Monks: A Population at Risk for Liver Fluke and Skin-Penetrating Helminths
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Study Population
2.3. Sample Size Estimation
2.4. Survey of Parasitic Infection and Data Collection
2.5. The Questionnaire
2.6. Statistical Analysis
3. Results
3.1. Demographic Characteristics
3.2. Prevalence of Parasitic Infection in Monks
3.3. Pre-Monkhood Raw Fish Ingestion and Offering Raw Fish Dishes to Monks Associated with Liver Fluke Infection
3.4. The Forbidden Footwear Rule Assigns a Risk for Skin-Penetrating Helminth Infection to Monks
3.5. Defecating on Ground Soil While Performing Off-Site Work Spread Liver Fluke and Skin-Penetrating Helminths
3.6. Univariate Regression for Opisthorchiasis and Skin-Penetrating Helminth
3.6.1. Opisthorchiasis
3.6.2. Skin-Penetrating Helminth
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | No. of Participants |
---|---|
n (%) | |
Age (n = 511) | |
≤20 | 26 (5.1) |
21–40 | 98 (19.2) |
41–60 | 204 (39.9) |
≥61 | 183 (35.8) |
Ordinate (n = 450) | |
Monkhood ≤ 1 year | 51 (11.3) |
Monkhood > 1 year | 399 (88.7) |
Secular education (n = 476) | |
≤Primary education | 226 (47.5) |
>Primary education | 250 (52.5) |
Dharma education (n = 438) | |
<Dharma scholar advanced level | 206 (47.0) |
Dharma scholar advanced level | 232 (53.0) |
Study area (n = 512) | |
Ubolratana | 58 (11.3) |
Ban Haet | 132 (25.8) |
Ban Phai | 322 (62.9) |
Underlying disease (n = 454) | |
No | 247 (54.4) |
Yes | 207 (45.6) |
Illegal combined drugs (n = 433) | |
No | 394 (91.0) |
Yes | 39 (9.0) |
Smoking (n = 480) | |
No | 196 (40.8) |
Ex- or current smoking | 284 (59.2) |
Alcohol before monkhood (n = 411) | |
No | 196 (47.7) |
Yes | 215 (52.3) |
Education of parasitic infection (n = 404) | |
Never | 216 (53.5) |
Received | 188 (46.5) |
Examination of parasitic infection (n = 467) | |
No | 320 (68.5) |
Yes | 147 (31.5) |
History of parasitic infection (n = 408) | |
No | 307 (75.2) |
Yes | 101 (24.8) |
Anthelmintic drugs per year ≥ 1 time/year (n = 480) | |
No | 134 (27.9) |
Yes | 346 (72.1) |
Offer raw meats to monk (n = 485) | |
No | 98 (20.2) |
Yes | 387 (79.8) |
Raw beef dishes (n = 475) | 327 (68.8) |
Raw fish dishes (n = 475) | 320 (67.4) |
Raw shrimp dishes (n = 447) | 257 (57.5) |
Raw pork dishes (n = 462) | 256 (55.4) |
Parasitic Infection (n = 514) | n | (%) |
---|---|---|
Single infection | 120 | (23.3) |
Multi-infection | 28 | (5.5) |
Total infections | 148 | (28.8) |
Helminth | ||
Opisthorchis viverrini | 57 | (11.1) |
Strongyloides stercoralis | 80 | (15.6) |
Hookworm | 36 | (7.0) |
Taenia spp. | 3 | (0.6) |
Echinostome sp. | 1 | (0.2) |
Minute intestinal flukes | 1 | (0.2) |
Ascaris lumbricoides | 1 | (0.2) |
Protozoa | ||
Giardia lamblia | 4 | (0.8) |
Entamoeba histolytica | 1 | (0.2) |
Isospora belli | 1 | (0.2) |
Entamoeba coli | 3 | (0.6) |
Variables | O. viverrini Negative | O. viverrini Positive | ORcrude (95% CI) | p-Value |
---|---|---|---|---|
n (%) | n (%) | |||
Age (n = 511) | ||||
<40 | 109 (90.1) | 12 (9.9) | 1 | |
≥40 | 345 (88.5) | 45 (11.5) | 1.18 (0.60–2.32) | 0.621 |
Ordinate (n = 450) | ||||
Monkhood ≤ 1 year | 46 (90.2) | 5 (9.8) | 1 | |
Monkhood > 1 year | 354 (88.7) | 45 (11.3) | 1.17 (0.44–3.10) | 0.753 |
Secular education (n = 476) | ||||
≤Primary education | 195 (86.3) | 31 (13.7) | 1 | |
>Primary education | 226 (90.4) | 24 (9.6) | 0.67 (0.38–1.18) | 0.163 |
Underlying disease (n = 454) | ||||
No underlying disease | 219 (88.7) | 28 (11.3) | 1 | |
Other underlying disease | 180 (89.1) | 22 (10.9) | 0.96 (0.53–1.73) | 0.881 |
Chronic kidney disease with other underlying disease | 5 (100) | 0 (0) | – | – |
Alcohol drinking before monkhood (n = 411) | ||||
