{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:19:23Z","timestamp":1783523963577,"version":"3.55.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0010429","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T00:00:00Z","timestamp":1654214400000}}],"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T00:00:00Z","timestamp":1653264000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82073665"],"award-info":[{"award-number":["82073665"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2022A1515010042"],"award-info":[{"award-number":["2022A1515010042"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012151","name":"Sanming Project of Medicine in Shenzhen","doi-asserted-by":"publisher","award":["SZSM201803061"],"award-info":[{"award-number":["SZSM201803061"]}],"id":[{"id":"10.13039\/501100012151","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Clonorchiasis is an important food-borne parasitic disease caused by <jats:italic>Clonorchis sinensis<\/jats:italic> infection. The evaluation of long-term cost-effectiveness of control strategies is important for disease control and prevention. The present study aimed to assess the cost-effectiveness of the three recommended strategies (i.e., WHO, Chinese and Guangdong strategies) and different combinations of commonly used measures (i.e., preventive chemotherapy, information, education, and communication (IEC) and environmental improvement) on clonorchiasis. The study area, Fusha town in Guangdong Province, was a typical high endemic area in China. The analysis was based on a multi-group transmission model of <jats:italic>C<\/jats:italic>. <jats:italic>sinensis<\/jats:italic> infection. We set the intervention duration for 10 years and post-intervention period for 50 years. The corresponding costs and DALYs were estimated. Strategies with incremental cost-effectiveness ratios (ICERs) less than 1\/5 of the willingness-to-pay threshold were identified as highly cost-effective strategies. The optimal control strategy was obtained using the next best comparator method. The ICERs of Guangdong strategy were $172 (95% <jats:italic>CI<\/jats:italic>: $143-$230) US for praziquantel and $106 (95% <jats:italic>CI<\/jats:italic>: $85-$143) US for albendazole, suggesting the highest cost-effectiveness among the three recommended strategies. For praziquantel, 470 sets of control strategies were identified as highly cost-effective strategies for achieving infection control (prevalence&lt;5%). The optimal strategy consisted of chemotherapy targeted on at-risk population, IEC and environmental improvement, with coverages all being 100%, and with the ICER of $202 (95% <jats:italic>CI<\/jats:italic>: $168-$271) US. The results for transmission control (prevalence&lt;1%) and albendazole were obtained with the same procedures. The findings may help to develop control policies for <jats:italic>C<\/jats:italic>. <jats:italic>sinensis<\/jats:italic> infection in high endemic areas. Moreover, the method adopted is applicable for assessment of optimal strategies in other endemic areas.<\/jats:p>","DOI":"10.1371\/journal.pntd.0010429","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T17:54:01Z","timestamp":1653328441000},"page":"e0010429","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Cost-effectiveness evaluation of different control strategies for Clonorchis sinensis infection in a high endemic area of China: A modelling study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7350-9703","authenticated-orcid":true,"given":"Yun-Ting","family":"He","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Hong","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue-Yi","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing-Sheng","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lai-De","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4324-5465","authenticated-orcid":true,"given":"Ying-Si","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,5,23]]},"reference":[{"issue":"1","key":"pntd.0010429.ref001","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/2049-9957-1-4","article-title":"The global epidemiology of clonorchiasis and its relation with cholangiocarcinoma","volume":"1","author":"M Qian","year":"2012","journal-title":"Infect Dis