Public Health Measures in Trematode Control in Asia

임한종,Rim, Han-Jong 한국농촌의학.지역보건학회 1988 농촌의학·지역보건 Vol.13 No.1

사람의 흡충류감염(吸蟲類感染)은 대부분(大部分) 열대(熟帶) 및 동부아세아지역(東部亞細亞地域) 여러 국가(國家)에서 발생(發生)한다. 주혈흡충증(住血吸蟲症), 간흡충증(肝吸蟲症), 태국간흡충증(泰國肝吸蟲症), 간흡충증(肝吸蟲症), 요꼬가와흡충증(吸蟲症), 이형이형흡충증(異型異型吸蟲症) 및 폐대흡충증(肺大吸蟲症)등은 어떤 일부(一部) 아세아국가(亞細亞國家)에 있어서 공중보건상(公衆保健上) 중요(重要)한 문제(間題)가 되어 있다. 이와 같은 패류매개성기생충감염(貝類媒介性寄生蟲感染)은 풍토병(風土病)을 일으키고 있다. 사람들의 생활습관은 풍토병을 일으키게될 원인이 될 뿐만 아니라 때로는 그 질병(疾病)을 유행(流行) 전파(傳播)시키는 기본적 요소가 되기도 한다. 주혈흡충을 제외한 흡충류감염은 우리가 중간숙주(中間宿主)을 먹었을때 그곳에 있었던 피낭유충(被囊幼蟲)에 의하여 감염이 이루어 진다. 식물(植物)의 생식(生殖)(간질(肝蛭), 폐대흡충(肺大吸蟲)), 게 및 가재 생식(폐흡충), 민물고기 생식(간흡충, 요꼬가와흡충, 이형이형흡충), 또는 우렁이 생식(극구흡충(棘口吸蟲)), 기타(몇가지 우연적감염(偶然的感染))등은 사람의 흡충류감염의 주 원인이 되는 것이다. 한편 주혈흡충 감염은 요염수원(汚染水源)에 접촉한 피부을 뚫고 들어온 쎌카리아 유충(幼蟲)에 노출되기 때문에 일어난다. 흡충류감염에 대하여 예방과 방어에 관한 공중보건학적 조치는 많다. 이들의 조치중에는 화학요법에 의한 감염원을 감소시키는 것, 패류숙주의 박멸, 만족할만한 위생시설의 비치, 급수시설, 보건교육, 진단기술의 보급, 환경관리 및 개선 등이 포함된다. 그러나 감염자들에 대한 화학요법은 가장 빠르고 효과적인 억제방법인 것으로 나타나고 있다. 흡충류감염을 예방하는데 있어서 가장 중요한 변화는 프라지콴텔과 같은 신약의 개발이었다. 프라지콴텔은 모든 종류의 주혈흡충, 간흡충, 폐흡충 및 여러가지 장내기생 흡충류등 사람의 병원성흡충류에 대한 치료제로서 가장 좋은 특효약이다. 흡충류감염이 중요한 보건문제가 되어 있는 곳에서는 그 예방과 억제책에 있어서 장단기계획(長短期計劃)을 수립하는 것이 좋을 것 같다. 단기는 집단화학요법을 조기에 실시하여야 하고 자기는 "비특이성 기구"로써, 예를들면 위생시설 및 급수시설의 설치, 보건교육등으로 감염을 감소시켜 감염유지 수준이하로 보지(保持)시키는 것이다. 이와같은 억제조치를 착실히 수행하기 위하여 많은일이 있다. 예를 들면 집단참여, 역학적 조사, 약물의 공급, 환경관리, 보건교육, 지역사회관련, 일차보건 진료와의 협조 및 재정후원등에 대하여 검토하고 연구하여야 할 것이다.

