目的 分析2022年广西宾阳县人群华支睾吸虫感染特征以及华支睾吸虫病知识、行为与态度及其影响因素，为制定针对性的防治措施提供依据。 方法 2022年，按地理方位将广西宾阳县划分为东、西、南、北、中5个片区，每片区抽取1个乡镇（街道）的1个行政村（社区），每个行政村（社区）整群抽取3周岁以上居民200人为调查对象。收集调查对象粪便，应用改良加藤厚涂片法（一粪两检）检测华支睾吸虫等蠕虫卵。每户完成1份问卷，同时每个村抽取40人开展华支睾吸虫病相关知识、行为及态度个案问卷调查。采用χ²检验或Fisher精确检验比较不同人群华支睾吸虫病知晓情况、食“鱼生”（即生淡水鱼鱼片）行为特征和意愿差异。采用logistic回归模型对不同人群华支睾吸虫感染率、食“鱼生”行为发生率和未来食“鱼生”意愿进行分析。 结果 共粪检1 007人，完成372户家庭问卷调查和202份个案问卷调查，其中175人同时完成了粪便检查和问卷调查。华支睾吸虫总感染率为15.49%（95% CI：13.25%~17.73%），其中思陇镇感染率最高（22.00%；95% CI：15.84%~27.38%）（P < 0.05），男性（26.32%；95% CI：22.27%~30.06%）高于女性（5.07%；95% CI：3.16%~6.97%）（P < 0.05）。不同年龄组人群感染率随年龄增长呈先升后降的趋势，以45~59岁组最高（24.31%；95% CI：19.01%~29.61%）（P < 0.05）。不同文化程度感染率以初中学历最高（23.77%；95% CI：19.89%~27.64%）（P < 0.05）。调查的372户家庭中，制作“鱼生”频次< 1、1~10、11~50和> 50次/年的家庭分别占4.03%（15/372）、21.77%（81/372）、15.06%（56/372）和8.60%（32/372），其中宾州镇制作“鱼生”频次在 1~10次/年的比例最高，为83.64%（46/55）；新圩镇制作“鱼生”频次在11~50和> 50次/年的比例均最高，分别为50.47%（54/107）和29.91%（32/107）（P < 0.05）。家庭曾在外购买过“鱼生”情况，以思陇镇占比最高，为 35.09%（20/57）（P < 0.05）；家庭曾向邻居赠送“鱼生”情况，以宾州镇占比最高，为 51.81%（43/55）（P < 0.05）；家庭曾接受过邻居赠送的“鱼生”情况和家庭日常生活中未做到生熟砧板分开使用情况，均以新圩镇占比最高，分别为99.07%（106/107）和98.08%（102/104）（P < 0.05）。知晓华支睾吸虫病、了解传播途径和危害的占比分别为54.46%（110/202）、50.00%（101/202）、38.12%（77/202），其中男性占比分别为63.00%（63/100）、59.00%（59/100）、46.00%（46/100），均高于女性的46.08%（47/102）、41.18%（42/102）和30.39%（31/102）（P < 0.05），不同人群以古辣镇（92.50%，37/40；92.50%，37/40；90.00%，36/40）、老年人（≥ 60岁）（71.43%，45/63；63.49%，40/63；50.79%，32/63）、汉族（58.29%，102/175；54.29%，95/175；41.14%，72/175）和高中及以上学历人群（87.50%，14/16；81.25%，13/16；62.50%，10/16）较高且其差异均有统计学意义（P < 0.05）。26.73%（54/202）的调查对象报告食用过“鱼生”，思陇镇食“鱼生”占比较高（45.00%，18/40）（P < 0.05），男性食“鱼生”占比（45.00%, 45/100）高于女性（8.82%, 9/102）（P < 0.05）。30~44岁人群食“鱼生”占比最高（42.31%, 11/26）（P < 0.05)。80.69%（163/202）的调查对象表示未来能停止食“鱼生”，其中女性持有未来能停止食“鱼生”意愿的比例（97.06%, 99/102）高于男性（64.00%, 64/100）（P < 0.05）。单因素logistic分析结果显示，华支睾吸虫感染与性别、年龄、知晓华支睾吸虫病情况，以及制作与食“鱼生”频次、“鱼生”获得方式有关（P < 0.05）；食“鱼生”行为与性别、知晓华支睾吸虫病、了解感染途径、制作过“鱼生”、从外面买过“鱼生”、赠送过或接受过“鱼生”有关（P < 0.05）；与未来食“鱼生”态度有关的因素有性别、年龄、粪检阳性、食“鱼生”频次和接受过邻居赠送的“鱼生”（P < 0.05）。多因素logistic回归分析结果显示，食“鱼生”频次在1~5次/年和 > 5次/年人群的华支睾吸虫感染率分别为不食“鱼生”人群的30.01倍（95% CI：7.56~152.04）和81.40倍（95% CI：7.78~287.37），接受过邻居赠送“鱼生”的人群感染率为未接受过人群的15.18倍（95% CI：2.15~123.25）。男性食“鱼生”行为的发生率为女性的17.58倍（95% CI：6.21~61.88）。知晓华支睾吸虫病的人群食“鱼生”行为发生率为不知晓人群的15.75倍（95% CI：1.40~185.99）。食“鱼生”频次在1~5次/年和> 5次/年的人群未来坚持食“鱼生”的可能性分别为不食“鱼生”人群的3.66倍（95% CI：1.85~4.32）和3.55倍（95% CI：1.17~3.03）。 结论 广西宾阳县人群华支睾吸虫感染较重，尤其是成年男性。特殊的食“鱼生”习惯是人群感染的主要原因。需要加强健康教育，改变居民食“鱼生”行为，以可持续性地控制华支睾吸虫病流行。

Objective To investigate the epidemiological characteristics of, and knowledge, attitude, and practice towards Clonorchis sinensis infections in humans in Binyang County, Guangxi in 2022, for providing insights into formulation of targeted control measures. Methods Binyang County in Guangxi was geographically divided into five regions (eastern, western, southern, northern, and central) in 2022, and one township was sampled from each geographical region, followed by one administrative village (community) sampled from each township. Two hundred residents at ages of over 3 years were sampled from each administrative village (community) using a cluster sampling method, and participants’ stool specimens were sampled for detection of C. sinensis eggs using a modified Kato-Katz thick smear method (two smears from one stool sample). One questionnaire survey was performed in each