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@#Abstract: Objective Quantitative assessment of risk factors of clonorchiasis can provide prevention for clonorchiasis. Methods Articles were retrieved in Chinese and English electronic databases from January 1, 2000 to December 31, 2020, including Wanfang Data, CNKI, PubMed, Web of Science, Embase. All studies were screened based on inclusion and exclusion criteria, and the quality of all enrolled literatures was evaluated. The software RevMan version 5.3 was used for Meta-analysis. The heterogeneity, sensitivity and publication bias of all included studies were analyzed. Results A total of 95 articles were retrieved, and 6 were included in this Meta-analysis which were case-control studies. There were 5 articles in Chinese and 1 in English. There was no single literature with a large impact on the results, and the results of this study were relatively stable. There were 1 170 cases of clonorchiasis in total and 1 291 cases in control. Most of the cases were from hospital patients and community residents, and the floating population was small. Meta-analysis showed that there were three independent risk factors: raw or semi-raw fish, raw or semi-raw shrimp, mix raw and cooked cutting boards, with a combined OR (95%CI) of 2.32(1.86, 2.88), 3.99(2.42, 6.58), 2.18(1.51, 3.14), respectively, with low heterogeneity consistent with the results of the total sample study: I2 values for risk factors were 30%, 12%, 27%, respectively. The results of bias tests showed no publication bias (P=0.731, 0.725, 0.334, P>0.05). Conclusions The key risk factors of clonorchiasis are raw or semi-raw fish, raw or semi-raw shrimp, mix raw and cooked cutting boards. Guidance and health education should be strengthened. It is necessary to strengthen the surveillance of clonorchiasis in the floating population, such as traveler, businessman and student.
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Objective To evaluate the effect of information-knowledge-attitude-practice (IKAP) theory-based health education interventions on clonorchiasis control among community residents and primary school students in Torch High-tech Development Zone of Zhongshan City, so as to provide insights into formulation of clonorchiasis control strategies among different types of populations. Methods Residents were randomly sampled from two communities and students from two primary schools using a random cluster sampling method in Torch High-tech Development Zone, Zhongshan City from 2019 to 2021, and health education pertaining to clonorchiasis control was performed based on the IKAP theory. The changes in the awareness of basic clonorchiasis control knowledge and belief, self-reported risk of Clonorchis sinensis infections and dietary behaviors were compared among community residents and primary school students before and after health education interventions. Results The participants included 146 male and 151 female community residents and 158 male and 153 female primary school students, with no significant difference detected in gender distribution (χ2 = 0.16, P > 0.05). The mean awareness of basic clonorchiasis control knowledge increased by 44.71% and 43.28% among primary school students and community residents 6 months following health education, and there were significant differences in the awareness of each item of basic clonorchiasis control knowledge before and after health education (χ2 = 41.53 to 284.44, all P values < 0.05). The proportions of primary school students and community residents thinking very high and high risks of C. sinensis infections increased from 9.35% and 6.71% before health education to 22.15% and 37.75% after health education, but only the difference of the attitudes in community residents achieve statistical significance (χ2 = 92.18, P < 0.05). The frequency of separation of raw and cooked foods with chopping board and knife significantly increased among community residents and primary school students following health education (χ2 = 16.04 to 62.65, all P values < 0.05). The frequency of eating raw freshwater fish (χ2 = 32.85, P < 0.05), fish congee (χ2 = 7.02, P < 0.05) and fish fillet hot pot (χ2 = 4.88, P < 0.05) significantly reduced among primary school students following health education, while only the frequency and proportions of eating raw freshwater fish have significantly reduced in community residents (χ2 = 11.77, P < 0.05). Conclusions Health education interventions based on the IKAP theory are effective to increase the awareness of clonorchiasis control knowledge and improve dietary behaviors associated with C. sinensis infections among community residents and primary school students in Zhongshan City.
