title: Reinfection by Opisthorchis Viverrini after Treatment with Praziquantel.
abstract: BACKGROUND
  The prevalence of infection by the liver fluke, Opisthorchis viverrini (O. viverrini), has remained high in Northeast Thailand where it is a major risk factor for the eventual development of cholangiocarcinoma (CCA). The infection is acquired by the consumption of dishes containing unsafely prepared freshwater fish, a dietary tradition which has proved resistant to change. Since many people are aware that dosing with praziquantel (PZQ) is a successful treatment for an episode of the infection, there is a risk that, to avoid the long term consequences, they will engage in a cycle of infection, dosing and reinfection.
  
  
  OBJECTIVE
  There is a dearth of studies of reinfection by O. viverrini, and the aims of this study were to assess re-infection rates in a typical province of Northeastern Thailand where O. viverrini infection is likely and to investigate factors associated with reinfection.
  
  
  METHODS
  A total of infected 607 villagers were treated with PZQ, and those found to be no longer infected were followed up at six-monthly intervals over 12 months.
  
  
  RESULTS
  At the end of this period data on 457 subjects were available for analysis using descriptive statistics and logistic regression, and 50 were found to have become reinfected, giving a cumulative reinfection rate of 10.9%. The results of a multiple logistic regression analysis showed that the only factor found to be associated with reinfection was past use of PZQ.
  
  
  CONCLUSIONS
  Recommendations are made for future larger scale and better designed reinfection studies in the light of limitations of the current study. Further efforts are needed to discourage people from eating fish dishes likely to contain viable metacariae.
authors.affiliation: Yasothon Provincial Health Office, Yasothon Province, Yasothon, Thailand E-mail : supannee@kku.ac.th.
authors.forename: Phubet
authors.initials: P
authors.lastname: Saengsawang
authors.forename: Supannee
authors.initials: S
authors.lastname: Promthet
authors.forename: Peter
authors.initials: P
authors.lastname: Bradshaw
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D000871:Anthelmintics / Q000009:adverse effects*; D001650:Bile Duct Neoplasms / Q000188:drug therapy* / Q000469:parasitology; D001653:Bile Ducts, Intrahepatic / Q000187:drug effects* / Q000469:parasitology; D018281:Cholangiocarcinoma / Q000188:drug therapy* / Q000469:parasitology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009889:Opisthorchiasis / Q000139:chemically induced* / Q000453:epidemiology / Q000469:parasitology*; D009891:Opisthorchis / Q000472:pathogenicity*; D011223:Praziquantel / Q000009:adverse effects*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D011223:Praziquantel