Opisthorchiasis in Northeastern Thailand: Effect of local environment and culture

Fluke is a common group of human parasitosis. There are many flukes in our world and many are problematic in public health[1]. Of several flukes, opisthorchiasis is a serious trematode infection. This parasitic infestation is a chronic hepatobiliary tract infection and can cause chronic irritation that will finally lead to cholangiocarcinoma[2,4]. This parasitic infestation is highly endemic in northeastern region of Thailand and contributes to many cholangiocarcinoma cases annually. It is believed that the chronic infestation caused by Opisthorchis spp. with the exposure to additional carcinogen in the local environment is the underlying pathogenesis for carcinogenesis of biliary tract cancer. Of interest, when a cholangiocarcinoma occurs, it is usually severe and the diagnosis is usually late. The patients usually present with unexplained severe hyperbilirubinemia and the tumor is usually detected by imaging investigation[5]. Unluckily, the disease is usually advanced and no curative treatment can be provided to the patients[5]. Since opisthorchiasis is a serious underlying risk for deve lopmen t o f cho lang ioca rc inoma , t he con t ro l o f opisthorchiasis becomes an important local public health issue. The attempt to control this disease becomes a national policy. Several campaigns have been launched[6,7]. Nevertheless, the problem is still persistent. Attempt to get rid of the parasite by universal usage of antihelminthic drug becomes unsuccessful[6,7]. In case of a parasitic infestation, the sanitation becomes an important underlying factor leading to infection, and the poverty and low education of the local people become an important concern. In this opinion, the authors discuss the effect of local environment and culture on opisthorchiasis in northeastern ARTICLE INFO ABSTRACT