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Children are key to behavior change to reduce infection

Schoolboy Youngyang was getting weaker day by day. When her symptoms worsened with diarrhea and abdominal pain, her parents took her to a nearby hospital in Guangxi, southeastern China, where the doctor checked her in and treated her.
To confirm his suspicions, the doctor ordered a strange examination. The results confirmed that Yangyang was suffering from a parasitic infection of the liver caused by eating raw fish – a traditional diet that has been developed.
In a growing public health problem in China.

"This practice of eating raw freshwater fish is passed on from generation to generation, especially among the working class which includes farmers, manual workers and fishermen,Dr. Deputy Chief of the Department of Men-Bao Qian said
Control of soil and food borne parasitic diseases, National Institute of Parasitic Diseases, Chinese Centers for Disease Control and Prevention.

An estimated 10 million Chinese people suffer from clonorosis (Chinese liver fluke disease), which is caused by infection Clonorchis sinensis. This parasite is believed to be largely prevalent in the provinces of Guangdong, Guangxi and Heilongjiang.

Behavioral test

In addition to medical treatment, researchers believe that behavior can be altered among young people by providing correct information to trigger changes. A recent school-based behavioral intervention test in southeastern China showed that clonarchis
The loss of eating raw or insufficiently cooked freshwater fish or shrimp can be greatly controlled by informing and educating children.

According to Dr. Xiao-nong Zhou, "Capturing the mechanism for eating raw-freshwater fish is important to formulate a sustainable strategy against clonarchis,"Add That" First we focused
Adults because they are the main population suffering from this disease. We neglected to assess how they develop this particular dietary practice. "

Consistent raw-fish feeding practices, particularly in adult males, often result in reinforcement. Health education should discourage such practices while recognizing the challenges of advocating for change in dietary practice in adult males. Experience from
The area demonstrates a relationship between these eating practices among family members.

Study findings

The study explored raw-freshwater fish feeding practices among families in four major clonoracis em endemic provinces in eastern China. A total of 23 222 students from 15 counties were included as participants and provided data for themselves and for themselves.
mother-father. This practice was found more in families with boys than girls.

Parental habits had a strong influence. The adjusted ratio of students to raw-eating exercises is 10.5 (95% Confidential Interval (95% CI): 9.4–11.7), with fathers practicing, 33.6 (95% CI: 26.3–42.9) with mothers.
Practice and 47.1 (95% CI: 42.0–52.8) with both parents practicing.

Husband-to-wife interaction also occurs due to the wife being more on the husband than the husband.

The belief that they would not eat freshwater fish in the future was younger than girls. This decreasing trust in children was related to raw-eating practice in parents; Children who previously ate raw freshwater fish
It was less likely to believe that they would not eat raw fish in the future.

These results suggest that individuals become accustomed to eating raw freshwater fish due to interracial assimilation from parents and from marriage. These individuals then practice for their children, resulting in continuous practice
And Clonorchisis infection in later generations.

"The findings reveal epidemiological profiles, namely high prevalence in men and adults; The persistence of clonoriasis in East Asia, as well as the difficulty for adult males to abandon the raw-eating practice,"
Dr. Bernadette Abella-Ridder, Team Leader, Veterinary Public Health, Vector Control and Environment Unit, WHO Department of Control of Negative Tropical Diseases. "It also means that early education during childhood will be useful in long-term early term control of clonarchis."

Early behavioral intervention reduces the prevalence of eating raw-freshwater fish in school children.

Researchers then applied a cluster-controlled trial to explore the effectiveness of behavioral interventions targeting schoolchildren in primary schools in southeastern China. Basic survey collected knowledge on transmission and symptoms
clonorchiasis, raw freshwater fish practice and believe that this practice will be discontinued in the future. Extensive educational activities were implemented in a traditional school, and assessment surveys were carried out.
To catch the change in knowledge, practice and belief after 6 and 12 months.

"Application of appropriate education products and education approaches is important,"Said Dr. Qian from the Chinese Control Disease and Prevention Center." We must consider the specific characteristics of children. "

The researchers also designed a cartoon, titled "Life of liver changes," to introduce the story of Youngyang and the doctor who educated him and his classmates. Transmission, symptoms, prevention and control information are shown sequentially,
Real illustrations have been integrated into the cartoon to improve student engagement. Comprehensive education activities were started in the school and disease information bulletin boards were put up in public areas. Cartoon movie was shown
Students were each given an educational brochure, and encouraged to participate in drawing and essay writing competitions on the control and prevention of clonorchiasis.

In the school where the trial took place, the percentage of pupils with knowledge about transmission routes, early symptoms, complications, and carcinogenicity increased from 15.0% to 78.5%, 6.5% to 36.8%, 4.0% to 93.9% and 4.5%. Service
49.4% respectively after 12 months.

Of the 247 students (6.5%), 16 ate raw freshwater fish during the year immediately prior to the baseline survey; This number decreased to 3 (1.2%) after 12 months. The percentage of students who were convinced should stop eating
Future raw freshwater fish were 70.9% at baseline and 97.2% after 12 months.

Dr. Said by Abella-Ridder, "Similar study of other food-borne tremors is needed. "Additionally, strong evidence will promote the control of food-borne tremors and benefit populations in endemic areas."

Other foodborne paroxysmal infection resulting in a higher burden of disease is due to other human liver fluke Opisthorchis vivrini And O. Feline, Which have similar biological and epidemiological features C. Sinensis.

Further studies

Qian MB, Jiang ZH, Zhou CH, Ge T, Wang X, Zhou XN. Familial assimilation in the transmission of raw-freshwater fish-eating practice, which leads to clonoracis. PLoS
Neg Trop Disc. 2020; 14 (4): e0008263. Doi: 10.1371 / journal.pntd.0008263.

MB, Gan XQ, Zhao ZG, Zheng WJ, Li W, Jiang ZH, et al. Effectiveness of health education in improving knowledge, practice, and trust related to clonorchisis in children. Acta
Trop. 2020; 207: 105,436. doi: 10.1016 / j.actatropica.2020.105436.

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