Association of raw-freshwater fish-eating practice with the infection of Clonorchis sinensis

doi:10.12140/j.issn.1000-7423.2019.03.010

Abstract

Abstract:

Objective To quantitatively evaluate the relationship between the raw-freshwater fish-eating practice and the infection of Clonorchis sinensis. Methods Total 16 counties were enrolled from 4 provinces highly endemic with clonorchiasis (Guangxi, Guangdong, Heilongjiang and Jilin), and 5 villages were selected from each investigated counties as survey sites. Total 200 residents from each site were recruited for the investigation. The fecal samples were collected from each participant and the eggs of C. sinensis in the feces were examined under microscope using Kato-Katz thick smear method, and the information on eating raw freshwater fish among the participants was collected. The linear relationship between the percentage of participants eating raw freshwater fish and the prevalence of C. sinensis infection was analyzed in people living in different counties, with different genders and age. The parameter of coefficient of determination (R²) was determined accordingly. The relative risk (RR) and 95% confidential intervals (95% CI) were calculated for those with raw-freshwater fish-eating practice compared to those without the practice. Subsequently, attributable risk (AR), attributable risk percent (ARP), population attributable risk (PAR) and population attributable risk percent (PARP) were analyzed. Results A total of 16 230 participants from 16 counties were enrolled in this survey. The percentage of participants with practice of eating raw freshwater fish was 26.5% (4 295/1 6230) and the overall prevalence of C. sinensis infection was 10.8% (1 747/1 6230) with a positive linear association between them in investigated counties (R² = 0.44, P < 0.01). The percentage of eating raw freshwater fish was 31.7% (2 687/8 478) in males and 20.7% (1 608/7 752) in females (P < 0.01), while the corresponding prevalence of C. sinensis infection was 13.7% (1 161/8 478) and 7.6% (586/7 752) (P < 0.01). The percentage of eating raw freshwater fish in males aged ≤14, 15-29, 30-44, 45-59 and ≥60 was 1.9%, 19.4%, 40.2%, 44.5% and 36.3%, respectively, positively correlating with the prevalence of C. sinensis infection of 1.5%, 7.5%, 15.1%, 20.8% and 15.4%, correspondingly (R² = 0.96, P < 0.01). The percentage of eating raw freshwater fish in females aged ≤14, 15-29, 30-44, 45-59 and ≥60 was 2.3%, 13.9%, 25.3%, 29.2% and 22.4%, correspondingly, with positive linear association with, the prevalence of C. sinensis infection of 1.2%, 6.1%, 9.0%, 10.4% and 8.0%, respectively(R² = 0.99, P < 0.01). Compared to those without the practice, RR of C. sinensis infection in those with the practice reached 12.9 (95% CI: 11.4-14.7). RR was 11.8 (95% CI: 10.0-14.0) in males and 13.4 (95% CI: 10.9-16.4) in females between eating raw freshwater fishes and the chance of getting infected. RR ranged from 8.2-16.1 in different age groups. Overall, AR for eating raw freshwater fishes and the infection of C. sinensis was 30.9%, ARP was 92.3%, PAR was 8.2%, and PARP was 75.9%. In males, AR was 33.5%, ARP was 91.5%, PAR was 10.6% and PARP was 77.4%, compared to those in female of 26.2%, 92.5%, 5.4% and 72.0%, respectively. AR ranged between 15.6% and 34.0%, ARP between 87.9% and 93.8%, PAR between 0.3% and 12.7%, and PARP between 24.1% and 79.7% in different age groups. Conclusion Raw-freshwater fish-eating practice is seriously associated with the infection of C. sinensis and the difference in raw-freshwater fish-eating practice determines the different distribution of C. sinensis infection in areas and population in these investigated endemic areas.

Key words: Clonorchiasis, Raw-freshwater fish-eating practice, Effect

CLC Number:

R532.23

Men-bao QIAN, Zhi-hua JIANG, Tao GE, Xin WANG, Zhuo-hui DENG, Chang-hai ZHOU, Hui-hui ZHU, Ying-dan CHEN, Xiao-nong ZHOU. Association of raw-freshwater fish-eating practice with the infection of Clonorchis sinensis[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2019, 37(3): 296-301.

