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Guangxi province, located in southeastern China, ranks among the highest endemic provinces. We explore the epidemiological status and determinants of <jats:italic>Clonorchis sinensis<\/jats:italic> (<jats:italic>C. sinensis<\/jats:italic>) infection in humans and freshwater fish in Guangxi, China.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Data on <jats:italic>C. sinensis<\/jats:italic> infection in humans from January 2008 to December 2017were extracted from the China Information System for Disease Control and Prevention. An active surveillance of <jats:italic>C. sinensis<\/jats:italic> infection in fish was conducted in 2016\u20132017. County level data including potential environmental, social-economical and behavioral determinants was also collected. Univariate and multivariate logistic regression models were used to explore the determinants of <jats:italic>C. sinensis<\/jats:italic> infection in humans and fish. Simple and multiple zero-inflated Poisson regression models were fit to assess the associated factors of clonorchiasis in humans at the county level.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Totally, 4526 <jats:italic>C. sinensis<\/jats:italic> cases were reported between 2008 and 2017, with an annual prevalencerate of 0.96\/100,000 persons. Of 101 counties in Guangxi, 97 reported at least 1 case. Among 2,098 fish samples, 203 (9.7%) from 70 counties contained <jats:italic>C. sinensis<\/jats:italic>. The rate was higher in small fish including <jats:italic>Pseudorasbora parva<\/jats:italic> (45.3%), <jats:italic>Misgurnus anguillicaudatus<\/jats:italic> (41.2%), <jats:italic>Hemicculter leuciclus<\/jats:italic> (34.5%), unclassified small fishes (30.9%), <jats:italic>Cyprinidae<\/jats:italic> (20.0%)<jats:italic>, Cirrhinus molitorella<\/jats:italic> (16.4%), <jats:italic>Carassius auratus<\/jats:italic> (13.6%) and <jats:italic>Cyprinus carpio<\/jats:italic> (13.3%), while it was lower in fish species that are usually used in preparing raw fish dishes including <jats:italic>Ctenopharyngodon idellus<\/jats:italic> (3.6%)<jats:italic>, Spinibarbus denticulatus<\/jats:italic> (3.7%)<jats:italic>, Monopterus albus<\/jats:italic> (6.4%)<jats:italic>, Cyprinus carpio<\/jats:italic> (4.4%), <jats:italic>Oreochromis mossambicus<\/jats:italic> (3.3%) and <jats:italic>Spualiobarbus Curriculus<\/jats:italic> (6.6%). The <jats:italic>C. sinensis<\/jats:italic> infection in fish was only associated with fish species. The estimated human clonorchiasis prevalence at the county level was positively associated with raw fish consumption habits and certain rivers.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Clonorchiasis is highly prevalent in both humans and freshwater fish in Guangxi. Environmental, social-economic and behavioral determinants contribute to the high prevalence as well as the significant differential distribution by county. Regular surveillance should be implemented for clonorchiasis to demonstrate the change in epidemiology and burden, which will benefit the design of interventions.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-022-07244-2","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T12:04:53Z","timestamp":1647605093000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Epidemiological characterization of Clonorchis sinensis infection in humans and freshwater fish in Guangxi, China"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6734-0777","authenticated-orcid":false,"given":"Yihong","family":"Xie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaushi S. 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The National Health Commission of China determined that the collection of data from fish and humans was a part of continuing public health surveillance of infectious diseases and was thus considered exempt from institutional review board assessment. All data were supplied and analyzed in an anonymous format and without access to personal identifying information.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"263"}}