Community-Based Cross-Sectional Study of Carcinogenic Human Liver Fluke in Elderly from Surin Province, Thailand

  • Published : 2012.09.30


Background: Opisthorchis viverrini infection is a serious public-health problem in Southeast Asia. It is associated with a number of hepatobiliary diseases and the evidence strongly indicates that liver fluke infection is the etiology of cholangiocarcinoma. Objectives: This study aimed to determine Opisthorchis viverrini infection in elderly people in Surin province, Northeastern Thailand. Methods: A community-based cross-sectional survey was conducted among 333 elderly in 17 districts of Surin province, during one year period from January to December 2011. O. viverrini infection was determined using Kato's Thick Smear technique and socio-demographic were collected using predesigned semi-structured questionnaires, respectively. Results: A total of 333 elderly including 116 males and 217 females were selected from different study sites. Overall intestinal parasitic infection was 16.2%, predominantly in O. viverrini (9.91%) and followed by Strongyloides stercolaris (4.80%) and hookworm (1.50%), respectively. The O. viverrini infection was found higher in males (13.8%) than females (7.83%), and frequently in elderly 60-70 year old with 14.2%. Chi-square testing indicated that education and occupation were significantly associated with O. viverrini infection (P value = 0.02). The distribution of O. viverrini infection was found in 11 districts which was covered 64.7% of the studies areas. The highest prevalence was found in Thatum with 39.1%, and followed by Sangkha (24.0%), Buachet (21.1%), Samrong Thap (19.1%), Si Narong (15.0%), and Ratanaburi (13.3%) districts. Conclusion: This findings stress that O viverrini is still a problem in Thailand. We confirmed, for the first time, the high endemicity of human O. viverrini infections in elderly in Surin province of Thailand, underlying the fact that mass treatment and health education are urgently required.


  1. Ball PAJ, Gilles, Herbert Michael (1991). Hookworm infections. Human Parasitic Diseases, 4, 38-3.
  2. Harinasuta T, Riganti M, Bunnag D (1984). Opisthorchis viverrini infection: pathogenesis and clinical features. Arzneimittelforschung, 34, 1167-9.
  3. Harinasuta C, Vajrasthira S (1960). Opisthorchiasis in Thailand. Am J Trop Med Hyg, 54, 100-5.
  4. IARC (1994). Infection with liver flukes (Opisthorchis viverrini, Opisthorchis felineus and Clonrochis sinensis). IARC Monogr Eval Carcinog Risks of Hum, 61, 121-75.
  5. Jongsuksuntigul P, Imsomboon T (2003). Opisthorchiasis control in Thailand. Acta Trop, 88, 229-32.
  6. Kaewpitoon N, Kaewpitoon SJ, Pengsaa P, Pilasri C (2007). Knowledge, attitude and practice related to liver fluke infection in northeast Thailand. World J Gastroenterol, 28, 1837-40.
  7. Kaewpitoon N, Kaewpitoon SJ, Pengsaa P (2008). Opisthorchiasis in Thailand: review and current status. World J Gastroenterol, 14, 2297-302.
  8. Kato K, Miura M (1954). Comparative examinations. Jpn J Parasitol, 3, 35.
  9. Sadun EH (1995). Studies on Opisthorchis viverrini in Thailand. Am J Hyg, 62, 81-115
  10. Sithithaworn P, Pipitgool V, Srisawangwong T, Elkins DB, Haswell-Elkins MR (1997). Seasonal variation of Opisthorchis viverrini infection in cyprinoid fish in northeast Thailand: implications for parasite control and food safety. Bull World Health Organ, 75, 125-31
  11. Sithithaworn P, Haswell-Elkins M (2003). Epidemiology of Opisthorchis viverrini. Acta Trop, 88, 187-4.
  12. Sithithaworn P, Andrews RH, Nguyen VD, et al (2012). The current status of opisthorchiasis and clonorchiasis in the Mekong Basin. Parasitol Int, 61, 10-6.
  13. Sriamporn S, Pisani P, Pipitgool V, et al (2004). Prevalence of Opisthorchis viverrini infection and incidence of cholangiocarcinoma in Khon Kaen, Northeast Thailand. Trop Med Int Health, 9, 588-94.
  14. Sripa B, Kaewkes S, Sithithaworn P, et al (2007). Liver fluke induces cholangiocarcinoma. PLoS Med, 4, 201.
  15. Sripa B, Kaewkes S, Intapan PM, Maleewong W, Brindley PJ (2010). Food-borne trematodiases in Southeast Asia: epidemiology, pathology, clinical manifestation and control. Adv Parasitol, 72, 305-50.
  16. Thamavit W, Bhamarapravati N, Sahaphong S, Vajrasthira S, Angsubhakorn S (1978). Effects of dimethylnitrosamine on induction of cholangiocarcinoma in Opisthorchis viverriniinfected Syrian golden hamsters. Cancer Res, 38, 4634-9.
  17. Upatham ES, Viyanant V, Kurathong S, et al (1982). Morbidity in relation to intensity of infection in Opisthorchiasis viverrini: study of a community in Khon Kaen, Thailand. Am J Trop Med Hyg, 31, 1156-63.
  18. Vichasri S, Viyanant V, Upatham ES (1982). Opisthorchis viverrini: intensity and rates of infection in cyprinoid fish from an endemic focus in northeast Thailand. Southeast Asian J Trop Med Public Health, 3, 138-41.
  19. Wykoff DE, Chittayasothorn K, Winn MM (1966). Clinical manifestation of Opisthorchis viverrini infection in Thailand. Am J Trop Med Hyg, 15, 914-8.

