Beruflich Dokumente
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Presented by:
Introducti
on
Paragonimiasis
is a disease caused by an infection of a
number
of
species
of
trematodes
belonging to the genus Paragonimus
(WHO, 2012)
lung fluke disease
food-borne and zoonotic
LIFE CYCLE of
Paragonimus
Mode of
Transmissi
on
Eggs in
sputum or
in stool
Embryonat
ion
Miracidium
First
intermediate
host (snail)
Miracidium
Second
intermediate
host(crabs/crayf
shes)
Sporocyst
Metacercariae
Rediae
Cercariae
Defnitive
host
Ingestion of
metacercari
ae
Adults live
in the lungs
Chin
a
Koreas
Lao
s
Vietna
m
Thailan
d
Paragonimiasis
Paragonimiasis
Endemicity in Japan
Before 1950:
Endemic in
MiyazakiPrefecture,
Japan
1950-1960:
Mass screening
and Prevention
by Local
Government
1970:
Eradicated and
considered
disease of the
past
Endemicity in Japan
Late 1980s: new cases sporadically
emerged in previously endemic areas
re-
Endemicity in Nigeria
1964:
Recorded to be
endemic
1968-1970:
Civil war
caused the
disease to be a
major public
health concern
1980:
Reported to be
eradicated
Endemicity in Nigeria
Endemicity in Nigeria
Endemicity in Nigeria
Method
s
Sample Population
Sampling
Cross-sectional study
2760 households in total; 400 selected
using calculation for qualitative value
n=z^2Pq/d^2
Systematic sampling by sampling
interval of 7
Data Collection
household interview with interviewer
administered questionnaire
review of health facilities record books
interactive discussion with health
providers to assess level of awareness
on paragonimiasis (index of suspicion &
lab diagnosis)
Results
Knowledge/Awareness of
Paragonimiasis by Age
Age = significant factor
0% awareness (25-35 y.o.)
Possible reason:
Paragonimiasis was no longer
prevalent when they were
born/young.
Majority of those aware were of
the elderly age group.
Identifed Cultural
Methods for Preparing
Crab
Unsafe cooking practices are
culturally accepted
Raw crab with alcohol
Alternatives to alcohol:
Pepper Sauce
Vinegar
Habit of Washing
Utensils
Cultural Habit of
Disposing Excreta &
Sputum
Unhygienic disposal of
excreta and sputum
implication:
Constant discharge of greater
number of Paragonimus
uterobilateralis eggs into
the environment
Appropriate molluscs may then
become infected.
Discussion
Japan
Maruyama, et al. +
Nawa
reported reemergence of
paragonimiasis in areas
where it was previously
eradicated
Reemergence in
Japan
Enwereji + Eke
reported the
reemergence of
paragonimiasis in
Nigeria after almost 30
years
RISK OF SPREAD
*reemergence
elsewhere showed the
circle of transmission is
closed
ID: determinant
factors
contributing to the
reemergence of
paragonimiasis
SUSTAINABLE
ERADICATION PROGRAM
WHY???
most of them have not been
born at the time of
paragonimiasis eradication in
Nigeria; the few born were about
6 yo and were too young to
comprehend and use the
eradication measures
AGE
FACTOR
crabs
as a delicacy in
custom of eating
Pseudanautes africanus
an intermediate host of
Paragonimus uterobilateralis
from the research study of Abraham and Akpan, Vectors of Paragonimus uterobilateralis a Causative Fluke for Paragonimiasis in
Cross-River State-Nigeria
retrieved from http://www.ajol.info/index.php/afrrev/article/viewFile/64538/52320
eating crabs RAW also consistent with a previous report by Lucas and Gilles that
infection can occur by eating uncooked crabs and crayfish and also when encysted
cercariae are left on utensils
...as long as the chain of transmission was broken and later become closed,
FACTOR
the disease would certainly reemerge. -Enwereji and Eke
FACTOR
3
Unhygienic habit of
properly after
FACTOR
Insanitary
Disposal of
excreta and
sputum
FACTOR
Lack of
Awareness
Recommendatio
ns
Health education
Health promotion
Provision of better health care services
Surveillance
Health Education
Health Promotion
Health Care
Services
Surveillance
In the Philippines
This journal article is a good reference if ever
paragonimiasis is eradicated in the Philippines
The mentioned recommendations may be done
to avoid reemergence of paragonimiasis.