Abstract
High-intensity clonorchiasis infection is associated with serious outcomes, including cancer. Understanding the infection intensity of Clonorchis sinensis and its risk factors in local endemic regions could facilitate effective control measures. In a county located in a highly endemic area in Guangxi Province, P. R. China, local residents were randomly enrolled in the study; helminth egg examinations were performed with the Kato-Katz method, and the intensity of infection was identified as mild, moderate or heavy. Knowledge, attitudes, and high-risk behaviours were investigated among those infected with Clonorchis sinensis. A total of 2521 local residents participated in this study, and the Clonorchis sinensis-positive proportion was 28.9% (728 persons). Among the infected persons, the percentages of mild, moderate and heavy infections were 66.2%, 28.4% and 5.4%, respectively. Males experienced a higher proportion of moderate and heavy infections (37.5%) than females (18.1%) (p<0.05). The highest infection proportion among the different levels of infection intensity was identified among persons aged 30–59 years (15.7% for moderate and heavy infections). Among the 509 persons who reported eating raw fish, 302 persons (59.3%) had eaten raw fresh fish for more than 10 years, and 131 (25.7%) persons ate raw fish ≥12 times a year. Multivariate logistic regression revealed that eating raw fish 12–50 times in the last year (adjusted odds ratio [aOR] = 1.74, 95%CI: 1.09–2.80) and eating raw fish >50 times in the last year (aOR = 2.89, 95%CI: 1.20–7.50) were risk factors for high-intensity infections (moderate and heavy). The overall infection proportion was high in the study area, with a large group of residents experiencing high-intensity infections. High frequency of raw fish consumption was associated with high-intensity infections. Intervention strategies targeting people with a high frequency of raw fish consumption should be implemented to reduce the probability of severe consequences.
Highlights
Clonorchis sinensis (C. sinensis), the oriental liver fluke, is an important fish-borne zoonosis
Clonorchiasis, which is caused by Clonorchis sinensis, is one of the most endemic parasite diseases in China
Humans get infected by eating the raw or undercooked freshwater fish that contain the nymphal stage of Clonorchis sinensis
Summary
Clonorchis sinensis (C. sinensis), the oriental liver fluke, is an important fish-borne zoonosis. Adult Clonorchis sinensis, which are located in the livers of various mammals, including humans, produce eggs that are passed into the intestine. Human beings become infected by ingesting raw or undercooked fish that contain the metacercariae of liver flukes [1,2,3,4,5]. The first zone includes south-eastern China and the northern area of Vietnam, and the second zone covers north-eastern China, the Republic of Korea, part of Russia and probably the Democratic People’s Republic of Korea [5]. The conservative estimate of the population infected with C. sinensis reached 15 million in 2004 globally, with over 85% of the estimated population in China [5]. According to the results of three large-scale surveys of clonorchiasis carried out in mainland China, the prevalence of clonorchiasis increased from 0.37% between 1988 and 1992 to 0.58% between 2002 and 2004, which indicated that the population infected with clonorchiasis increased from 4.70 million to 12.49 million people [8,9,10]
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