A 24-week prospective cohort of 612 people in a northeastern Thai endemic community found baseline prevalence of 41.0% by urine antigen versus 8.1% by faecal examination, with roughly tenfold higher incidence and reinfection estimates from the urine assay. Raw-fish consumption in the previous six months carried an adjusted risk ratio of 7.52. Drug treatment alone will not interrupt transmission if behavioural and environmental exposure persists.
Key findings
- Baseline prevalence was 41.0% by urine antigen versus 8.1% by FECT. Urine ELISA estimated incidence at 64.6 and reinfection at 63.7 per 100 person-years, compared with 7.5 and 5.9 by FECT. Raw fish in the prior six months had aRR 7.52 (p
Why this matters globally
Control of opisthorchiasis, linked to cholangiocarcinoma, requires sensitive diagnosis, treatment, reinfection follow-up, food safety and non-stigmatising behaviour change rather than episodic drug campaigns alone.
Thai researcher contribution
The network spans Thai parasitology, cholangiocarcinoma, public health, nursing, veterinary science, government laboratories and primary care, led by Khon Kaen University collaborators. Affiliation errors were corrected: Kasetsart's Sakon Nakhon campus is not Sakon Nakhon Rajabhat University, and Nhonghin Health Promoting Hospital is not Kalasin University.
Limitations to consider
Assay differences may reflect sensitivity, antigen persistence or cross-reactivity and FECT limitations, not two separate truths. Twenty-four weeks is short; diet is self-reported; and previous treatment likely marks repeated exposure rather than causing infection.