Abstract
Paragonimus spp. are zoonotic trematodes endemic in several Asian countries, often mimicking pulmonary tuberculosis (TB) due to overlapping clinical manifestations. Although Indonesia’s geographical proximity to endemic countries and shared culinary practices may increase exposure risk, human paragonimiasis has not been reported since a 1963 case in a Sumatran tiger. This study represents the first molecular screening for human paragonimiasis in Indonesia, aiming to investigate Paragonimus DNA and eggs in sputum samples of pulmonary TB patients. This study addresses infectious disease epidemiology and prevention through molecular surveillance. A cross-sectional study was conducted involving 60 sputum samples from TB patients in South Jakarta. Microscopy examination using Ziehl– Neelsen staining and the NaOH concentration method confirmed Mycobacterium tuberculosis in all samples, with no Paragonimus eggs observed. DNA extracted was performed using a commercial kit and DNA quality was assessed via agarose gel electrophoresis. Positive and negative controls were included to verify assay performance. None of the clinical DNA extracts showed visible Paragonimus-specific bands (~221 bp), and therefore PCR amplification was not performed. Although Paragonimus was not detected, this does not definitely exclude its presence. Using the zero-case prevalence concept with a 95% confidence level, the findings suggest a prevalence of less than one percent in the study population. Our findings underscore the importance of maintaining diagnostic vigilance for neglected parasitic infections in Indonesia, provide evidence to guide prevention strategies, enhance epidemiological monitoring for zoonotic diseases in TB-endemic areas, supporting the urgency of updating national parasitological surveillance policies and strengthening One Health-based disease monitoring.
Keywords: Molecular, Neglected Tropical Disease, One Health Paragonimiasis, Tuberculosis.