Abstract
Liver fluke infection caused by the parasite Opisthorchis viverrini (O. viverrini), a human carcinogen, is endemic in north-eastern Thailand and remains a major health problem. The objectives of the study were to (1) resurvey the prevalence of O. viverrini infection in a field site from the Khon Kaen Cohort Study (in newly recruited subjects as well as previous cohort subjects surveyed in 1992); (2) investigate how subjects' lifestyle habits and their exposure to health promotion initiatives influence changes in prevalence of O. viverrini infection. The prevalence of O. viverrini infection in the cohort subjects (as well as new subjects) was investigated using faecal egg counts. Information on demographic factors, lifestyle and awareness of health promotion initiatives were obtained through questionnaires. O. viverrini infection rates in the same individuals of the cohort were lower in 2006 than in 1992. Also, by studying the period effect, the current 35-44 year olds had a 12.4% (95% CI 3.9% to 20.9%) lower prevalence of O. viverrini infection than the 35-44 year olds in 1992 (24.2% versus 11.8%). Lifestyle choices showed that smoking and alcohol consumption were associated with an increased chance of acquiring O. viverrini infection with adjusted odds ratios of 10.1 (95%CI 2.4-41.6) and 5.3 (95%CI 1.2-23.0), respectively. Our study has demonstrated that although the prevalence of O. viverrini infection over a 14-year period has decreased, unhealthy lifestyle was common with smoking and alcohol consumption being associated with increased chances of infection, emphasising the double burden of disease which developing countries are facing.
Highlights
Opisthorchis viverrini, a trematode parasite which has been classified as a human carcinogen for cholangiocarcinoma (CCA) (Bouvard et al, 2009; IARC, 2012), remains a major global health problem (Andrews et al, 2008; Fürst et al, 2012; Murray et al, 2012)
Our study has demonstrated that the prevalence of O. viverrini infection over a 14-year period has decreased, unhealthy lifestyle was common with smoking and alcohol consumption being associated with increased chances of infection, emphasising the double burden of disease which developing countries are facing
In the present study we investigate the O. viverrini infection status in a group of individuals who had been recruited into a cohort study, (Sriamporn et al, 2005) some 14 years earlier, and examine lifestyle, demographic information and awareness of health promotion initiatives for associations with current as well as the change of O. viverrini infection rates
Summary
Opisthorchis viverrini, a trematode parasite which has been classified as a human carcinogen for cholangiocarcinoma (CCA) (Bouvard et al, 2009; IARC, 2012), remains a major global health problem (Andrews et al, 2008; Fürst et al, 2012; Murray et al, 2012). In the 1990s, the overall prevalence of O. viverrini infection in the north-eastern province of Khon Kaen was 24.5%, ranging from 2.1% to 70.8% in its different districts (Sriamporn et al, 2004). This high prevalence accounts for the extraordinarily high incidence of CCA with age-standardised rates of 93.8 to 317.6 per 100,000 person-years in 1988-1989 (Vatanasapt et al, 1992). Liver fluke infection caused by the parasite Opisthorchis viverrini (O. viverrini), a human carcinogen, is endemic in north-eastern Thailand and remains a major health problem. Conclusions: Our study has demonstrated that the prevalence of O. viverrini infection over a 14-year period has decreased, unhealthy lifestyle was common with smoking and alcohol consumption being associated with increased chances of infection, emphasising the double burden of disease which developing countries are facing
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