Abstract
Raw or undercooked freshwater fish consumption contributes to persistent Opisthorchis viverrini infection in Northeast Thailand. This study aims to assess the relationship between misconceptions, unhealthy eating habits, and O. viverrini infection. Data were obtained from the Cholangiocarcinoma Screening and Care Program in Northeast Thailand from 2019 to 2021. Participants were screened for O. viverrini annually over the following 2 years using the Kato-Katz technique. Misconceptions and unhealthy eating habits were assessed through questionnaires. The relationship between these factors and O. viverrini infection was evaluated using adjusted risk ratios (ARRs) and 95% confidence intervals (CIs) from generalized estimating equations under binomial regression framework. Of 5375 participants screened for O. viverrini over 3 years, infection rates were 21.53%, 10.7%, and 4.6% each year, respectively. Out of those, 636 participants responded to questions regarding misconceptions. Results showed that participants who believed in the efficacy of putting lime or red ants in Koi pla (raw fish salad) or eating Koi pla with white whiskey to kill parasites, and early-stage cholangiocarcinoma can be cured, were 41% (ARR, 1.41; 95% CI, 1.03–1.94) and 57% (ARR, 1.57; 95% CI, 1.06–2.33), respectively, more likely to be infected with O. viverrini. Our study confirms that belief in using lime or red ants in Koi pla or eating Koi pla with white whiskey to make it cooked, or early-stage cholangiocarcinoma can be cured, increases O. viverrini infection risk in high-risk populations. Changing health beliefs and eating habits is necessary to reduce O. viverrini infection and its risk to cholangiocarcinoma.
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The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
The authors are truly thankful for all members of CASCAP, particularly the cohort members and staff from all participating institutions including the Ministry of Public Health, Ministry of Interior, and Ministry of Education of Thailand. This research was supported by National Science, Research and Innovation Fund (NSRF) under the Basic Research Fund of Khon Kaen University through Cholangiocarcinoma Research Institute. Additional support was also granted by the Fundamental Fund of Khon Kaen University, Thailand Science Research and Innovation (TSRI), Thailand, with Project ID 161735.
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JS, ATS, and KT initiated the idea, and provided constructive criticism and edited of the drafts of the manuscripts. JS, and KT performed data management and data quality assurance, data analysis, and wrote all statistical methods and the results sections of the manuscript. JS, ATS, KS, MK, and KT initiated the idea, provided feedback, and edited the drafts of the manuscript. All authors have seen and approved the final version of the manuscript.
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The research protocol was approved by Khon Kaen University Ethics Committee for Human Research, reference number HE651362. The data were provided from the Cholangiocarcinoma Screening and Care Program (CASCAP). The CASCAP data collection was conducted according to the principles of Good Clinical Practice, the Declaration of Helsinki, and national laws and regulations about clinical studies. It was approved by the Khon Kaen University Ethics Committee for Human Research under the reference number HE551404.
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Sornpom, J., Suwannatrai, A.T., Suwannatrai, K. et al. Influence of misconceptions and inappropriate eating behaviors on Opisthorchis viverrini infection among at-risk populations undergoing cholangiocarcinoma screening in Northeastern Thailand. Parasitol Res 122, 3131–3138 (2023). https://doi.org/10.1007/s00436-023-08003-1
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DOI: https://doi.org/10.1007/s00436-023-08003-1