Raw Fish Consuming Behavior Related to Liver Fluke Infection among Populations at Risk of Cholangiocarcinoma in Nakhon Ratchasima Province, Thailand

Abstract

Opisthorchiasis is a health problem in rural communities of Thailand, particularly in the northeast and north regions. Therefore, this study aimed to investigate raw fish consuming behavior related to liver fluke infection among the population at risk for opisthorchiasis and cholangiocarcinoma (CCA). A cross-sectional descriptive study was conducted in Meuang Yang district, Nakhon Ratchasima province, northeast Thailand, between June and October 2015. Participants were screened for CCA, and samples who had a high score of CCA risk were purposively selected. A predesigned questionnaire was utilized to collect the data from all participants. X2-test was used for analysis of associations between demographic data and raw fish consumption. The results revealed that participants had past histories of stool examination (33.0%), liver fluke infection (21.0%), praziquantel use (24.0%), raw fish consumption (78.0%), relatives family consuming raw fish (73.0%), and relatives family with CCA (3.0%). Participants consumed several dished related to liver fluke infection, mainly raw fermented fish (13.0%), under smoked catfish (5.00%), raw pickled fish (4.00%), and raw spicy minced fish salad (3.00%). The most common types of cyprinoid fish were <em>Barbodes gonionotus </em>(39%), <em>Hampala dispar </em>(38%), <em>Puntius brevis </em>(37%), <em>Cyclocheilichthys armatus </em>(33%), <em>Puntioplites proctozysron </em>(32%), and <em>Luciosoma bleekeri </em>(30%), respectively. Participants had a low level of knowledge (mean=3.79, SD=0.74), moderate attitude (mean=7.31, SD=7.31) and practice (mean=38.64, SD=6.95) regarding liver fluke prevention and control. Demographic variables like age (>36 years old; X2-test=17.794, p-value=0.001), education (primary school; X2-test=18.952, p-value=0.001), marital status (married; X2-test=12.399, p-value=0.002), and income (<5,000 baht; X2-test=27.757, p-value=0.015) were significantly associated with raw fish consumption. This result indicates that the population had risk consumption for liver fluke infection particularly of various cyprinoid fishes that are 2nd intermediate hosts. Therefore, health education is required to improve their behavior.