No | 176 (89.8) | 20 (10.2) | 1 | |
Yes | 188 (87.4) | 27 (12.6) | 1.26 (0.68–2.33) | 0.455 |
Smoking (n = 480) | ||||
No smoking | 175 (89.3) | 21 (10.7) | 1 | |
Ex- or current smoking | 251 (88.4) | 33 (11.6) | 1.1 (0.61–1.96) | 0.758 |
Education about parasitic infection (n = 404) | ||||
Never | 189 (87.5) | 27 (12.5) | 1 | |
Received | 171 (91.0) | 17 (9.0) | 0.67 (0.37–1.32) | 0.268 |
Anthelmintic drugs used ≥ 1 time/year (n = 331) | ||||
No | 67 (88.2) | 9 (11.8) | 1 | |
Yes | 230 (90.2) | 25 (9.8) | 0.81 (0.36–1.81) | 0.608 |
Offered raw fish dish ≥ 1 type (n = 475) | ||||
No | 147 (94.8) | 8 (5.2) | 1 | |
Yes | 271 (84.7) | 49 (15.3) | 3.32 (1.53–7.20) | 0.002 * |
Defecation on ground soil (n = 376) | ||||
No | 199 (87.7) | 28 (12.3) | 1 | |
Yes | 136 (91.3) | 13 (8.7) | 0.68 (0.34–1.36) | 0.274 |
Variables | Skin-Penetrating Helminth Negative | Skin-Penetrating Helminth Positive | ORcrude (95% CI) | p-Value |
---|---|---|---|---|
n (%) | n (%) | |||
Age (n = 511) | ||||
<40 | 114 (94.2) | 7 (5.8) | 1 | |
≥40 | 298 (76.4) | 92 (23.6) | 5.02 (2.26–11.17) | <0.001 * |
Ordinate (n = 450) | ||||
Monkhood ≤ 1 year | 47 (92.2) | 4 (7.8) | 1 | |
Monkhood > 1 year | 312 (78.2) | 87 (21.8) | 3.28 (1.15–9.34) | 0.026 * |
Secular education (n = 476) | ||||
≤Primary education | 166 (73.5) | 60 (26.5) | 1 | |
>Primary education | 218 (872) | 32 (12.8) | 0.41 (0.25–0.65) | <0.001 * |
Underlying disease (n = 454) | ||||
No underlying disease | 207 (83.8) | 40 (16.2) | 1 | |
Other underlying disease | 158 (78.2) | 44 (21.8) | 1.44 (0.90–2.32) | 0.132 |
Chronic kidney disease with other underlying disease | 1 (20) | 4 (80) | 20.7 (2.54–190.1) | 0.007 * |
NSAIDs (n = 433) | ||||
Never use | 288 (81.6) | 65 (18.4) | 1 | |
Using | 60 (75.0) | 20 (25.0) | 1.48 (0.83–2.62) | 0.182 |
Illegal combined drugs (n = 433) | ||||
Never used | 318 (80.7) | 76 (19.3) | 1 | |
Using | 30 (76.9) | 9 (23.1) | 1.25 (0.57–2.75) | 0.571 |
Alcohol drinking before monkhood (n = 411) | ||||
No | 167 (85.2) | 29 (14.8) | 1 | |
Yes | 172 (80.0) | 43 (20.0) | 1.44 (0.86–2.41) | 0.167 |
Smoking (n = 480) | ||||
No smoking | 171 (87.2) | 25 (12.8) | 1 | |
Ex- or current smoking | 219 (77.1) | 65 (22.9) | 2.03 (1.23–3.36) | 0.007 * |
Education of parasitic infection (n = 404) | ||||
Never | 165 (76.4) | 51 (23.6) | 1 | |
Received | 164 (87.2) | 24 (12.8) | 0.47 (0.28–0.80) | 0.006 * |
Anthelmintic drugs used ≥ 1 time/year (n = 331) | ||||
No | 63 (82.9) | 13 (17.1) | 1 | |
Yes | 213 (83.5) | 42 (16.5) | 0.96 (0.48–1.89) | 0.896 |
Wearing shoes outside (except during alms work) (n = 430) | ||||
Do not always wear | 94 (79.0) | 25 (21.0) | 1 | |
Always wear | 253 (81.4) | 58 (18.6) | 0.86 (0.51–1.46) | 0.579 |
Defecation on ground soil (n = 376) | ||||
No | 182 (80.2) | 45 (19.8) | 1 | |
Yes | 119 (79.9) | 30 (20.1) | 1.02 (0.60–1.71) | 0.940 |
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Ekobol, N.; Boonjaraspinyo, S.; Artchayasawat, A.; Boonmars, T. Monks: A Population at Risk for Liver Fluke and Skin-Penetrating Helminths. Trop. Med. Infect. Dis. 2023, 8, 135. https://doi.org/10.3390/tropicalmed8030135
Ekobol N, Boonjaraspinyo S, Artchayasawat A, Boonmars T. Monks: A Population at Risk for Liver Fluke and Skin-Penetrating Helminths. Tropical Medicine and Infectious Disease. 2023; 8(3):135. https://doi.org/10.3390/tropicalmed8030135
Chicago/Turabian StyleEkobol, Nuttapon, Sirintip Boonjaraspinyo, Atchara Artchayasawat, and Thidarut Boonmars. 2023. "Monks: A Population at Risk for Liver Fluke and Skin-Penetrating Helminths" Tropical Medicine and Infectious Disease 8, no. 3: 135. https://doi.org/10.3390/tropicalmed8030135