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Objective:To explore a fast method to identify and confirm suspected clonorchis sinensis infection.Methods:For suspected clonorchis sinensis infection, the clonorchiasis serum antibody was detected first with ELISA. If the antibody was positive, the fecal examination for eggs was performed. If the fecal examination was negative, duodenal drainage under gastroscopy was recommended to detect eggs from the drainage fluid.Results:A total of 126 patients met the requirements and aged 54.14±13.33 (24- 87). There were 83 cases (65.87%, 83/126) with eggs positive in the drainage fluid, of which 53 cases were male, aged 55.91±11.47 (30-86), and 30 cases female, aged 55.87± 13.85(30-87). There was no significant difference in age between males and females( P>0.05). The time of catheterization (T1) of 126 cases was 3.79 ±1.45 min. The time of drainage (T2) of 126 cases was 31.39 ±14.29 min. There was no significant difference in T1 or T2 between the positive group and the negative group( P>0.05). The detection rates of eggs were 91.57% (76 cases) in intrahepatic bile duct drainage, 81.93% (68 cases) in the bile-cyst juice and 75.90% (63 cases) in the common bile duct fluid. No serious adverse reactions occurred during or after the operation. Conclusion:The detection rate of clonorchiosis sinensis can be effectively improved by the combination of clonorchiasis serum antibody test and gastroscopy-guided duodenal drainage.
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Objective To build a discriminant function of clonorchiasis sinensis using stepwise discriminant analysis, so as to investigate the feasibility of discriminant analysis for clonorchiasis sinensis screening. Methods Ten villages in Mulan County of Harbin City were sampled as the study sites using a cluster random sampling method. The fecal samples were collected from the permanent residents in the study sites and detected for Clonorchis sinensis eggs using the modified Kato-Katz smear technique. A questionnaire of clonorchiasis sinensis was designed. All data were entered into Epidata 3.1, and a discriminant analysis was performed using the software SPSS version 15.0. Variable were screened using the stepwise discriminant analysis, and the discriminant function was built using the Fisher’s discriminant analysis method. The effectiveness of the discriminant function for clonorchiasis sinensis screening was evaluated by comparison with the modified Kato-Katz smear method. Results Eight variables with statistical significance were included to build the discriminant function, including chronic cholecystitis, cholangitis, gender, eating raw fish, abdominal distension, ethnicity, abdominal pain and age, and the correction rate of the discriminant function was 88.75% to identify clonorchiasis sinensis. Conclusions The discriminant function of clonorchiasis sinensis can be rapidly and simply built based on the strong data processing and analysis capability of the SPSS software, which is rapid to screen clonorchiasis sinensis in Harbin City. Such a function has a high discriminant analysis capability, and provides insights into the establishment of rapid screening of clonorchiasis sinensis in other endemic areas.
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Objective To assess the clinical significance of transient elastography (Fibroscan) in detection of clonorchiasis, so as to provide new insights into the assessment of therapeutic efficacy of deworming. Methods The liver stiffness measurement (LSM) values were measured in parasitologically diagnosed clonorchiasis patients using FibroScan before and after deworming, and the patients’age, gender, body mass index (BMI), duration of raw fish consumption and total amount of raw fish consumption were collected for correlation analyses. Results The clonorchiasis patients’age, gender, BMI, duration of raw fish consumption and total amount of raw fish consumption had no associations with pre-treatment LSM values (r/rs = 0.189, 0.073, 0.180; 0.071, –0.098, 0.033; 0.166, 0.309, 0.172; 0.235, 0.247, 0.209; 0.164, 0.277, 0.088; all P values > 0.05). There was a significant difference in the LSM values from the seventh, eighth and ninth intercostal space prior to deworming (F = 3.259, P < 0.05), and no significant difference was detected after deworming (F = 0.851, P > 0.05). The LSM values from the seventh, eighth and ninth intercostal space were significantly lower pre-deworming than post-deworming (t = 6.724, 5.603, 2.884; all P values < 0.05). Conclusion FibroScan is feasible to assess the therapuetic efficacy of deworming in patients with clonorchiasis; however, measurement at various sites affects the LSM value.
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Objective To understand the status and capability of professionals at provincial parasitic diseases control institutions in main clonorchiasis-endemic areas of China. Methods The status and capacity of professionals at four provincial parasitic diseases control institutions were collected using questionnaire surveys, including Guangdong, Guangxi, Heilongjiang and Jilin, and the data were analyzed. Results There were totally 37 professionals working on parasitic diseases control in the four provincial institutions in 2018, including 33 full-time and 4 part-time professionals, and there were 12, 16, 3 and 6 professionals working at Guangdong, Guangxi, Heilongjiang and Jilin provincial institutions, respectively. Of the 37 professionals, there were 24.32%, 37.84% and 37.84% at ages of 35 years and lower, 35 to 45 years, and greater than 45 years. Men consisted of 54.05% of all professionals, and 86.49% had an education of bachelor and above, while 78.38% had a title of moderate or above. Among all professionals, there were 29 responsible for clonorchiasis prevention and control; however, they all participated in the prevention and control of other parasitic diseases; 33 professionals were able to prepare Kato-Katz smears and 34 read the smears; 30 professionals were able to detect metacercaria in fishes, and 24 and 16 professionals were able to perform immunological and mo-lecular tests. In addition, 26 professionals participated in provincial projects, 19 in national projects; however, few professionals participated in international projects or undertook provincial, national or international projects. Furthermore, there were 34 professionals (91.89%) participating in national trainings on parasitic diseases; however, only 12 (32.43%) completed a training for more than one week. Conclusions There are few professionals at provincial parasitic diseases control institutions in main clonorchiasis-endemic areas of China, and they have a relative high capability in parasitic disease control; however, their research capacity is relative weak.