Poverty"},{"key":"pntd.0010429.ref002","author":"World Health Organization [Internet]","year":"2021","journal-title":"WHO estimates of the global burden of foodborne diseases;"},{"issue":"10020","key":"pntd.0010429.ref003","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/S0140-6736(15)60313-0","article-title":"Clonorchiasis","volume":"387","author":"MB Qian","year":"2016","journal-title":"Lancet"},{"issue":"2","key":"pntd.0010429.ref004","doi-asserted-by":"crossref","first-page":"e601","DOI":"10.1371\/journal.pntd.0000601","article-title":"Effect of control strategies on prevalence, incidence and re-infection of clonorchiasis in endemic areas of China","volume":"4","author":"M Choi","year":"2010","journal-title":"Plos Neglect Trop D"},{"issue":"6","key":"pntd.0010429.ref005","first-page":"1012","article-title":"[Relationship between propagation of Clonorchis sinensis and ecology cultivation]","volume":"9","author":"Q Zhang","year":"2009","journal-title":"China Trop. Med"},{"issue":"9","key":"pntd.0010429.ref006","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1111\/tmi.12338","article-title":"Control of clonorchiasis in Korea: effectiveness of health education for community leaders and individuals in an endemic area","volume":"19","author":"J Oh","year":"2014","journal-title":"Trop Med Int Health"},{"issue":"5","key":"pntd.0010429.ref007","first-page":"501","article-title":"[Cost\u2043effectiveness analysis of integrated control strategy of parasitic diseases in demonstration plots]","volume":"23","author":"Y Chen","year":"2011","journal-title":"Chin J Schisto Control"},{"key":"pntd.0010429.ref008","volume-title":"[A study of the epidemiology and the control measurements of Clonorchis Sinensis in Guangdong Province] [dissertation]","author":"Y. Fang","year":"2006"},{"key":"pntd.0010429.ref009","volume-title":"Making choices in health: WHO guide to cost-effectiveness analysis","author":"World Health Organization","year":"2003"},{"issue":"12","key":"pntd.0010429.ref010","doi-asserted-by":"crossref","first-page":"e168512","DOI":"10.1371\/journal.pone.0168512","article-title":"A systematic review of cost-effectiveness studies reporting cost-per-DALY averted","volume":"11","author":"PJ Neumann","year":"2016","journal-title":"Plos One"},{"issue":"5","key":"pntd.0010429.ref011","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.trstmh.2009.01.007","article-title":"Cost comparison of rapid questionnaire screening for individuals at risk of clonorchiasis in low- and high-prevalence communities in northern Vietnam","volume":"103","author":"A Yajima","year":"2009","journal-title":"T Roy Soc Trop Med H"},{"issue":"1","key":"pntd.0010429.ref012","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1186\/s40249-021-00917-1","article-title":"Comparison on different treatment strategies against Clonorchis sinensis infection","volume":"10","author":"M Qian","year":"2021","journal-title":"Infect Dis Poverty"},{"issue":"4","key":"pntd.0010429.ref013","first-page":"E584","article-title":"Impact and cost-effectiveness of snail control to achieve disease control targets for schistosomiasis","volume":"115","author":"NC Lo","year":"2018","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"9","key":"pntd.0010429.ref014","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1016\/S1473-3099(16)30073-1","article-title":"Assessment of global guidelines for preventive chemotherapy against schistosomiasis and soil-transmitted helminthiasis: a cost-effectiveness modelling study","volume":"16","author":"NC Lo","year":"2016","journal-title":"Lancet Infect Dis"},{"issue":"19","key":"pntd.0010429.ref015","doi-asserted-by":"crossref","first-page":"7952","DOI":"10.1073\/pnas.1221396110","article-title":"Cost-effectiveness of a community-based intervention for reducing the transmission of Schistosoma haematobium and HIV in Africa","volume":"110","author":"ML Ndeffo Mbah","year":"2013","journal-title":"P Natl Acad Sci Usa"},{"issue":"2","key":"pntd.0010429.ref016","first-page":"3000223","article-title":"Threshold and stability results for Clonorchiasis epidemic model","volume":"2","author":"D Yanfei","year":"2013","journal-title":"Journal of Science, Technology and Environment"},{"issue":"2","key":"pntd.0010429.ref017","doi-asserted-by":"crossref","first-page":"881","DOI":"10.3934\/mbe.2019041","article-title":"Mathematical