National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China.
Chinese Center for Tropical Diseases Research, Shanghai, China.
PLoS Negl Trop Dis. 2021 Jan 28;15(1):e0009116. doi: 10.1371/journal.pntd.0009116. eCollection 2021 Jan.
Clonorchis sinensis infection is highly prevalent in Asia. Diverse hepatobiliary morbidity has been documented for C. sinensis infection. This study aimed to assess the association between C. sinensis infection and hepatobiliary morbidity, taking into consideration of the control, confounders and infection intensity. A cross-sectional community survey was implemented in Hengxian county, southeastern China. Helminth infections were detected by fecal examination. Physical examination and abdominal ultrasonography were then conducted. After excluding confounding effects from gender, age and alcohol drinking, quantitative association between C. sinensis infection and hepatobiliary morbidity was assessed, and the effect from infection intensity was also evaluated, through adjusted odds ratio (aOR) and 95% confidence intervals (95% CI). 696 villagers older than 10 years were enrolled. The prevalence and infection intensity of C. sinensis were higher in male, elder people and the individuals consuming alcohol. Light C. sinensis infection was associated with the increase of diarrhoea (aOR: 2.2, 95% CI: 1.1-4.5). C. sinensis infection was associated with the increase of fatty liver (aOR: 2.7, 95% CI: 1.4-5.2), and the effect was similar in different infection intensities. Moderate C. sinensis infection was associated with the increase of gallbladder stone (aOR: 3.0, 95% CI: 1.1-8.6), while moderate and heavy infections with the increase of intrahepatic bile duct dilatation (aOR: 2.2, 95% CI: 1.0-4.9 and aOR: 4.3, 95% CI: 1.9-9.9, respectively). C. sinensis infection had an effect on the development of periductal fibrosis (aOR: 3.2, 95% CI: 2.1-4.9), which showed increasing trend by infection intensity. The length and width of gallbladder in those with C. sinensis infection were enlarged, especially in those over 30 years old. C. sinensis infection is significantly associated with hepatobiliary morbidity. The occurrence of some morbidity was strongly related to the infection intensity. Awareness on harm of clonorchiasis should be raised both for policy-makers and villagers to adopt effective interventions.
华支睾吸虫感染在亚洲高度流行。有多种肝胆疾病已被证明与华支睾吸虫感染有关。本研究旨在评估华支睾吸虫感染与肝胆疾病的关联，同时考虑到控制因素、混杂因素和感染强度。在中国东南部的横县进行了一项横断面社区调查。通过粪便检查检测寄生虫感染。然后进行体格检查和腹部超声检查。在排除了性别、年龄和饮酒的混杂影响后，通过调整后的优势比（aOR）和 95%置信区间（95%CI）来评估华支睾吸虫感染与肝胆疾病发病率之间的定量关联，并评估感染强度的影响。共纳入 696 名年龄大于 10 岁的村民。男性、老年人和饮酒者的华支睾吸虫感染率和感染强度较高。轻度华支睾吸虫感染与腹泻的增加有关（aOR：2.2，95%CI：1.1-4.5）。华支睾吸虫感染与脂肪肝的增加有关（aOR：2.7，95%CI：1.4-5.2），不同感染强度的效果相似。中度华支睾吸虫感染与胆囊结石的增加有关（aOR：3.0，95%CI：1.1-8.6），而中度和重度感染与肝内胆管扩张的增加有关（aOR：2.2，95%CI：1.0-4.9 和 aOR：4.3，95%CI：1.9-9.9）。华支睾吸虫感染对胆管周围纤维化的发展有影响（aOR：3.2，95%CI：2.1-4.9），且感染强度呈上升趋势。感染华支睾吸虫的患者胆囊的长度和宽度增大，尤其是年龄大于 30 岁的患者。华支睾吸虫感染与肝胆疾病发病率显著相关。一些疾病的发生与感染强度密切相关。决策者和村民都应该提高对华支睾吸虫病危害的认识，以便采取有效的干预措施。
