Prospects and Challenges towards Sustainable Liver Fluke Control

Area of Science:

• Tropical medicine
• Parasitology
• Public health

Background:

• Opisthorchis viverrini (Ov) infection is endemic in Southeast Asia, affecting over 10 million people.
• Ov infection is a significant risk factor for hepatobiliary diseases, notably cholangiocarcinoma (CCA).
• Northeast Thailand is a high-prevalence area for Ov transmission, despite ongoing public health interventions.

Purpose of the Study:

• To review the current understanding of social-ecological factors driving Ov transmission.
• To propose an integrated research approach for effective liver fluke control.
• To align liver fluke control strategies with sustainable health development goals.

Main Methods:

• Literature review of social-ecological determinants of Ov transmission.
• Analysis of cultural and ecological factors contributing to high infection rates.
• Synthesis of existing knowledge to inform control strategies.

Main Results:

• High Ov infection rates are linked to a combination of wet-rice agriculture, traditional raw-food consumption, and parasite biology.
• Existing public health campaigns have not fully mitigated transmission due to these complex factors.
• A comprehensive understanding of social-ecological systems is crucial for successful intervention.

Conclusions:

• Effective control of Opisthorchis viverrini requires addressing multifaceted social and ecological determinants.
• An integrated research framework is needed to develop sustainable liver fluke control programs.
• Future strategies must consider local cultural practices and environmental contexts for public health improvement.