Human paragonimiasis in Viet Nam: Epidemiological survey and identification of the responsible species by DNA sequencing of eggs in patients' sputum

Parasitological and sero-epidemiological surveys for human paragonimiasis were conducted in three provinces of Viet Nam. A total of 590 participants from two known endemic areas of human paragonimiasis (Sinho district of Laichau province and Lucyen district of Yenbai province) and from Dakrong district of Quangtri province where we recently found crab hosts heavily infected with Paragonimus westermani metacercariae. By multiple dot-ELISA screening, 28 (12.7%) out of 220 participants in Sinho district of Laichau province and 4 (3.3%) out of 120 participants in Lucyen district of Yenbai province were proven to be antibody-positive against the Paragonimus antigen. None of the 250 sera of the residents in Dakrong, Quangtri province, gave sero-positivity. Among a total of 32 sero-positive patients Paragonimus eggs were found in 6 cases. ITS2 sequences were successfully determined from a single Paragonimus egg from each patient. The results of homology search by BLAST and alignment clearly confirmed that Paragonimus eggs collected from 6 patients were all of Paragonimus heterotremus. The pathogenicity of P. westermani for human paragonimiasis in Viet Nam is still questionable and needs to be explored in the future.

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► A total of 590 participants were examined for Paragonimus infection in Viet Nam.
► Sero-prevalence was 12.7% in Laichau province and 3.3% in Yenbai province.
► Paragonimus eggs were found in 6 among 32 sero-positive cases.
► The eggs from all positive cases were molecularly identified as P. heterotremus.
► In Quangtri province, none of 250 participants were infected with Paragonimus.