UNCOVERING THE PATHOGENIC LANDSCAPE OF HELMINTH (OPISTHORCHIS VIVERRINI) INFECTIONS: THE CONTRIBUTION OF PHYSICAL ENVIRONMENT, SOCIAL ENVIRONMENT, AND HEALTHCARE INTERVENTIONS

Abstract

Extant disease-specific approaches tend to overlook the complex relationships, including the broader environmental and social conditions shaping the pathogenic landscape of diseases. This study uses O. viverrini to examine how a holistic approach can facilitate the understanding of geographical focality of diseases, allowing for issues of re-infection and recalcitrance to control efforts to be addressed. Waterscapes around a reservoir dam construction in Thailand were examined. The impact of the dam and rivers on the intermediate fish host, including fish species and fish infection, and humans’ fish species preferences and fish procurement locations, were determined. The influence of dam construction, socioeconomic factors, and disease control efforts was examined for the causality of human infection. The facilitation of O. viverrini transmission to fish and humans by rice cultivation and associated water use were investigated. Collectively, the main actors and pathways contributing to the pathogenic landscape of O. viverrini infections were uncovered.