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Mass chemotherapy in the control of paragonimiasis
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Korean J Parasito > Volume 7(1):1969 > Article

Original Article
Korean J Parasitol. 1969 Jun;7(1):6-14. English.
Published online Mar 20, 1994.  http://dx.doi.org/10.3347/kjp.1969.7.1.6
Copyright © 1969 by The Korean Society for Parasitology
Mass chemotherapy in the control of paragonimiasis
Joung Soon Kim
Department of Epidemiology, School of Public Health, Seoul National University, Korea.
Abstract

Among 11,005 inhabitants(61% of total population) surveyed in 13 villages of Che Ju Island in 1964, were identified as paragonimiasis patients, of these 1,355 were treated with 40 mg/kg body weight of bithionol for 10-15 doses. The purpose of the study was to test whether mass chemotherapy of the human host may provie an answer for the control of paragonimiasis in an area where the human host is main source of infection to the intermediate hosts. The efficacy of the mass chemotherapy as control program was measured by the acceptance of the survey and treatment by the inhabitants, the efficacy and the toxicity of the drug applied, and the influence of the infection rates of the intermediate hosts.

The acceptance of the survey and the treatment was not entirely satisfactory: an estimate based on data suggests that only fifty to sixty percent of all cases infected were detected, and 93% of detected cases were treated in the primary program. All cases detected during the follow up survey, which could not cover whole population, were treated.

The efficacy of bithionol was excellent when the treatment was completed. 40 mg/kg body weight for 10~15 doses was sufficient to turn the sputum egg-negative except in a few cases infected heavily that needed 20 doses. Side reactions were generally mild; the most frequent reaction was gastrointestinal; which spontaneously subsided within a few to several days.

The infection rate of intermediate hosts started to decrease from the third year of the mass treatment with a pattern of gradual drop.

Follow up studies on general population in three and four years of the mass treatment also showed markedly decreased prevalence of paragonimiasis by intradermal test and sputum examination.

It is concluded that a complete mass chemotherapy with bithionol in an area where human is the main source of infection to the intermediate hosts can be the answer for control of paragonimiasis.

Tables


Table 1
Age distribution of patients and percentage treated


Table 2
Results of sputum examination on 1,166 patients one year after the treatment of 1,350 egg positives


Table 3
The result of human population survey before and after the mass treatment with bithionol in three and four years follow-up study


Table 4
Toxic side reactions in 775 patients classified by age group


Table 5
Symptoms of side reactions and its frequency


Table 6
The changes of the infection rates of intermediate hosis(crab and snail) before and after the mass treatment of human cases in follow-up study

References
1. Chu DS. The Korean Central J Med 1962;7(6):1–20.
2. Chung HL, et al. Chinese Med J Peking 1954;72(1):1–14.
3. Kang SY, et al. Korean J Med Assoc 1963;6:59–66.
4. Katamine D, et al. Dis Bull Nagasaki Univ 1961;3(2):130–138.
5. Kobayashi H. Keijo Med Hochschul Mitteil 1921;4(1):5–16.
6. Sadun EH, Buck AA. Paragonimiasis in South Korea--immunodiagnostic, epidemiologic, clinical, roentgenologic and therapeutic studies. Am J Trop Med Hyg 1960;9:562–599.
 
7. Wang CN, et al. Chines Med J Peking 1964;83(3):163–170.
8. Yokogawa M, et al. Jpn J Parasit 1960;10(2):302–316.
9. Yokogawa M, et al. Jpn J Parasit 1960;10(2):317–327.
10. Yokogawa M, Iwasaki M, Shigeyasu M, Hirose H, Okura T, Tsuji M. Chemotherapy of Paragonimiasis with Bithionol V Studies on the Minimum Effective Dose and Changes in Abnormal X-Ray Shadows in the Chest after Treatment. Am J Trop Med Hyg 1963;12:859–869.
 
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