modeling the dynamics of Clonorchiasis in Guangzhou City of China","volume":"16","author":"R Yuan","year":"2019","journal-title":"Math Biosci Eng"},{"key":"pntd.0010429.ref018","doi-asserted-by":"crossref","first-page":"15176","DOI":"10.1038\/s41598-018-33431-w","article-title":"Modeling the transmission dynamics of Clonorchiasis in Foshan, China","volume":"8","author":"R Yuan","year":"2018","journal-title":"Sci Rep-Uk"},{"key":"pntd.0010429.ref019","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2019\/5878424","article-title":"Modelling the effects of snail control and health education in Clonorchiasis infection in Foshan, China","author":"S Gao","year":"2019","journal-title":"Complexity"},{"issue":"3","key":"pntd.0010429.ref020","doi-asserted-by":"crossref","first-page":"e8152","DOI":"10.1371\/journal.pntd.0008152","article-title":"Assessment of control strategies against Clonorchis sinensis infection based on a multi-group dynamic transmission model","volume":"14","author":"X Huang","year":"2020","journal-title":"Plos Neglect Trop D"},{"issue":"3","key":"pntd.0010429.ref021","first-page":"273","article-title":"[Epidemiology of clonorchiasis in the towns near the Pearl River Delta] (author\u2019s tranl)","volume":"41","author":"S Du","year":"2015","journal-title":"South China J Prev Med"},{"issue":"7","key":"pntd.0010429.ref022","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1016\/S1473-3099(15)00268-6","article-title":"Cost-effectiveness of scaling up mass drug administration for the control of soil-transmitted helminths: a comparison of cost function and constant costs analyses","volume":"16","author":"HC Turner","year":"2016","journal-title":"Lancet Infect Dis"},{"key":"pntd.0010429.ref023","unstructured":"National Bureau of Statistics of the People\u2019s Republic of China [Internet]. [Consumer Price Index]. [cited 2021 Oct 27]. Available from: http:\/\/data.stats.gov.cn\/easyquery.htm?cn=C01. Chinese"},{"key":"pntd.0010429.ref024","author":"The World Bank","journal-title":"PPP conversion factor, GDP (LCU per international $)\u2014China"},{"issue":"3","key":"pntd.0010429.ref025","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/S1473-3099(11)70294-8","article-title":"Global burden of human food-borne trematodiasis: a systematic review and meta-analysis","volume":"12","author":"T F\u00fcrst","year":"2012","journal-title":"Lancet Infect Dis"},{"key":"pntd.0010429.ref026","author":"A Pr\u00fcss-Ust\u00fcn","year":"2003","journal-title":"Introduction and methods\u2014Assessing the environmental burden of disease at national and local levels"},{"issue":"9859","key":"pntd.0010429.ref027","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1016\/S0140-6736(12)61680-8","article-title":"Common values in assessing health outcomes from disease and injury: Disability weights measurement study for the Global Burden of Disease Study 2010","volume":"380","author":"JA Salomon","year":"2012","journal-title":"Lancet"},{"key":"pntd.0010429.ref028","author":"Central People\u2019s Government of the People\u2019s Republic of China","journal-title":"The 2018 Statistical Communique of the People\u2019s Republic of China on National Economic and Social Development"},{"key":"pntd.0010429.ref029","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s40249-016-0235-5","article-title":"Socio-ecological dynamics and challenges to the governance of Neglected Tropical Disease control","volume":"6","author":"E Michael","year":"2017","journal-title":"Infect Dis Poverty"},{"issue":"3","key":"pntd.0010429.ref030","first-page":"300","article-title":"Research on chemotherapy measures in different Clonorchis sinensis infectiosity endemic areas","volume":"26","author":"FY","year":"2014","journal-title":"Chin J Schisto Control"},{"issue":"3","key":"pntd.0010429.ref031","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.cmi.2018.04.028","article-title":"Rapid diagnosis of parasitic diseases: current scenario and future needs","volume":"25","author":"S Mom\u010dilovi\u0107","year":"2019","journal-title":"Clin Microbiol Infec"},{"issue":"5","key":"pntd.0010429.ref032","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1097\/QCO.0000000000000395","article-title":"Prospects