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Identifying Helminth Infections via Routine Fecal Parasitological Examinations in Korea

Seung Ho ChoiDepartment of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea

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Changhyun LeeDepartment of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea

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Jong In YangDepartment of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea

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Min-Sun KwakDepartment of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea

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Goh Eun ChungDepartment of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea

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Hae Yeon KangDepartment of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea

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Su Jin ChungDepartment of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea

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Jeong Yoon YimDepartment of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea

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Joo Sung KimDepartment of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea

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We conducted this study to explore the extent of occult helminth infection identified by fecal parasitological examinations or organ-specific examinations such as colonoscopy and abdominal ultrasonography (US) during health checkups. We analyzed 197,422 fecal samples from 99,451 subjects who received health checkups at a single center over 10 years. We found that 3,472 (1.8%) samples from 3,342 (3.4%) subjects tested positive for parasitic ova, including clonorchiasis, metagonimiasis, trichuriasis, ascariasis, trichostrongylosis, taeniasis, and enterobiasis. The detection rate for clonorchiasis was higher in those who were taking their first examination than in those who had been examined previously. The detection rate for clonorchiasis decreased gradually over the 10 years. Only 2.5% of the patients with clonorchiasis showed US or computed tomography (CT) images that were compatible with the disease. Clonorchiasis patients who had abdominal US or CT images that suggested clonorchiasis were older and had lower body mass indices and higher eosinophil counts than did those whose US or CT images did not suggest the disease. We observed worms in 9% of the patients with trichuriasis who had received a colonoscopy. Colonoscopy also uncovered adult worms in 0.03% of subjects who were not identified as having Trichuris trichiura ova in their fecal helminth examinations. In summary, our study shows that occult helminth infection is fairly frequently identified by a variety of methods during health checkups, which suggests that doctors need to make greater effort to identify and treat occult helminth infections in Korea.

Author Notes

Address correspondence to Jong In Yang, Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, 152 Teheran-ro, Gangnam-gu, Seoul 06236, Korea. E-mail: dr1004@snu.ac.kr

Authors’ addresses: Seung Ho Choi, Changhyun Lee, Jong In Yang, Min-Sun Kwak, Goh Eun Chung, Hae Yeon Kang, Su Jin Chung, Jeong Yoon Yim, and Joo Sung Kim, Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea, E-mails: cshmed@snuh.org, mdchlee@gmail.com, dr1004@snu.ac.kr, kms39@snuh.org, 65513@snuh.org, haeykang@gmail.com, medjsj7@hanmail.net, yjy@snuh.org, and jooskim@snu.ac.kr.

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