Foodborne zoonotic trematode infections in Yen Bai, Vietnam: a situational analysis on knowledge, attitude, and practice (KAP) and risk behaviors.

Introduction: Foodborne Zoonotic Trematode Infections (FZTi) are neglected tropical diseases of public health concern in Vietnam. The transmission of FZTi is linked to human behavior patterns. The aims to investigate the knowledge, attitude, and practices regarding FZTi among local people. Methods: A cross-sectional study was conducted using a mixed method, which included a baseline survey and in-depth interviews. 375 participants were interviewed face-to-face in the survey, and 27 participants had the in-depth interviews. Results: The results showed that 36.3% passed the knowledge assessment, 86.7% passed the attitude assessment, and 24% passed the practical assessment. There were differences in average knowledge scores among gender (men higher than women, p = 0.006), ethnicities (Kinh higher than Dao and Tay, p < 0.001), and educational level (higher education, higher knowledge score, p < 0.001). There were differences in the frequency of eating raw fish between men and women (men higher than women, p < 0.001), and in the average practice score between men and women (women higher than men, p = 0.028). Eating raw fish and/or undercooked fish, raw vegetables, and drinking untreated water from Thac Ba lake in Yen Bai province were identified as FZTi risk behaviors. The occurrence of these risky habits can be explained by the lack of knowledge on FZTi, poor economic conditions and typical social features of local people. Conclusion: The current knowledge of local people in regard to safe eating practices is poor. They keep performing unsafe practices, which lead to infection with FZTi; therefore, an integrated control of FZTi is essential.

Insights on foodborne zoonotic trematodes in freshwater snails in North and Central Vietnam.

Foodborne zoonotic trematode (FZT) infections are common neglected tropical diseases in Southeast Asia. Their complicated life cycles involve freshwater snails as intermediate hosts. A cross-sectional study was conducted in Yen Bai and Thanh Hoa provinces in North and Central Vietnam, to investigate the diversity of cercariae of potential FZT and to construct the phylogenetic relationship of trematode cercariae based on the Internal Transcribed Spacer 2 (ITS2) region. Among 17 snail species collected from various habitats, 13 were infected by 10 cercarial groups among which parapleurolophocercous, pleurolophocercous, and echinostome cercariae were of zoonotic importance. The monophyletic tree separated cercarial sequences into different groups following the description of the cercariae families in which Haplorchidae, Opisthorchiidae, Echinochasmidae, and Echinostomatidae are important families of FZT. The overall prevalence was different among snail species and habitats and showed a seasonal trend. Parapleurolophocercous and echinostome cercariae emerged as the most common cercariae in snails in Yen Bai, while monostome, echinostome, and megalura cercariae were most common in Thanh Hoa. Using a molecular approach, we identified Parafossarulus striatulus as the first intermediate snail host of Clonorchis sinensis in Thac Ba Lake. Melanoides tuberculata and Bithynia fuchsiana were we identified preferred intermediate snail hosts of a diverse range of trematode species including intestinal flukes (i.e., Haplorchis pumilio and Echinochasmus japonicus) in Yen Bai and Thanh Hoa, respectively.