경상남도(慶尙南道) 밀양군(密陽郡) 삼랑진읍(三浪津邑)에 있어서의 간흡충(肝吸?) 감염실태조사(感染實態調査)

임한종,주경환,엄기선,박수배,Rim, Han-Jong,Joo, Kyoung-Hwan,Eom, Kee-Seon,Park, Soo-Bae 한국농촌의학지역보건학회 1982 농촌의학·지역보건 Vol.7 No.1

In order to observe the endemic status of Clonrchis sinensis infection in Samrangjin eup, Milyang gun, Kyongsang nam do, a total number of 294 stool specimens were collected from the inhabitants who lived in the basin of the Nakdong river. The specimens were examined by cellophane thick smear technique and Stoll's egg dilution technique during the period from May to June 1983. The epidemiological status was analysed statistically by the regression equation and catalytic curv with the results obtained from this area. The results are as follows : 1) The infestation rate of Clonorchis sinensis in 294 was 49.0%. 2) No remarkable difference was observed between male (52.5%) and female (44.8%). 3) Average E.P.G. by Stoll's egg dilution technique in this area was 9,597. 4) The degree of the intensity of Clonorchis infection by E.P.G. count was distributed as 10.5% in very heavy infection, 14.7% in heavy infection, 47.4% in moderate infection, and 29.3% in light infection. 5) The intensity of endemicity in this area was represented with the regression equation calculated with the cumulative percentages of E.P.G. counts. Regression equation was y=3.40+1.23 log x and Cs. $D._{50}$ was 19.99. 6) The two stage catalytic model was applied and the calculation lead to the equation $y=1296(e^{-0.008t}-e^{-0.035t})$ ; a=0.035 > b=0.008 in this surveyed area. 7) Other helminthic infection rate in this area was 7.1% in A. lumbricoides, 9.5% in T. trichiura and 4.1% in E. vermicularis respectively.

광범위(廣範圍) 구충제(駒蟲劑) Albendazole의 인체연충류감염(人體??類感染)에 대한 구충효과

임한종,주경환,이준상,왕진성,Rim, Han-Jong,Joo, Kyoung-Hwan,Lee, Joon-Sang,Wang, Jin-Sung 한국농촌의학지역보건학회 1984 농촌의학·지역보건 Vol.9 No.1

Albendazole, a new broad spectrum anthelmintic drug, was evaluated for anthelmintic effects in 74 patients with single or mixed infections of Ascaris lumbricoides, Trichuris trichiura. Enterobius vermicularis, Metagonimus yokogawai, Clonorchis sinensis and Taenia spp. Albendazole was administered as a single dose of 400 mg. The cure rate for A. lumbricoides and E. vermicularis was 91.4% and 98.1% respectively at day 30 post-treatment: for T. trichiura it was 51.1% and for M. yakogawai and C. sinensis it was 33.3% and 13.3% respectively. The egg reduction rate at day 30 was 98.5% in A. lumbricoides, 76.5% for T. trichiura : 60.0% for M. yokogawai and 59.6% for C. sinensis However it was not cured in all 5 cases of taeniasis at three months follow-up examination. On the other hand, the various dosages of albendazole were given to the patients infected with C. sinensis and Taenia spp. respectively. The follow-up examinations were carried out at 30 days after treatment in clonorchiasis and at 3 months after treatment in taeniasis. In the results, the recommended dosage of albendazole for clonorchiasis is $3{\times}400mg$ for 3 consecutive days and for taeniasis $2{\times}400mg$ for 3 consecutive days. There were no side effects with the above dosages except only a mild abdominal pain and dizziness in a few patients. Albendazole appears to be more effective than the other available broad spectrum anthelmintic drugs.

지역사회개발(地域社會開發)과 기생충(寄生?)

