Fasciola

Abstract: Purpose of reviewHepatobiliary flukes – Fasciola, Opisthorchis, Clonorchis– are a major public health problem in east Asia, east Europe, Africa and Latin America. The present review focuses on current knowledge of clinical, diagnostic and treatment aspects caused by hepatobiliary flukes that can be

Abstract: Fascioliasis and paragonimiasis, which are caused by liver flukes (Fasciola) and lung flukes (Paragonimus), are emerging public health problems Several hundred millions of people are at risk of the two diseases that cause considerable morbidity and delay socio-economic development Triclabendazole, a benzimidazole derivative, has been routinely used since 1983 in veterinary medicine to control infections with Fasciola spp in domestic herbivorous animals In 1986, a veterinary formulation of triclabendazole was first administered to two human patients with fascioliasis Clinical data obtained thus far suggest that triclabendazole is the most efficacious and best tolerated drug for the treatment of fascioliasis Moreover, the drug holds promise as a useful therapeutic alternative to praziquantel in the treatment of paragonimiasis This review of triclabendazole includes an overview of the pharmacodynamics and pharmacokinetics, toxicology and efficacy against the major food-borne trematodes in laboratory animals Data from case reports and clinical trials in humans infected with Fasciola spp and Paragonimus spp are summarised and the current state of triclabendazole regarding treatment of human fascioliasis and paragonimiasis is described Efforts to facilitate broader registration of this drug should go hand-in-hand with research and development on novel drugs against food-borne trematodiasis, better access to improved sanitation, sound health education and the development of new technologies for assuring food safety

Abstract: Summary Fasciola hepatica is a trematode parasite with a global distribution, which is responsible for considerable disease and production losses in a range of food producing species. It is also identified by WHO as a re-emerging neglected tropical disease associated with endemic and epidemic outbreaks of disease in human populations. In Europe, F. hepatica is mostly associated with disease in sheep, cattle and goats. This study reviews the most recent advances in our understanding of the transmission, diagnosis, epidemiology and the economic impact of fasciolosis. We also focus on the impact of the spread of resistance to anthelmintics used to control F. hepatica and consider how vaccines might be developed and applied in the context of the immune-modulation driven by the parasite. Several major research gaps are identified which, when addressed, will contribute to providing focussed and where possible, bespoke, advice for farmers on how to integrate stock management and diagnosis with vaccination and/or targeted treatment to more effectively control the parasite in the face of increasing the prevalence of infection and spread of anthelmintic resistance that are likely to be exacerbated by climate change.