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Objective To understand the status and capability of professionals at provincial parasitic diseases control institutions in main clonorchiasis-endemic areas of China. Methods The status and capacity of professionals at four provincial parasitic diseases control institutions were collected using questionnaire surveys, including Guangdong, Guangxi, Heilongjiang and Jilin, and the data were analyzed. Results There were totally 37 professionals working on parasitic diseases control in the four provincial institutions in 2018, including 33 full-time and 4 part-time professionals, and there were 12, 16, 3 and 6 professionals working at Guangdong, Guangxi, Heilongjiang and Jilin provincial institutions, respectively. Of the 37 professionals, there were 24.32%, 37.84% and 37.84% at ages of 35 years and lower, 35 to 45 years, and greater than 45 years. Men consisted of 54.05% of all professionals, and 86.49% had an education of bachelor and above, while 78.38% had a title of moderate or above. Among all professionals, there were 29 responsible for clonorchiasis prevention and control; however, they all participated in the prevention and control of other parasitic diseases; 33 professionals were able to prepare Kato-Katz smears and 34 read the smears; 30 professionals were able to detect metacercaria in fishes, and 24 and 16 professionals were able to perform immunological and mo-lecular tests. In addition, 26 professionals participated in provincial projects, 19 in national projects; however, few professionals participated in international projects or undertook provincial, national or international projects. Furthermore, there were 34 professionals (91.89%) participating in national trainings on parasitic diseases; however, only 12 (32.43%) completed a training for more than one week. Conclusions There are few professionals at provincial parasitic diseases control institutions in main clonorchiasis-endemic areas of China, and they have a relative high capability in parasitic disease control; however, their research capacity is relative weak.
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Objective To assess the clinical significance of transient elastography (Fibroscan) in detection of clonorchiasis, so as to provide new insights into the assessment of therapeutic efficacy of deworming. Methods The liver stiffness measurement (LSM) values were measured in parasitologically diagnosed clonorchiasis patients using FibroScan before and after deworming, and the patients’age, gender, body mass index (BMI), duration of raw fish consumption and total amount of raw fish consumption were collected for correlation analyses. Results The clonorchiasis patients’age, gender, BMI, duration of raw fish consumption and total amount of raw fish consumption had no associations with pre-treatment LSM values (r/rs = 0.189, 0.073, 0.180; 0.071, –0.098, 0.033; 0.166, 0.309, 0.172; 0.235, 0.247, 0.209; 0.164, 0.277, 0.088; all P values > 0.05). There was a significant difference in the LSM values from the seventh, eighth and ninth intercostal space prior to deworming (F = 3.259, P < 0.05), and no significant difference was detected after deworming (F = 0.851, P > 0.05). The LSM values from the seventh, eighth and ninth intercostal space were significantly lower pre-deworming than post-deworming (t = 6.724, 5.603, 2.884; all P values < 0.05). Conclusion FibroScan is feasible to assess the therapuetic efficacy of deworming in patients with clonorchiasis; however, measurement at various sites affects the LSM value.