for elimination of soil-transmitted helminths","volume":"30","author":"KH \u00c1sbj\u00f6rnsd\u00f3ttir","year":"2017","journal-title":"Curr Opin Infect Dis"},{"key":"pntd.0010429.ref033","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s40249-016-0166-1","article-title":"Current status and perspectives of Clonorchis sinensis and clonorchiasis: epidemiology, pathogenesis, omics, prevention and control","volume":"5","author":"Z Tang","year":"2016","journal-title":"Infect Dis Poverty"},{"issue":"5","key":"pntd.0010429.ref034","doi-asserted-by":"crossref","first-page":"1879","DOI":"10.1007\/s00436-012-3152-y","article-title":"A review of the control of clonorchiasis sinensis and Taenia solium taeniasis\/cysticercosis in China","volume":"111","author":"W Wu","year":"2012","journal-title":"Parasitol Res"},{"key":"pntd.0010429.ref035","doi-asserted-by":"crossref","first-page":"105436","DOI":"10.1016\/j.actatropica.2020.105436","article-title":"Effectiveness of health education in improving knowledge, practice and belief related to clonorchiasis in children","volume":"207","author":"M Qian","year":"2020","journal-title":"Acta Trop"},{"issue":"3","key":"pntd.0010429.ref036","first-page":"229","article-title":"Epidemic situation and prevention and control strategy of clonorchiasis in Guangdong Province, China","volume":"28","author":"Z Deng","year":"2016","journal-title":"Chin J Schisto Control"},{"key":"pntd.0010429.ref037","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.jenvman.2017.09.043","article-title":"Toilet revolution in China","volume":"216","author":"S Cheng","year":"2018","journal-title":"J Environ Manage"},{"issue":"12","key":"pntd.0010429.ref038","first-page":"1291","article-title":"Compare the efficacy of two antiparasitic drugs against Clonorchiasis","volume":"6","author":"Q Feng","year":"2006","journal-title":"J Trop Med"},{"issue":"Suppl 1","key":"pntd.0010429.ref039","first-page":"47","article-title":"Epidemiology and control of clonorchiasis in Korea","volume":"28","author":"HJ Rim","year":"1997","journal-title":"Southeast Asian J Trop Med Public Health"},{"key":"pntd.0010429.ref040","doi-asserted-by":"crossref","first-page":"105650","DOI":"10.1016\/j.actatropica.2020.105650","article-title":"Effectiveness of a community-based integrated strategy to control soil-transmitted helminthiasis and clonorchiasis in the People\u2019s Republic of China","volume":"214","author":"Y Chen","year":"2021","journal-title":"Acta Trop"},{"issue":"33","key":"pntd.0010429.ref041","first-page":"86","article-title":"A comparative study on the clinical efficacy and safety of albendazole and praziquantel in the treatment of liver flukes","volume":"13","author":"Y Zeng","year":"2020","journal-title":"Chinese Journal of Clinical Rational Drug Use"},{"issue":"5","key":"pntd.0010429.ref042","doi-asserted-by":"crossref","first-page":"197","DOI":"10.2188\/jea.JE20180007","article-title":"Cholangiocarcinoma trends, incidence, and relative survival in Khon Kaen, Thailand from 1989 through 2013: a population-based cancer registry study","volume":"29","author":"S Kamsa-ard","year":"2019","journal-title":"J Epidemiol"},{"issue":"Suppl 2","key":"pntd.0010429.ref043","doi-asserted-by":"crossref","first-page":"S129","DOI":"10.3346\/jkms.2016.31.S2.S129","article-title":"Disability weights measurement for 228 causes of disease in the Korean burden of disease study 2012","volume":"31","author":"M Ock","year":"2016","journal-title":"J Korean Med Sci"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0010429","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T00:00:00Z","timestamp":1654214400000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0010429","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T18:06:14Z","timestamp":1654279574000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0010429"}},"subtitle":[],"editor":[{"given":"jong-Yil","family":"Chai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,5,23]]},"references-count":43,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5,23]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0010429","relation":{"new_version":[{"id-type":"doi","id":"10.1371\/journal.pntd.0010429","asserted-by":"object"}]},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,23]]}}}