Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, P.O. Box 530021, Nanning, Guangxi, China.
Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, P.O. Box 55414, Minneapolis, USA.
BMC Infect Dis. 2022 Mar 18;22(1):263. doi: 10.1186/s12879-022-07244-2.
Clonorchiasis is a widespread yet neglected foodborne disease with over 85% of all cases found in China. Guangxi province, located in southeastern China, ranks among the highest endemic provinces. We explore the epidemiological status and determinants of Clonorchis sinensis (C. sinensis) infection in humans and freshwater fish in Guangxi, China.
Data on C. sinensis infection in humans from January 2008 to December 2017were extracted from the China Information System for Disease Control and Prevention. An active surveillance of C. sinensis infection in fish was conducted in 2016-2017. County level data including potential environmental, social-economical and behavioral determinants was also collected. Univariate and multivariate logistic regression models were used to explore the determinants of C. sinensis infection in humans and fish. Simple and multiple zero-inflated Poisson regression models were fit to assess the associated factors of clonorchiasis in humans at the county level.
Totally, 4526 C. sinensis cases were reported between 2008 and 2017, with an annual prevalencerate of 0.96/100,000 persons. Of 101 counties in Guangxi, 97 reported at least 1 case. Among 2,098 fish samples, 203 (9.7%) from 70 counties contained C. sinensis. The rate was higher in small fish including Pseudorasbora parva (45.3%), Misgurnus anguillicaudatus (41.2%), Hemicculter leuciclus (34.5%), unclassified small fishes (30.9%), Cyprinidae (20.0%), Cirrhinus molitorella (16.4%), Carassius auratus (13.6%) and Cyprinus carpio (13.3%), while it was lower in fish species that are usually used in preparing raw fish dishes including Ctenopharyngodon idellus (3.6%), Spinibarbus denticulatus (3.7%), Monopterus albus (6.4%), Cyprinus carpio (4.4%), Oreochromis mossambicus (3.3%) and Spualiobarbus Curriculus (6.6%). The C. sinensis infection in fish was only associated with fish species. The estimated human clonorchiasis prevalence at the county level was positively associated with raw fish consumption habits and certain rivers.
Clonorchiasis is highly prevalent in both humans and freshwater fish in Guangxi. Environmental, social-economic and behavioral determinants contribute to the high prevalence as well as the significant differential distribution by county. Regular surveillance should be implemented for clonorchiasis to demonstrate the change in epidemiology and burden, which will benefit the design of interventions.
华支睾吸虫病是一种广泛存在但被忽视的食源性疾病，全球超过 85%的病例在中国发现。位于中国东南部的广西壮族自治区是流行程度最高的疫区之一。我们探索了中国广西人群和淡水鱼中华支睾吸虫（C. sinensis）感染的流行病学状况和决定因素。
从 2008 年 1 月至 2017 年 12 月，从中国疾病预防控制信息系统中提取了人类华支睾吸虫感染的数据。2016-2017 年对鱼类的华支睾吸虫感染进行了主动监测。还收集了包括潜在环境、社会经济和行为决定因素的县级数据。使用单变量和多变量逻辑回归模型探索了人群和鱼类中感染华支睾吸虫的决定因素。使用简单和多重零膨胀泊松回归模型评估了县级人群感染华支睾吸虫的相关因素。
2008 年至 2017 年期间共报告了 4526 例华支睾吸虫病病例，年患病率为 0.96/100000 人。广西壮族自治区 101 个县中，有 97 个县报告了至少 1 例病例。在 2098 个鱼类样本中，来自 70 个县的 203 个（9.7%）样本中含有华支睾吸虫。小鱼类（包括圆口铜鱼、黄颡鱼、白甲鱼、小杂鱼、鲤鱼、鲫、草鱼和鲤鱼）中的检出率较高，分别为 45.3%、41.2%、34.5%、30.9%、20.0%、16.4%、13.6%和 13.3%，而在通常用于制作生鱼片的鱼类中检出率较低，包括草鱼、斑点叉尾鮰、中华鳖、鲤鱼、罗非鱼和团头鲂，分别为 3.6%、3.7%、6.4%、4.4%、3.3%和 6.6%。鱼类中的华支睾吸虫感染仅与鱼类物种有关。县级人群华支睾吸虫病的估计患病率与生鱼片消费习惯和某些河流呈正相关。
广西人群和淡水鱼中的华支睾吸虫病均高度流行。环境、社会经济和行为决定因素是导致高流行率和显著的县级差异分布的原因。应定期开展华支睾吸虫病监测，以展示其流行病学和负担的变化，这将有利于干预措施的设计。