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A clonorchiasis case in a captive leopard cat, Prionailurus bengalensis euptilurus, was confirmed by ultrasonographic findings and egg morphologies found in the bile juice sample in the Korea. The leopard cat was introduced from the wild habitat of Gyeongsangnam-do, to Cheongju Zoo in Cheongju-si, Chungcheongbuk-do, Korea in August 2014. Physical examinations were basically performed for quarantine and check-up health. The cat was comparatively good in health except anorexia. The cyst-like bile duct dilation and the increased echogenicity of gall bladder wall and hepatic parenchyma were observed by ultrasonography. Ultrasound-guided needle biopsy was conducted for collecting bile juice and the specimens were observed under light microscope. The numerous small trematode eggs were detected in the bile juice sample of the light microscopy. The eggs were 25–33 (28±3) μm by 18–22 (20±1) μm in size and showed typical characteristics of Clonorchis sinensis egg, i.e., a dominantly developed operculum, shoulder rim and dust-like wrinkles in surface. To treat the liver fluke infection, 20 mg/kg of praziquantel was orally administered only once to the case. Follow-up studies including fecal examinations were conducted during 2 years after treatment. But no more eggs were detected from the case. In the present study, we described the first clonorchiasis case of leopard cat, which was confirmed by ultrasonographic findings and egg morphologies from the bile juice sample in Korea.
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Animals , Cats , Anorexia , Bile , Bile Ducts , Biopsy, Needle , Clonorchiasis , Clonorchis sinensis , Ecosystem , Eggs , Fasciola hepatica , Follow-Up Studies , Korea , Microscopy , Ovum , Panthera , Physical Examination , Praziquantel , Quarantine , Republic of Korea , Shoulder , Ultrasonography , Urinary BladderABSTRACT
Objective To understand the epidemic status of clonorchiasis sinensis in western region of Jilin Province, so as to provide the evidence for formulating the planning and strategy of prevention and control of the disease. Methods In 2017, the areas where the residents had the customs of eating Sashimi were selected as the research areas in the western region of Jilin Province, and according to the cluster sampling, 25 villages in 25 towns (each village per town) of 5 counties in the region were selected as the investigation points. The basic information of crowd was collected by a questionnaire investigation. The Kato-Katz method was used for etiological examinations. The results were analyzed statistically. Results A total of 4 980 people in the 25 villages were investigated, and 1 220 people were infected with Clonorchis sinensis. The average infection rate was 24.50%. There was a significant difference among different counties (cities, districts) in the infection rate of C. sinensis (P < 0.01), and the infection rate in Daan City was the highest (53.82%). In addition, there were significant differences between/among the gender, nation, age, educational level, and occupation in the infection rate (all P values < 0.01). The infection rate of the male was higher than that of the female, the rate of Han was higher than that of other ethnic groups, the rate of the high age group was higher than that of the low age group, the rate of the college degree group was higher than that of the other educational level groups, the rate of the cadre was higher than that of the other occupation groups, and the rate of the group who had vermifuge before the investigation was lower than that of the group who did not have vermifuge. Conclusions The western region of Jilin Province is still the highincidence area of clonorchiasis sinensis. Therefore, the comprehensive control and prevention measures, such as giving vermifuge and health education, should be strengthened in key population and areas in the future.
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Objective To analyze the current drug treatment against clonorchiasis in China, in order to promote the standardization of drug treatment and national deworming for clonorchiasis. Methods All the 10 provinces were enrolled, which reported clonorchiasis in the work report for important helminthiasis in 2016. Then, 20 counties were selected from these 10 provinces. The data on drug treatment including both mass chemotherapy and individual treatment against clonorchiasis were collected and compared. Results All the 10 provinces had no guideline for mass chemotherapy, while only 3 had that for individual treatment against clonorchiasis. Out of 20 counties, only 1 implemented mass chemotherapy. Among these 20 counties, 13 applied praziquantel in individual treatment, while other 7 employed albendazole. In the 12 counties with clear protocol for praziquantel, the total dosage for a man of 60 kg ranged from 3.6 to 18.0 g, the days and times for administration ranged from 1 to 6 and from 3 to 18, respectively. In the 4 counties with clear protocol for albendazole, the total dosage for a man of 60 kg ranged from 0.8 to 8.4 g, the days and times for administration ranged from 2 to 7 and from 2 to 14, respectively. Conclusions Nowadays, the guideline on mass chemotherapy for clonorchiasis is inadequate in China. Although individual treatment is applied in many areas, the protocols vary in drugs, dosage, and days and times for treatment. Thus, the national guideline of mass chemotherapy for clonorchiasis should be established, while the protocols for individual treatment should be standardized.
