Impact of Community-Based Health Education and Sanitation Interventions on Opisthorchis viverrini Infection in an Endemic Area of Northeastern Thailand.

Opisthorchis viverrini infection remains a significant public health concern in Southeast Asia, particularly in rural communities of Northeast Thailand, where persistent environmental and behavioral factors sustain transmission. A quasi-experimental study aimed to identify environmental and behavioral risk factors for infection and to evaluate the effectiveness of a community-based intervention program. The intervention program study was conducted over 10 months and comprised three phases: baseline survey' health education intervention program implementation' and follow-up evaluation. The results were analyzed for the prevalence of parasitic infections, and multivariable logistic regression was performed to identify associated factors. The majority of study participants were female (67.94%)' aged 55 to 64 years (48.09%)' and farmers (89.31%). Parasitic infections' especially O. viverrini' substantially decreased during the follow-up period' and independent risk factors predicting infection included lower education' previous infection' raw fish consumption' and pesticide use' according to multivariable logistic regression analysis. This intervention considerably improved knowledge; mean knowledge score increased by 6.29 points (p < 0.001). Analysis of fecal sludge after treatment with the sand-drying system identified S. stercoralis larvae (20 eggs/L) and Taenia spp. eggs (12.4 eggs/g). These findings indicated that, despite treatment, integrated behavioral and environmental interventions can be effective in interrupting parasite transmission in rural endemic settings.