Cited by

  1. Prevalence and Risk Factors for Opisthorchis viverrini Infections in Upper Northeast Thailand vol.15, pp.16, 2014,
  2. Comparative evaluation of Strongyloides ratti and S. stercoralis larval antigen for diagnosis of strongyloidiasis in an endemic area of opisthorchiasis vol.114, pp.7, 2015,
  3. Prevalence and Risk Factors for Infection by Opisthorchis viverrini in an Urban Area of Mahasarakham Province, Northeast Thailand vol.16, pp.10, 2015,
  4. Review and Current Status of Opisthorchis viverrini Infection at the Community Level in Thailand vol.16, pp.16, 2015,
  5. The Carcinogenic Liver Fluke Opisthorchis viverrini among Rural Community People in Northeast Thailand: a Cross-Sectional Descriptive Study using Multistage Sampling Technique vol.16, pp.17, 2015,
  6. GIS-Based Spatial Statistical Analysis of Risk Areas for Liver Flukes in Surin Province of Thailand vol.16, pp.6, 2015,
  7. Nutritional Status among Rural Community Elderly in the Risk Area of Liver Fluke, Surin Province, Thailand vol.16, pp.18, 2016,
  8. Detection of the Carcinogenic Liver Fluke Opisthorchis viverrini Using a Mini Parasep SF Faecal Parasite Concentrator vol.17, pp.1, 2016,
  9. Population-Based Intervention for Liver Fluke Prevention and Control in Meuang Yang District, Nakhon Ratchasima Province, Thailand vol.17, pp.2, 2016,
  10. GIS Database and Google Map of the Population at Risk of Cholangiocarcinoma in Mueang Yang District, Nakhon Ratchasima Province of Thailand vol.17, pp.3, 2016,
  11. Uncovering the Pathogenic Landscape of Helminth (Opisthorchis viverrini) Infections: A Cross-Sectional Study on Contributions of Physical and Social Environment and Healthcare Interventions vol.10, pp.12, 2016,
  12. CX-4945 Induces Methuosis in Cholangiocarcinoma Cell Lines by a CK2-Independent Mechanism vol.10, pp.9, 2018,