Abstract：
Opisthorchis viverrini infection is a pressing health issue in rural Southeast Asia and is associated with the risk of cholangiocarcinoma. Despite control efforts, high infection rates persist, including evidence of reinfection post-treatment. This study aimed to address this public health concern through an integrated One-Health approach in endemic areas in rural Thailand over a 3-year period. The study included data from 3600 participants from Udon Thani Province, Thailand, during the years 2020 to 2022 and involved integrated epidemiological data collection and risk factor analysis to understand the impact of various interventions on disease transmission in the community. The efficacy of interventions was assessed by monitoring the incidence of O. viverrini reinfection in 2021 and 2022. In 2020, 218 cases of O. viverrini infection (6.0%) were identified. Significant risk factors included proximity to water bodies and consumption of raw fish. Variables contributing to infection risk among participants (P < 0.001) were education level, engagement in traditional ceremonies, poor sanitation, absence of ducks in nearby water bodies, self-medication for parasitic conditions, and multiple infections within a household. Dogs, cats, and cyprinoid fish showed prevalence rates of 5.4%, 6.3%, and 11.5%, respectively. Geographic analysis revealed clusters of infected households around water bodies. Interventions, including in-depth interviews, focus-group discussions, health education, anthelminthic treatment, and biological control using local free-range ducks, were implemented, resulting in no human reinfections in the second year and a minimal 0.3% prevalence rate in the third year. This study offers valuable insights into the dynamic changes in infection prevalence, making a significant contribution to effective disease control and community health promotion. This integrated One-Health approach proved to be an effective strategy for the prevention and control of opisthorchiasis.
摘要：
Opisthorchisviverrini感染是东南亚农村地区的一个紧迫的健康问题，并且与胆管癌的风险有关。尽管控制努力，高感染率持续存在，包括治疗后再感染的证据。这项研究旨在通过在3年的时间内在泰国农村流行地区采取综合的“单一健康”方法来解决这一公共卫生问题。该研究包括来自Udon他尼省的3600名参与者的数据，泰国,在2020年至2022年期间，涉及综合流行病学数据收集和危险因素分析，以了解各种干预措施对社区疾病传播的影响。通过监测2021年和2022年O.Viverrini再感染的发生率来评估干预措施的有效性。2020年，确认了218例O.viverrini感染（6.0%）。重要的风险因素包括靠近水体和食用生鱼。影响参与者感染风险的变量（P<0.001）是教育水平，参与传统仪式，卫生条件差,附近的水体中没有鸭子，寄生虫的自我药物治疗，和家庭中的多种感染。狗,猫,鲤鱼的患病率为5.4%，6.3%,11.5%，分别。地理分析显示，水体周围有成群的受感染家庭。干预措施,包括深度访谈,焦点小组讨论,健康教育,驱虫治疗,和使用当地自由放养鸭子的生物防治，实施了，第二年没有人再感染，第三年的患病率最低为0.3%。这项研究为感染流行率的动态变化提供了有价值的见解，为有效的疾病控制和社区健康促进做出重大贡献。这种综合的“一个健康”方法被证明是预防和控制opisthorchiasis的有效策略。
