Clonorchis sinensis is the most common fish-borne intestinal parasite in Korea. The aim of the present investigation was to survey the status of C. sinensis infection and analyze associated risk factors in residents of Haman-gun, Gyeongsangnam-do. A total of 5,114 residents from 10 administrative towns/villages voluntarily agreed to participate in the study, which comprised fecal examination, a questionnaire survey for risk factors, ultrasonography, and enzymelinked immunosorbent assay for cancer biomarker detection in the blood. We detected C. sinensis eggs in 5.3% of the subjects. By region, Gunbuk-myeon had the highest number of residents with C. sinensis eggs. The infection rate and intensity were higher in male than in female residents. Based on the risk factor questionnaire, infection was highly associated with drinking, a history of C. sinensis infection, and the practice of eating of raw freshwater fish. Extension of the bile duct, infection intensity, and cancer biomarker detection significantly correlated with the presence of eggs in the study population. In conclusion, the development of feasible, long-term control policies and strategies for the elimination of C. sinensis in Korea is still required.
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The prevalence of fish-borne trematodes (FBT), including Clonorchis sinensis, is still high in riverside areas of the Republic of Korea. The author reviewed the detection and identification methods, differential keys, fish intermediate hosts, and morphological characteristics of FBT metacercariae. FBT metacercariae found in freshwater fish are classified mainly into 4 families, i.e., Opisthorchiidae, Heterophyidae, Echinostomatidae, and Clinostomidae. The metacercariae of C. sinensis, found in 40 species of freshwater fish, are elliptical and 0.15-0.17 × 0.13-0.15 mm in size, have nearly equal sized oral and ventral suckers, brownish pigment granules, and an O-shaped excretory bladder. Their general morphologies are similar to those of Metorchis orientalis (except in the thickness of the cyst wall). Metagonimus spp. (M. yokogawai, M. takahashii, and M. miyatai) metacercariae are subglobular or disc-shaped, and 0.14-0.16 mm in diameter. They have yellow-brownish pigment granules, a ventral sucker deflectively located from median, and a V-shaped excretory bladder. The metacercariae and fish intermediate hosts of Centrocestus armatus, Clinostomum complanatum, and 3 echinostomatid flukes (Echinostoma hortense, E. cinetorchis, and Echinochasmus japonicus) were summarized. FBT metacercariae detected in brackish water fish are mainly members of the Heterophyidae. The morphological characters, identification keys, and fish intermediate hosts of 7 species (Heterophyes nocens, Heterophyopsis continua, Pygidiopsis summa, Stellantchasmus falcatus, Stictodora fuscata, Stictodora lari, and Acanthotrema felis) were also reviewed. The contents treated in this study will provide assistance at the laboratory bench level to those working on recovery of metacercariae from fish hosts and identifying them.
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