Abstract
Fish-borne trematodes (FiBT) are an important group of zoonotic parasites negatively affecting human health, mainly in Asia. Most studies on FiBT have applied a cross-sectional design, which provides weaker evidence on potential risk factors for transmission than a cohort study. This cohort study aimed to estimate the incidence and identify associated risk factors for FiBT infection in Vietnam. Between April 2018 and May 2019, two communes in Yen Bai province, a highly endemic area for FiBT, were visited for sampling. Participants with a negative stool result for FiBT at baseline, were invited for follow-up and data collection, at months 4, 9, and 13. Stools were examined using Kato-Katz and formalin-ethyl acetate concentration techniques to detect FiBT eggs, whereas a questionnaire was used for interviewing participants to determine the risk factors for FiBT infection during each follow-up period. The incidence risk and the incidence rate were calculated, and univariate and multivariable models were run to identify the risk factors for FiBT. A total of 194 people, negative for FiBT eggs at the baseline survey, were invited to participate in the study, and 111 people agreed to enroll in the follow-up. The incidence risk at months 4, 9, and 13 was 9.0%, 6.4%, and 5.1%, respectively. We finally used data from 95 participants for the risk factor analysis, excluding 16 people lost for the follow-up. Overall, 20 people became infected with FiBT (IR = 21.1%). The incidence rate of FiBT infection was 21.4/100 person-year. In the univariate analysis, consumption of raw fish was the main risk factor (RR = 4.59, 95%CI = 1.95–10.82), followed by being male (RR = 3.41, 95%CI = 1.56–7.45) and drinking alcohol (RR = 3.25, 95%CI = 1.49–7.11). In the multivariable analysis, only consumption of raw-fish dishes was significantly associated with FiBT infection. The people who consumed raw fish were 3.44 (95%CI = 1.11–10.70) times more at risk of infection with FiBT as compared to individuals who did not consume raw fish. It can be concluded that the FiBT incidence is high in the study area. More awareness campaigns are needed to stop eating raw fish in these areas to reduce FBT infection.
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Data availability
The data that support the findings of this study is available from the corresponding author (Thao Thi Bich Nguyen, nbthaopt88@gmail.com), upon reasonable request.
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Acknowledgements
We also acknowledge the dedication by members of Yen Bai CDC, Yen Binh district health center and two health stations in Phuc An and Vu Linh communes for their strong support.
Funding
This study presents research findings from the “Foodborne zoonotic trematode infections and integrated control in Vietnam—FOODTINC” project, supported by ARES and funded by the Belgian Development Cooperation.
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Thao Thi Bich Nguyen, Dung Trung Do, Pierre Dorny, Olivier Vandenberg: Conceptualization; Thao Thi Bich Nguyen, Veronique Dermauw, Dung Trung Do, Pierre Dorny, Olivier Vandenberg: Methodology; Thao Thi Bich Nguyen, Dung Thuy Le, Hien Thi Thu Nguyen: Investigation & Lab work; Thao Thi Bich Nguyen, Veronique Dermauw: Data analysis; Thao Thi Bich Nguyen: Writing original draft; Hafid Dahma, Dung Thi Bui, Dung Trung Do, Pierre Dorny, Bertrand Losson, Olivier Vandenberg: Writing – review & editing; Dung Trung Do, Pierre Dorny, Olivier Vandenberg: Supervision; Dung Thi Bui, Bertrand Losson, Olivier Vandenberg: Project administration; All the authors read and approved the final version of the manuscript.
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This study was approved by the Science, Technology and Ethics committee of NIMPE (number 113/QD-VSR, January 25th, 2018), Vietnamese Ministry of Health. Prior to the field work, the authorities at the provincial Center for Disease Control (CDC), district health center, and commune health stations were briefed on study objectives and procedures, and permission was obtained to conduct the study. Selected individuals were invited to participate in the cohort study and after explaining the study procedures, to sign a written informed consent. All participants were free to withdraw at any time during the study period. Individuals who tested positive for eggs of any helminth were treated free of charge with anti-helminthic drugs according to the Vietnamese Ministry of Health guidelines.
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Dung Trung Do, Pierre Dorny, and Olivier Vandenberg contributed equally to this work and share senior authorship.
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Nguyen, T.T.B., Dermauw, V., Bui, D.T. et al. Incidence of fish-borne trematode infections and associated factors: results from a cohort study in highly endemic communities in northern Vietnam. Parasitol Res 122, 1415–1425 (2023). https://doi.org/10.1007/s00436-023-07846-y
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DOI: https://doi.org/10.1007/s00436-023-07846-y