Abstract:

Objective To evaluate assess changes in knowledge, attitude, practice (KAP) towards clonorchiasis and the status of human infection three years after the establishment of a demonstration area for clonorchiasis control in Xinfeng County. Methods In 2016 and 2018, 150 permanent residents aged 3 years or above were cluster sampled in each of the 26 administrative villages in the demonstration area, for fecal examination and questionnaire survey. The questionnaires survey was applied to understand the changes of knowledge, behavior and attitude toward clonorchiasis control among participants. The fecal examination was conducted using the modified Kato-Katz thick smear method (two slide-reading/one sample) to assess the status of Clonorchis siensis infection. The participants in the two-year suvey were included in the analysis, and the comparisons between groups were made with the Chi-square test. Results A total of 1 108 residents participated in the two surveys in 2016 and 2018. The infection rate of Clonorchis sinensis dropped from 22.5% (249/1 108) in 2016 to 9.7% (107/1 108) in 2018 (P < 0.01). The infection rate in males (31.9%, 171/536; 13.6%, 73/536) was higher than that in females (13.6%, 78/572; 5.9%, 34/572) in the two years (P < 0.01). The questionnaire analysis revealed that the awareness rate on the knowledge of clonorchiasis control increased significantly from 4.3% (48/1 108) in 2016 to 25.0% (277/1 108)in 2018 (P < 0.01). The infection rate was higher in the awareness group (35.4%, 17/48; 10.1%, 28/277) than that in the unawareness group (21.9%, 232/1 060; 9.5%,79/831) in both years (P₂₀₁₆ < 0.01, P₂₀₁₈ > 0.05). In 2018, 77.9% (141/181) of raw-fish consumers would refuse to eat raw fish again, and 99.7% (1 105/1 108) would be willing to receive treatment after infection, which was higher than 28.9% (68/235) and 95.6% (1 059/1 108) in 2016 respectively (P < 0.01). The proportion of residents eating raw fish decreased from 21.2% (235/1 108) in 2016 to 16.3% (181/1 108) in 2018 (P < 0.01), and the infection rate in those eating raw fish (61.3%, 144/235; 43.1%, 78/181) was significantly higher than that in those not eating raw fish in both years(12.0%, 105/873; 3.1%, 29/927)(P < 0.01). The deworming coverage increased from 69.9% (174/249) in 2016 to 89.7% (96/107) in 2018 (P < 0.01). The percentage of residents who were unaware of clonorchiasis in both years was 73.2% (811/1 108), and the proportion of residents eating raw fish in both years was 10.3% (114/1 108). Conclusion With the implementation of control measures in the demonstration area, there has been a decrease in the Clonorchis infection rate and increases in the awareness rate of knowledge on clonorchiasis control, as well as the proportions of people showing willingness to give up eating raw fish and to receive treatment after being infected. The proportion of behavior of eating raw fish and the average infection rate were significantly decreased. These findings suggest remarkable achievements in clonorchiasis control.

Key words: Clonorchiasis, Knowledge, attitude and practice, Analysis, Jiangxi Province, Xinfeng County