Until recently, the infections of humans with representatives of the genus Oesophagostomum were thought to be rare and of zoonotic origin. In the 19805, it was recognised that intense transmission... Show moreUntil recently, the infections of humans with representatives of the genus Oesophagostomum were thought to be rare and of zoonotic origin. In the 19805, it was recognised that intense transmission associated with the disease was taking place in northern Togo and Ghana. Pathology can be severe and two clinical presentations, called 'Dapaong Tumour' and Multinodular disease', have been described. Lesions can now be efficiently and specifically visualised by ultrasound. The prevalence of infection appeared to be high in many villages, although its distribution was limited and focal. Parasitological diagnosis has been based on the demonstration of third-stage larvae in stool cultures and more recently on PCR. Molecular and epidemiological evidence supports the proposal that Oesophagostomum bifurcum infections of humans in Ghana and Togo represent a distinct genotype from that of non-human primates in the area. Mass treatment, using repeated doses of albendazole rapidly resulted in the effective elimination of human oesophagostomiasis in the affected areas. This review takes a historic perspective on oesophagostomiasis of humans. This chapter discusses how the unexpected success of mass treatment together with aberrant pathogenesis, the severity of pathology in humans and the limited geographic distribution of the parasite all reflect a poor adaptation of the parasite to the human host. Show less
Verweij, J.J.; Canales, M.; Polman, K.; Ziem, J.; Brienen, E.A.T.; Polderman, A.M.; Lieshout, L. van 2010
