title: Raw attitudes, wetland cultures, life-cycles: socio-cultural dynamics relating to Opisthorchis viverrini in the Mekong Basin.
abstract: Opisthorchis viverrini is one of the most common and medically important food-borne parasites in the Lower Mekong area of Southeast Asia. As we learn more about its ecology, pathology and epidemiology we see the need to consider more deeply the socio-cultural dynamics with which food-borne species complexes are associated. This paper argues that the Mekong region is characterized by strong livelihoods and life-style associations within wetland ecosystems, which are inseparable from human eating habits ("raw attitudes"). Within the fish-rice economies of the region there are many long-cherished food cultures based on eating raw, semi-cooked and fermented fish dishes, which are known to lead to opisthorchiasis, and potentially cholangiocarcinoma. This paper examines evidence from northeast Thailand showing that dedicated health outreach campaigns do help to reduce prevalence of opisthorchiasis over time. For disease prevention and health education approaches to be most effective, they must be sensitive to culture, livelihood economics, gender, and age. Further integrative, inter-disciplinary and international research must incorporate the complex dynamics of parasite ecology, human behavior, socio-economics, and public health awareness.
authors.affiliation: Department of Geography, National University of Singapore, 21 Lower Kent Ridge Road, Singapore 119077, Singapore.
authors.forename: Carl
authors.initials: C
authors.lastname: Grundy-Warr
authors.forename: Ross H
authors.initials: RH
authors.lastname: Andrews
authors.forename: Paiboon
authors.initials: P
authors.lastname: Sithithaworn
authors.forename: Trevor N
authors.initials: TN
authors.lastname: Petney
authors.forename: Banchop
authors.initials: B
authors.lastname: Sripa
authors.forename: Luxana
authors.initials: L
authors.lastname: Laithavewat
authors.forename: Alan D
authors.initials: AD
authors.lastname: Ziegler
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D001294:Attitude to Health; D002648:Child; D003530:Cyprinidae / Q000469:parasitology*; D004032:Diet / Q000145:classification / Q000523:psychology; D005260:Female; D005393:Fish Diseases / Q000469:parasitology; D016266:Food Parasitology / Q000193:education; D006266:Health Education; D006801:Humans; D008297:Male; D008541:Mekong Valley / Q000453:epidemiology; D008875:Middle Aged; D009889:Opisthorchiasis / Q000453:epidemiology* / Q000469:parasitology / Q000517:prevention & control*; D009891:Opisthorchis / Q000254:growth & development; D015995:Prevalence; D011634:Public Health; D012621:Seasons; D012737:Sex Factors; D012959:Socioeconomic Factors