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Objective To understand the epidemic status of clonorchiasis and awareness of prevention and control knowledge in Xinfeng County of Jiangxi Province, so as to provide the evidences for control measures. Methods The baseline survey was carried out with a clue in vestigation of raw-fish eating behavior in potential endemic areas in 2016.The residents were examined by stool tests. The metacercariae of Clonorchis sinensis in fish, the rediae and cercariae in freshwater mollusk were detected. The feces samples of cats, dogs and pigs were collected and examined by sedimentation technique. Meanwhile, the epidemic factors, health knowledge and behavior were also surveyed. Results The residents in 26 villages had the habit of eating raw freshwater fish, and 19.51% of the respondents had this habit. The average infection rates of the population, Parafossarulus striatulus, freshwater fishes and reservoir hosts were 21.56%, 0, 8.24% and 2.27%, respectively. The infection rate of the population increased with age. There was a significant positive correlation between the behavior and the infection rate of the population (r = 0.88, P < 0.01). Only 11.46% of the respondents knew that eating raw-fish might cause C. sinensis infection, and 5.28% of them knew that C. sinensis was harmful to health. Conclusions Twenty-six villages in five townships were endemic areas of clonorchiasis in Xinfeng County. The permanent solution of prevention and control of clonorchiasis is to strengthen the health education and change the habit of raw-fish eating gradually.
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Objective To analyze the current drug treatment against clonorchiasis in China, in order to promote the standardization of drug treatment and national deworming for clonorchiasis. Methods All the 10 provinces were enrolled, which reported clonorchiasis in the work report for important helminthiasis in 2016. Then, 20 counties were selected from these 10 provinces. The data on drug treatment including both mass chemotherapy and individual treatment against clonorchiasis were collected and compared. Results All the 10 provinces had no guideline for mass chemotherapy, while only 3 had that for individual treatment against clonorchiasis. Out of 20 counties, only 1 implemented mass chemotherapy. Among these 20 counties, 13 applied praziquantel in individual treatment, while other 7 employed albendazole. In the 12 counties with clear protocol for praziquantel, the total dosage for a man of 60 kg ranged from 3.6 to 18.0 g, the days and times for administration ranged from 1 to 6 and from 3 to 18, respectively. In the 4 counties with clear protocol for albendazole, the total dosage for a man of 60 kg ranged from 0.8 to 8.4 g, the days and times for administration ranged from 2 to 7 and from 2 to 14, respectively. Conclusions Nowadays, the guideline on mass chemotherapy for clonorchiasis is inadequate in China. Although individual treatment is applied in many areas, the protocols vary in drugs, dosage, and days and times for treatment. Thus, the national guideline of mass chemotherapy for clonorchiasis should be established, while the protocols for individual treatment should be standardized.
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Objective To understand the epidemic status of clonorchiasis and awareness of prevention and control knowledge in Xinfeng County of Jiangxi Province, so as to provide the evidences for control measures. Methods The baseline survey was carried out with a clue in vestigation of raw-fish eating behavior in potential endemic areas in 2016.The residents were examined by stool tests. The metacercariae of Clonorchis sinensis in fish, the rediae and cercariae in freshwater mollusk were detected. The feces samples of cats, dogs and pigs were collected and examined by sedimentation technique. Meanwhile, the epidemic factors, health knowledge and behavior were also surveyed. Results The residents in 26 villages had the habit of eating raw freshwater fish, and 19.51% of the respondents had this habit. The average infection rates of the population, Parafossarulus striatulus, freshwater fishes and reservoir hosts were 21.56%, 0, 8.24% and 2.27%, respectively. The infection rate of the population increased with age. There was a significant positive correlation between the behavior and the infection rate of the population (r = 0.88, P < 0.01). Only 11.46% of the respondents knew that eating raw-fish might cause C. sinensis infection, and 5.28% of them knew that C. sinensis was harmful to health. Conclusions Twenty-six villages in five townships were endemic areas of clonorchiasis in Xinfeng County. The permanent solution of prevention and control of clonorchiasis is to strengthen the health education and change the habit of raw-fish eating gradually.
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Clonorchiasis is one key food-borne parasitic disease in China.Owing to several years' efforts and preparation,the national clonorchiasis surveillance system in China has been established preliminarily since 2016.In this article,the necessity to establish the national clonorchiasis surveillance system is explained.Then,the structure,content and corresponding methods of the surveillance system are briefly introduced.Key points in the surveillance are summarized and the development of surveillance in future is discussed.Furthermore,the contribution of clonorchiasis surveillance in China to the world is also analyzed.
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Clonorchiasis is one key food-borne parasitic disease in China.Owing to several years' efforts and preparation,the national clonorchiasis surveillance system in China has been established preliminarily since 2016.In this article,the necessity to establish the national clonorchiasis surveillance system is explained.Then,the structure,content and corresponding methods of the surveillance system are briefly introduced.Key points in the surveillance are summarized and the development of surveillance in future is discussed.Furthermore,the contribution of clonorchiasis surveillance in China to the world is also analyzed.
