Prevalence and Factors Affecting the Prevention of Opisthorchis viverrini Infection in Khon Kaen Province, Northeast Thailand

Abstract

BACKGROUNDS: Opisthorchis viverrini is a significant risk factor for bile duct cancer and poses a public health problem in Southeast Asia. In northeastern Thailand, the consumption of raw freshwater fish is a common practice and a cause of O. viverrini infection. This study investigated the factors influencing the consumption of raw freshwater fish. Methods: This analytical cross-sectional study was conducted between September and December 2024, covering areas in Khon Kaen Province with varying prevalences of liver fluke disease. Stratified multistage cluster sampling, proportional to size, was used to select representative participants from different sex and age groups. The eligibility criteria included individuals aged 18 years and older living in Khon Kaen who were interviewed using a structured questionnaire. The questionnaire included sections on sociodemographic characteristics, health beliefs regarding liver fluke disease, preventive behaviors, and knowledge of O. viverrini prevention. Preventive behaviors were defined as avoiding the consumption of 10 types of staple raw freshwater fish. Multiple logistic regression was used to identify potential factors influencing preventive behaviors. RESULTS: Among the 980 participants, 896 (91.4%) reported consuming raw freshwater fish at least once per month. Of these, 299 participants lived in areas with an O. viverrini infection prevalence of ≥3.3%. More than half of the participants were agriculturists (53.2%), 23.7% were daily laborers, and 8.3% were unemployed. Factors independently associated with the prevention behaviors include age ≤ 50 years, with specific groups as follow: 18-30 years (AOR 6.2, 95% CI: 2.7-14.0); age 31-40 years (AOR 2.6, 95% CI: 1.1-6.2); and 51-60 years (AOR 2.9, 95% CI: 1.3-6.2), compared to the older age group ( >60 years); living outside municipality (AOR 1.8, 95% CI: 1.1-2.9); Agriculturist (AOR 5.0, 95% CI: 2.4-14.9), Unemployment/No information (AOR 5.0, 95% CI: 1.6-15.0); Trading/Civil officer/Private sector employee (AOR 4.0, 95% CI: 1.6-10.0), compared to daily laborer; Never or stopped consumed alcohol (AOR 3.4, 95% CI: 1.8-6.3); higher perceived benefit (AOR 2.4, 95% CI: 1.2-4.9); higher perceived severity (AOR 2.6, 95% CI: 1.5-4.3) and higher self-efficacy (AOR 2.9, 95% CI: 1.3-6.7). CONCLUSION: The consumption of raw freshwater fish is common in the northeastern Thai population. Health education campaigns should focus on promoting the benefits of prevention, severity of the infection, and enhancing participants' self-efficacy. Targeting vulnerable groups such as the elderly, residents of municipal areas, and individuals with lower socioeconomic status is strongly recommended.