household, and 40 residents were sampled from each village for individual questionnaire surveys on knowledge, attitude, and practice towards clonorchiasis control. The differences in the awareness of clonorchiasis control knowledge, practice towards consumption of raw freshwater fish, and attitude to consume raw freshwater fish were compared among different participants with Chi-square test or Fisher’s exact test. In addition, univariate and multivariate logistic regression models were employed to identify factors affecting the prevalence of C. sinensis infections in humans, practice of consuming raw freshwater fish, and attitude towards consumption of raw freshwater fish in future among participants. Results A total of 1 007 residents received stool examinations, and 372 household questionnaire surveys and 202 individual questionnaire surveys were completed, including 175 individuals completing both stool examinations and questionnaire surveys. The overall prevalence of C. sinensis infections was 15.49% [95% confidential interval (CI): (13.25%, 17.73%)] among participants, with the highest prevalence in Silong Township [22.00%; 95% CI: (15.84%, 27.38%)] (P < 0.05), and the prevalence was higher in males [26.32%; 95% CI: (22.27%, 30.06%)] than females [5.07%; 95% CI: (3.16%, 6.97%)] (P < 0.05). The prevalence of C. sinensis infections in humans raised and then decreased following the increase of ages, with a peak at ages of 45 to 59 years [24.31%; 95% CI: (19.01%, 29.61%)] (P < 0.05), and the highest prevalence was found among participants with an educational level of junior high school [23.77%; 95% CI: (19.89%, 27.64%)] (P < 0.05). Among the 372 households surveyed, the proportions of households preparing raw freshwater fish less than once, once to 10 times, 11 to 50 times and more than 50 times annually were 4.03% (15/372), 21.77% (81/372), 15.06% (56/372) and 8.60% (32/372), respectively. Notably, Binzhou Township recorded the highest proportion of households preparing raw freshwater fish once to 10 times annually (83.64%, 46/55), and Xinxu Township recorded the highest proportion of households preparing raw freshwater fish 11 to 50 times annually (50.47%, 54/107) and more than 50 times annually (29.91%, 32/107), respectively (P < 0.05). The highest proportion of households that had purchased raw freshwater fish from outside was found in Silong Township (35.09%, 20/57) (P < 0.05), and the highest proportion of households that had presented raw freshwater fish to their neighbors was seen in Binzhou Township (51.81%, 43/55) (P < 0.05), while both the highest proportion of households that had received raw freshwater fish from neighbors (99.07%, 106/107) and did not separate raw and cooked chopping boards in daily life (98.08%, 102/104) was found in Xinxu Township (P < 0.05). The awareness of hearing of clonorchiasis, knowing the transmission route of clonorchiasis and knowing the harm of clonorchiasis was 54.46% (110/202), 50.00% (101/202) and 38.12% (77/202) among all participants, with 63.00% (63/100), 59.00% (59/100), and 46.00% (46/100) in males and 46.08% (47/102), 41.18% (42/102), and 30.39% (31/102) in females, respectively (P < 0.05), and the awareness was higher in Gula Township (92.50%, 37/40; 92.50%, 37/40; 90.00%, 36/40), among the elderly at ages of 60 years and older (71.43%, 45/63; 63.49%, 40/63; 50.79%, 32/63), Han ethnic group (58.29%, 102/175; 54.29%, 95/175; 41.14%, 72/175), and participants with an educational level of senior high school and above (87.50%, 14/16; 81.25%, 13/16; 62.50%, 10/16) (P < 0.05). There were 26.73% (54/202) of respondents reporting ingestion of raw freshwater fish, with a higher percentage in Silong Township (45.00%, 18/40) (P < 0.05). The percentage of consuming raw freshwater fish was higher in males (45.00%, 45/100) than females (8.82%, 9/102) (P < 0.05), and the highest proportion of consuming raw freshwater fish was seen among participants at ages of 30 to 44 years (42.31%, 11/26) (P < 0.05). There were 80.69% (163/202) of respondents that were willing to stop consuming raw freshwater fish in future, with a higher proportion in females (97.06%, 99/102) than males (64.00%, 64/100) (P < 0.05). Univariate logistic regression analysis showed that C. sinensis infection was associated with gender, age, awareness of clonorchiasis, frequency of preparing and consuming raw freshwater fish and way of acquiring raw freshwater fish (P < 0.05), and the practice of consuming raw freshwater fish was associated with gender, awareness of clonorchiasis, understanding routes of C. sinensis infection, having experiences of preparing raw freshwater fish, having experiences of purchasing raw freshwater fish from outside, and having experiences of presenting or receiving raw freshwater fish (P < 0.05), while factors affecting the attitude towards consumption of raw freshwater fish in future included gender, age, positive fecal test, frequency of consuming raw freshwater fish, and having experiences of receiving raw freshwater fish from neighbors (P < 0.05). Multivariate logistic regression analysis revealed that the prevalence of C. sinensis infections was 30.01 [95% CI: (7.56, 152.04)] times among respondents consuming raw freshwater fish once to 5 times annually and 81.40 [95% CI: (7.78, 287.37)] times than among those consuming raw freshwater fish more than 5 times annually relative to individuals without ingestion of raw freshwater fish, and the prevalence was 15.18 [95% CI: (2.15, 123.25)] times higher among respondents that had received raw freshwater fish from their neighbors than among those who had not. The proportion of consuming raw freshwater fish was 17.58 [95% CI: (6.21, 61.88)] times in males than females, and the proportion of consuming raw freshwater fish was 15.75 [95% CI: (1.40, 185.99)] times among respondents that knew clonorchiasis than among those who did not, while the percentages of continuing to consume raw freshwater fish were 3.66 [95% CI: (1.85, 4.32)] times among respondents with consumption of raw freshwater fish once to five times annually and 3.55 [95% CI: (1.17, 3.03)] times among those with consumption of raw freshwater fish more than five times annually than among individuals without consumption of raw freshwater fish. Conclusion The prevalence of C. sinensis infection is high in Binyang County, Guangxi, notably among adult males, and the special dietary habit of consuming raw freshwater fish is the major cause of C. sinensis infections among human. Intensified health education and changes of the behavior of consuming raw freshwater fish are required to achieve sustainable clonorchiasis control.