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.