Dynamics of Key Identities Influencing the Changing Prevalence of Opisthorchiasis in Health-Management Sub-districts, Chiang Mai Province

Abstract

This qualitative study, employing a focused of micro-ethnographic approach, aimed to understand social and personal identities influencing the prevalence of Opisthorchiasis within Health Management Sub-districts in Chiang Mai. 175 Key informants were purposively selected from individuals previously screened for Liver Fluke and Health Management Sub-district committee’s member from high-risk, low-risk and non-risk subdistricts, covering 15 sub-districts. Data were collected between November 1, 2023 to October 31, 2024 by using focus group discussions, in-depth interviews and observations. Data were analyzed through content analysis. The study found that key identities influenced the changing prevalence of Opisthorchiasis as
1) Social identity, which included cultural practices such as raw fish consumption during funeral ceremonies, settlement patterns near water sources, and traditional rural lifestyles, which have gradually diminished due to urbanization, expanded infrastructure, formal education, and new normal lifestyles and 2) Personal identity, which involed a reduced in raw fish consumption behaviors and related personal beliefs, alongside improved preventive behaviors—particularly among females and the younger generations and increased access to liver fluke screening services. Furthermore, the study suggests that the dynamics of personal identity must be driven through the health management sub-districts. Key driving activities include community health screening, health education, integration into school curricula, the promotion of role models, and the implementation of social innovations or measures.