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 Helminthology Platyhelminthes
A patients was examined at the Institute.
Fascioliasis and emerging parasitic diseases - the issues should be resolved

In recent years, Fascioliasis in the Central Vietnam has become the hot issue of the whole country. It is a parasitic disease relating to the habits of eating and driking and environmental hygiene, directly affects the people's health and productivity. Along with Fascioliasis, some emerging helminthic diseases with tens of thousands of infected cases each year such as Clonorchiasis, Taeniasis, Strongyloidiasis, Gnathostomiasis, Ascariasis, Necatoriasis, Ancylostomiasis, or larval diseases like Baylisascaris, Cysticercosis, etc.  are also of great interest to public opinion.

The helminthic diseases have made significant impacts o­n the population like malnutrition, anemia and limited working ability and can even be dangerous to human life such as Cysticercosis, Paragonimiasis, Fascioliasis, etc. However, at present, helminthiases are still considered neglected diseases because their symptoms develop silently and are obscured easily by lots of other acute illnesses, so they haven't received a proper concern for treatment and prevention.

Fascioliasis

Previously, Fascioliasis mainly occurred in herbivores, Ectopic Fascioliasis is acquired in humans by eating raw water plants like watercress or drinking water infected with the encysted form of the parasite.

Within 5 years (2006-2010), the situation of Fascioliasis in the country has been really alarming with more than 15,764 newly-infected cases; it was noticeable that 93% of these cases concentrated mainly in seven provinces of Central Vietnam, including Binh Dinh, Quang Ngai, Phu Yen, Quang Nam, Khanh Hoa, Da Nang City and Gia Lai, of which over 10,000 cases were detected and treated at the specialist clinic of the IMPE Quy Nhon. The health sector has made an effort to prevent the development of the disease; however, the settlement of this problem requires not o­nly medical treatment for patients but also a model of long-term and sustainable prevention. So far human fascioliasisis no longer a scarce parasitic disease, while the prevalence rate of Fascioliasis in grass-feeding animals (buffalo, cow) in the provinces of central region was very high (50-60%), which creates more and more favourable environment for the disease infection in humans, especially in the areas with habits of eating raw aquatic vegetables like coriander, watercress, persicaria or drinking water infected with the encysted form of the parasite, making difficulties in preventing Fascioliasis in the community.

Fascioliasis situation in the last five years (2006-2010)

Year

Total number of infected cases nationwide

Number of cases detected

in the Central Vietnam

 

Total cases

Rate compared with the whole country

2006

3,838

3,543

92%

2007

2,196

1,862

84%

2008

2,000

1,812

90%

2009

4,500

4,200

92%

2010

3,230

3,097

95%

Total

15,764

14,514

93%

 

Currently, the Fascioliasis infection continues to increase in Central Vietnam; the monthly number of patients who require medical examination and treatment at health facilities is about a few hundred cases, the risk of Fascioliasis infection is not o­nly in the poor but also all the objects in the society.Although Fascioliasis has become a "hot" problem as such, the health education and communication o­n the disease control for the community has been still too poor, resulting in the people's low awareness and weak undestanding in preventing this disease. The activities of disease detection, diagnosis and treatment at the levels of health service have still met lots of difficulties; many grassroots medical facilities have been still confused in diagnosing and treating the disease, they even misdiagnosed Fascioliasis as other diseases, so troubling patients.The studies relating to the epidemiology of human and animal Fascioliasis havenot been implemented yet, especially the reservoirs for transmission, transmission seasons, the natural and social factors which influence the disease as well as the communication model for the control of Fascioliasis remain unanswered.

To contain Fascioliasis, in the past years the IMPE Quy Nhon has made great efforts in detection, diagnosis and treatment of patients at the specialist clinic of the Institute; it also gave advisory ideas to the Ministry of Health (MoH) in issuing "Guidance o­n diagnosis and treatment of human fascioliasis" and asked for MoH's permit in importing the specific drug for Fascioliasis (Triclabendazole 250mg) to solve the shortage of drugs at treatment facilities, carried out many studies o­n evaluating the disease infection and intervention measures, especially looked for international projects (Belgium) to support the long-term prevention program of Fascioliasis in Vietnam.

 
Patients waiting for medical examination at the clinic of the IMPE Quy Nhon.
According to the plan for the next 5 years (2011-2015), the priority was given to the build of a pilot model against Fascioliasis on the district scale in combination with the veterinary branch in prevention activities of Fascioliasis in humans and herbivores; besides, many other activities were also mentioned; for examples carry out the interview o­n knowledge, attitude and practice (KAP survey) in Fascioliasis control, enhance the capacity of medical workers in health care facilities in terms of medical examination, diagnosis and treatment of Fascioliasis in humans and grass-feeding animals (buffalo, cow, sheep, etc.), study the effective messages and channels of communication, manufacture and supply communication materials for health centers, conduct health communication and education o­n Fascioliasis control for the community to reduce the morbidity rates, organize workshops and seminars o­n diagnosis, treatment and prevention of Fascioliasis nationwide and worldwide so as to exchange experiences and propose effective intervention measures, provide specific drugs (Triclabendazole) and equipments for the Fascioliasis prevention at instuitute and provincial levels (ultrasound scan, ELISA, test kit).

Several other emerging helminthiases

In addition to Fascioliasis, some emerging parasitic diseases which are of great interest to the community such as Clonorchiasis, Taeniasis, Strongyloidiasis, Gnathostomiasis, Ascariasis, Necatoriasis, Ancylostomiasis, or larval diseases like Baylisascaris, Cysticercosis, etc. can cause acute symptoms and serious consequences for human health, even leading to more cases of death from complications of these diseases. According to the investigation statistics in Central Vietnam, the helminthiasis situation in this region is quite alarming. Within five years (2005-2010), there were 79,535 patients coming to the Institute's clinic for medical examination and treatment of emerging helminthiases, particularly in 2010 the number of patients was 44,010, accounting for 50% compared to that of previous years, in which 4,908 patients were infected with Toxocariasis (11.15%), 2,640 infected with Strongyloidiasis (6%), 1,941 withGnathostomosis (4.41%), 1,612 with Cysticercosis (3.66%), 882 with amoeba (2 %), etc. Most these patients had acute symptoms and came to the clinic of the Institute for examination and treatment after being unsuccessfully treated at various health facilities in the country.

At the Institute's clinic.

According to the plan for the next 3 years (2011-2013), the Institute will build the research project for the prevention of Fascioliasis and emerging parasitic diseases with the aims of reducing infection rates and the impacts of emerging parasitic diseases, at the same time raising the health staff's capacity in the control of parasitic diseases.
  The Institute also orient the survey and assessment of epidemiological distribution of endemic areas and determine the pathogenic causes for the diseases so as to have grounds for proposing effective control measures. Besides, The IMPE-Quy Nhon continues to hold courses o­n training and transfer of technology to medical staff of all levels who are capable of detection, diagnosis and treatment right from grassroots level.

 

02/16/2011
Translated by Huynh Thi An Khang and Tran Minh Quy  

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