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Cholangiocarcinoma (CCA) is an aggressive cancer arising from epithelial cells of the bile duct. Most patients with CCA have an unresectable tumor at the time of diagnosis. In Western countries, the risk of CCA increases in patients with primary sclerosing cholangitis, whereas liver fluke infection appears to be the major risk factor for CCA in Asian countries. A diagnosis of liver fluke infection often relies on stool samples, including microscopic examination, polymerase chain reaction-based assays, and fluke antigen detection. Tests of serum, saliva and urine samples are also potentially diagnostic. The presence of liver fluke along with exogenous carcinogens magnifies the risk of CCA in people living in endemic areas. The “liver fluke-cholangiocarcinoma” carcinogenesis pathways consist of mechanical damage to the bile duct epithelium, immunopathologic and cellular reactions to the liver fluke's antigens and excretory/secretory products, liver fluke-induced changes in the biliary tract microbiome and the effects of repeated treatment for liver fluke. A vaccine and novel biomarkers are needed for the primary and secondary prevention of CCA in endemic areas. Importantly, climate change exerts an effect on vector-borne parasitic diseases, and awareness of liver fluke should be enhanced in potentially migrated habitat areas.
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Humans , Asian People , Bile Ducts , Biliary Tract Neoplasms , Biliary Tract , Biomarkers , Carcinogenesis , Carcinogens , Cholangiocarcinoma , Cholangitis, Sclerosing , Climate Change , Clonorchiasis , Diagnosis , Ecosystem , Epithelial Cells , Epithelium , Fasciola hepatica , Liver , Microbiota , Opisthorchiasis , Parasitic Diseases , Risk Factors , Saliva , Secondary Prevention , TrematodaABSTRACT
Clonorchis sinensis infection is carcinogenic to human,which results in cholangiocarcinoma,confirmed by the World Health Organization. An investigation in 2005 indicated that the standardized C. sinensis infection rate was 0.58%,with 12490000 infected people estimated in the clonorchiasis endemic areas in China. In the world,80%of C. sinensis infected peo-ple were distributed in China. Diagnostic Criteria for Clonorchiasis(WS309-2009)was compiled by the ex-Ministry of Health of the People's Republic of China and it was issued and implemented in March 13,2009. The Diagnostic Criteria for Clonorchiasis is composed of six chapters,including the Range of Application,Terms and Definitions,Diagnostic Basis,Diagnostic Princi-ple,Diagnostic Standard,and Differential Diagnosis. Three informative appendices(etiology,epidemiology,clinical manifesta-tion;enzyme-linked immunosorbent assay;differential diagnosis)and one normative appendix(laboratory examination)are ap-pended. The Criteria provides the technical reference for diagnosis of clonorchiasis in medical institutions and disease control in-stitutions. Combined with the current epidemic situation of clonorchiasis in China,this paper interprets the main contents of the Diagnostic Criteria for Clonorchiasis(WS309-2009),so as to promote its learning and implementing.
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Objective To understand the status of knowledge awareness rates and influencing factors of clonorchiasis among the residents in 4 counties(cities)of Hunan Province,so as to provide the references for formulating the prevention and control strategy of clonorchiasis in the province. Methods A total of 1224 subjects were selected by the multi-stage cluster sampling method and investigated with questionnaires and face-to-face interviews. Results The clonorchiasis knowledge awareness rates of the residents were 15.67% in Yongzhou City,9.94% in Yueyang City,13.25% in Wangcheng County,and 21.96% in Tongd-ao County,respectively. In the whole province,the clonorchiasis knowledge awareness rates of the residents were 44.67%, 56.43%,60.95%,and 42.46% in the etiology,clinical manifestations,epidemiological characteristics and daily prevention,re-spectively. The logistic regression showed that the influencing factors of clonorchiasis knowledge awareness rates were the daily dining place,whether or not having the medical personnel in the family,the degree of attention to the relevant news reports, and the history of parasitic diseases. Conclusions The level of clonorchiasis than that in other areas,but the overall level of clonorchiasis knowledge awareness of the residents in Hunan Province is not high. Therefore,the relevant authority should strengthen the health education in clonorchiasis prevention knowledge including personal daily food hygienic knowledge. knowl-edge awareness rate of the residents in the west-southern areas of Hunan Province is higher