Figures/Tables 2

Table 1

Table 2

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调查点 Counties	调查人数 No. examined	生食淡水鱼者比例/% Eating raw freshwater fish/%	华支睾吸虫感染率/% Prevalence of C. sinensis infection/%	相对危险度RR(95% CI)	归因危险度AR/%	归因危险度百分比ARP/%	人群归因危险度PAR/%	人群归因危险度百分比PARP/%
广西Guangxi
宾阳Binyang	1 026	16.9	15.4	4.1(2.8~6.0)	31.5	75.8	5.3	34.5
横县Hengxian	1 000	40.8	7.4	4.9(2.8~8.5)	11.1	79.4	4.5	61.2
靖西Jingxi	1 020	0	0
灵山Lingshan	1 026	5.2	5.0	215.7(58.9~790.4)	88.3	99.5	4.6	91.7
钦南Qinnan	1 110	0	0.7
田阳Tianyang	1 048	36.6	9.8	11.0(6.2~19.6)	21.1	90.9	7.7	78.5
广东Guangdong
龙门Longmeng	955	0.5	0.3	380.0(26.7~5403.4)	39.9	99.7	0.2	66.5
翁源Wengyuan	1 037	1.3	0.8	26.3(4.8~144.7)	14.8	96.2	0.2	24.0
新会Xinhui	1 005	17.9	15.5	2.8(1.9~4.1)	21.0	64.1	3.8	24.3
黑龙江Heilongjiang
桦川Huachuan	1 000	61.4	16.5	103.1(14.4~739.8)	26.5	99.0	16.2	98.4
五常Wuchang	1 000	0	0
依兰Yilan	1 000	11.9	0.2	7.4(0.5~119.2)	0.7	86.5	0.1	43.2
肇源Zhaoyuan	1 003	54.3	7.9	15.8(5.7~43.4)	12.9	93.7	7.0	88.9
吉林Jilin
大安Daan	1 000	52.6	53.7	23.3(10.5~51.7)	94.1	95.7	49.5	92.1
宁江Ningjiang	1 000	48.4	13.1	2.1(1.4~3.1)	9.4	52.6	4.6	34.9
镇赉Zhenlai	1 000	79.1	27.2	11.7(5.1~26.7)	30.8	91.5	24.3	89.4
合计Total	16 230	26.5	10.8	12.9(11.4~14.7)	30.9	92.3	8.2	75.9

性别 Gender	年龄组 Age groups	调查人数 No. examined	生食淡水鱼者比例/% Eating raw freshwater fish/%	华支睾吸虫感染率 /% Prevalence of C. sinensis infection/%	相对危险度RR (95% CI)	归因危险度AR/%	归因危险度百分比ARP/%	人群归因危险度PAR/%	人群归因危险度百分比PARP/%
女 Female	≤14	1 295	2.3	1.2	21.1 (6.7~66.2)	15.9	95.3	0.4	31.8
	15~29	791	13.9	6.1	15.0 (7.7~29.3)	28.9	93.3	4.0	66.1
	30~44	1 583	25.3	9.0	7.3 (4.9~10.7)	21.7	86.2	5.5	61.3
	45~59	2 241	29.2	10.4	13.3 (9.2~19.3)	28.0	92.5	8.2	78.3
	≥60	1 842	22.4	8.0	14.1 (9.2~21.5)	26.5	92.9	6.0	74.6
	小计Subtotal	7 752	20.7	7.6	13.4 (10.9~16.4)	26.2	92.5	5.4	72.0
男 Male	≤14	1 570	1.9	1.5	13.5 (4.7~39.0)	15.4	92.6	0.3	19.3
	15~29	756	19.4	7.5	11.6 (6.2~21.7)	26.1	91.4	5.1	67.3
	30~44	1 713	40.2	15.1	8.6 (6.0~12.4)	28.3	88.4	11.4	75.4
	45~59	2 582	44.5	20.8	9.5 (7.2~12.6)	37.0	89.5	16.4	79.2
	≥60	1 857	36.3	15.4	9.4 (6.7~13.2)	32.0	89.4	11.6	75.3
	小计Subtotal	8 478	31.7	13.7	11.8(10.0~14.0)	33.5	91.5	10.6	77.4
合计 Total	≤14	2 865	2.1	1.4	16.1 (7.5~34.9)	15.6	93.8	0.3	24.1
	15~29	1 547	16.6	6.8	13.2(8.3~20.7)	27.3	92.4	4.5	66.9
	30~44	3 296	33.0	12.1	8.2 (6.4~10.7)	25.9	87.9	8.6	70.5
	45~59	4 823	37.4	16.0	11.5 (9.2~14.4)	34.0	91.3	12.7	79.7
	≥60	3 699	29.4	11.7	11.7 (9.0~15.2)	30.2	91.4	8.9	75.8
	合计Total	16 230	26.5	10.8	12.9 (11.4~14.7)	30.9	92.3	8.2	75.9