals may experience little to no symptoms. However, in more severe cases, the following symptoms may be present.
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Abdominal Pain - This can be dull or sharp and is caused by flukes in the intestine.
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Diarrhea - This can be caused by the flukes irritating the intestinal lining.
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Loss of Appetite - Flukes block the absorption of nutrients.
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Weight Loss - This can be caused by the flukes blocking the absorption of nutrients and leading to malnourishment.
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Fatigue - Flukes block the absorption of nutrients and lead to malnourishment.
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Nausea and Vomiting - Flukes irritate the intestinal lining and cause inflammation.
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Anemia - Flukes block the absorption of nutrients and lead to a lack of iron in the body.
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Jaundice - This is a yellowing of the skin and eyes caused by a build-up of bilirubin in the body. This can be caused by the flukes blocking the bile ducts, leading to a backup of bilirubin in the blood.
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Abdominal Distention - Flukes blocking the bile ducts, leading to fluid build-up in the abdomen.
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Tenderness of the Liver - Flukes migrate to the liver and cause inflammation.
How to Diagnose Fasciolopsiasis?
It is important to note that fasciolopsiasis can be easily misdiagnosed due to the similarity of its symptoms with other parasitic infections, such as Ascaris lumbricoides, Taenia saginata, or Giardia lamblia. Therefore, it is essential to have a proper medical professional diagnosis and perform the appropriate tests to confirm the diagnosis. Diagnosis of fasciolopsiasis is typically made by detecting eggs in the feces or identifying the flukes in the intestine during an endoscopic examination. It includes the following:
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Fecal Examination - A fecal examination is the most common method of diagnosis, and it typically involves looking for the presence of eggs in the stool using microscopy. The eggs are oval, operculate, and measure about 80 by 50 micrometers. The examination should be done in two samples collected on different days to increase the accuracy of the diagnosis.
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Endoscopic Examination - Another diagnostic method is an endoscopic examination, which involves using a small camera to look inside the intestine. This can be done through a colonoscope or an endoscope and can help identify the presence of flukes in the intestine.
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Imaging Studies - In some cases, imaging studies such as ultrasound or CT (computed tomography) scans may be used to identify the presence of flukes in the liver or bile ducts.
How to Treat Fasciolopsiasis?
Treatment for fasciolopsiasis typically involves the use of anthelmintic medications, which are drugs that are specifically designed to kill parasitic worms. The most commonly used anthelmintic medications for fasciolopsiasis are:
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Praziquantel - This is a broad-spectrum anthelmintic medication effective against many parasitic worms, including fasciolopsiasis. Praziquantel is typically administered in a single dose and is well-tolerated, with few side effects.
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Nitazoxanide - This is an antiparasitic medication active against many parasitic infections, including fasciolopsiasis. Nitazoxanide is typically administered twice daily for three days.
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Triclabendazole - This anthelmintic medication is effective against fasciolopsiasis and other trematode infections. Triclabendazole is typically administered in a single dose, and it has been found to have a high cure rate and be well-tolerated.
How to Prevent Fasciolopsiasis?
Prevention of fasciolopsiasis primarily involves avoiding exposure to the intermediate host (snail) and the parasite's metacercariae (the infective stage). Some of the key prevention measures include:
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Avoiding Consumption of Raw or Undercooked Aquatic Plants - The metacercariae of the parasite are found in aquatic plants, so preventing the consumption of raw or undercooked aquatic plants, such as water chestnuts, can help prevent infection.
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Proper Cooking and Food Preparation - Cooking all aquatic plants before consuming them can help kill any metacercariae present.
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Personal Hygiene - Good hygiene, such as washing hands before eating, can help prevent infection.
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Educating the Public - Educating the public about the risks of fasciolopsiasis, the importance of proper sanitation and food preparation, and the signs and symptoms of the infection can help prevent the spread of the disease.
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Chemical Control - In areas where the snail population is high, chemical control can be used to control the population.
Conclusion:
Fasciolopsiasis is a parasitic infection that can cause significant health problems, particularly in Southeast Asia and parts of China. Individuals in affected areas must know the risks and take precautions to prevent infection. Additionally, efforts to improve access to diagnosis, treatment, and prevention for fasciolopsiasis and other neglected tropical diseases are crucial for improving the health and well-being of affected communities. Working with the local communities to implement these prevention measures is essential. Community-based approaches are often more effective than top-down approaches, as they allow local people to take ownership of the problem and develop solutions tailored to their specific needs and circumstances.
