Epidemiological characterization of Clonorchis sinensis infection in humans and freshwater fish in Guangxi, China

Yihong Xie, Kaushi S.T. Kanankege, Zhihua Jiang, Shun Liu, Yichao Yang, Xiaoling Wan, Andres M. Perez

Research output: Contribution to journalArticlepeer-review

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish (US)
Article number263
JournalBMC infectious diseases
Volume22
Issue number1
DOIs
StatePublished - Dec 2022

Bibliographical note

Funding Information:
We thank all the local staff members of the CDC in Guangxi for their support in fish sampling and participation in the survey on raw fish consumption habits. This project was partially funded by the University of Minnesota Center for Global Health and Social Responsibility Faculty Travel Awards Program. We thank Assistant Professor Edward McNeil from The Chinese University of Hong Kong for help with the English editing.

Funding Information:
We thank all the local staff members of the CDC in Guangxi for their support in fish sampling and participation in the survey on raw fish consumption habits. This project was partially funded by the University of Minnesota Center for Global Health and Social Responsibility Faculty Travel Awards Program. We thank Assistant Professor Edward McNeil from The Chinese University of Hong Kong for help with the English editing.

Funding Information:
The study was funded by Guangxi Natural Science Foundation (2016GXNSFCA380016). The funders had no role in the study design, data collection, analysis and interpretation of data, decision to publish or preparation of the manuscript. The corresponding author has access to all the data in the study and had final responsibility for the decision to submit for publication.

Publisher Copyright:
© 2022, The Author(s).

Keywords

  • Clonorchiasis
  • Clonorchis sinensis
  • Determinants
  • Epidemiology
  • Animals
  • Clonorchiasis/epidemiology
  • Humans
  • Carps
  • Fresh Water
  • China/epidemiology

PubMed: MeSH publication types

  • Journal Article

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