임한종,Rim, Han-Jong 한국농촌의학지역보건학회 1976 농촌의학·지역보건 Vol.1 No.1

The traditional application of night soil to vegetable gardens and rice paddies results in a most wide spread condition of parasitism, with a variety of helminths found in Korea. In addition to the above fact, the peculiar habit of the consumption of raw vegetables, fish, crustaceans and mammals provides a means of infestations of helminths. During the last sixty years numerous reports were found on the prevalence of helminths amongst the Korean population in different parts of the country, and it was generally recognized that ascariasis, hookworm disease, filariasis, clonorchiasis and paragonimiasis constitute the important helminthic disease in Korea. In practical measures of parasite control activities the main measures are summarized as mass-treatment, night-soil disposal and transmission control. Among the three, the mass-treatment has been commonly applied, however, no reduction of transmission has been obtained by treatment of a population. Therefore, the ultimate eradication of parasites will depend upon the application of comprehensive environmental sanitation measures. The basic environmental measures will be concerned with (a) the safe disposal of human excreta, (b) the provision of adequate and safe water supplies in such a way as to promote a higher standard of personal hygiene in the population, and (c) the prevention of food contamination by faecal material. Additional environmental measures will deal with the improvement of housing and housing hygiene and with general community development. Community development means social and cultural as well as economic development. The control measures on the parasitic endemic diseases, such as clonorchiasis and paragonimiasis are the good examples for community health development in Korea. The control of Clonorchis and Paragonimus infections are theoretically very simple, as the infection can only invade the human body by way of encysted metacercaria which are taken into the body when eating passive intermediate hosts(fishes, crabs and crayfishes). Although prophylactic measures in the case of the infections deal with above merely consist the fishes in cooking or submerging in hot water before eating them, it is exceedingly difficult to carry out such simple measures in face of century old traditions, to which the relatively primitive population clings with great tenacity. There is no one universally applicable method of control. The choice of methods must be dictated by the nature of the environment. the habit and custom of the people. the pattern of transmission and the resources of the country. There must exist a well organized public health infrastructure. Since a control programme is of necessity on a longterm basis and continuity in its implementation is essential. An investigation should be made on the prevalence of the diseases and its relationships to irrigation engineering, freshwater ecology, agricultural methods, hydro-electric schemes, and the development of communities in affected areas. In conclusion, however. the control of clonorchiasis and paragonimiasis in Korea is not an impossible task. A combination of efforts with major emphasis on health education and mass chemotherapy coupled with governmental aid in enforcing legislative public health measures could reduce the diseases. Health education in particular attempts following four things: (a) It supplies a person with enough general knowledge about a disease to make the preventive measures. (b) It makes a person feel sufficiently about the importance of his own health to make him alter his behavior and adopt these preventive measure. (c) It makes him concerned for the health others. (d) It tries to make him feel so strongly about the first three that be supports and even initiates preventive action by the community. Educational efforts should be directed primarily toward school children because it is during the early years that most persons become infected, and also because children are less entrenched

요꼬가와 吸蟲의 성장기간별 蟲體組織內 抗原性 部位

林漢鍾(Han-Jong Rim),金洙鎭(Soo-Jin Kim),梁美京(Me-Gyoung Yang) 대한기생충학열대의학회 1992 The Korean Journal of Parasitology Vol.30 No.4

우리나라의 주요 寄生蟲疾患에 대한 血淸疫學的 調査

林漢鐘(Han-Jong Rim),李駿商(Joon-Sang Lee),朱炅煥(Kyoung-Hwan Joo),鄭明淑(Myung-Sook Chung) 한국농촌의학 지역보건학회 1991 농촌의학·지역보건 Vol.16 No.1

韓國農村의 奇生蟲性人畜共通疾患의 現況과 問題點

林漢鐘(Han-Jong Rim) 한국농촌의학 지역보건학회 1990 농촌의학·지역보건 Vol.15 No.1

江華郡의 肺吸蟲症에 關한 疫學的 調査

林漢鍾(Han-Jong Rim),李駿商(Joon-Sang Lee),鄭漢成(Han-Sung Chung),玄逸(Il Hyun),鄭啓憲(Kye-Hun Jung) 대한기생충학열대의학회 1975 The Korean Journal of Parasitology Vol.13 No.2

Effectiveness of Anthelmintic drugs against Clonorchis sinensis infection of rabbits

Han-Jong Rim(林漢鍾),Dong-Shik Chang(張東植),Il Hyun(玄逸),Sun-Dae Song(宋善大) 대한기생충학열대의학회 1975 The Korean Journal of Parasitology Vol.13 No.2

우리나라에 있어서의 條蟲症 感染現況

林漢鍾(Han-Jong Rim),宋坰元(Kyung-Won Song),朱炅煥(Kyoung-Hwan Joo),李駿商(Joon-Sang Lee),金正俊(Jeong-Joon Kim) 대한기생충학열대의학회 1980 The Korean Journal of Parasitology Vol.18 No.2