Perceptions of Opisthorchis viverrini infection and raw fish consumption among villagers in Champasak Province, Lao PDR: a qualitative study

Opisthorchis viverrini ( O. viverrini ) infection is a major public health concern in the Greater Mekong Subregion. Lao People’s Democratic Republic (Lao PDR) has been reported to have a remarkably higher prevalence. This study aimed to explore local perceptions and practices related to O. viverrini infection and raw fish consumption. We conducted a qualitative study on O. viverrini infection in villages in Champasak Province, Lao PDR. We investigated villagers’ perceptions and practices, focusing on the consumption of raw fish dishes. Focus group discussions (FGDs) were carried out in September 2024 and April 2025 in four villages, two in Khong District and two in Mounlapamok District. A total of 68 participants from four villages participated in 10 FGD sessions. The mean age was 46.5 years (range: 19–73; SD = 11.15), with 26.5% male and 73.5% female. The majority of participants had completed primary school (44.1%) or had some secondary education (33.8%). In total, 94.1% of the participants reported farming as their main occupation. The participants were generally uncertain when asked whether they knew the disease. Some believed that alcohol, lime juice, and other ingredients could kill parasites in raw fish meat. All participants reported having eaten raw fish dishes, except for two elderly women who had stomach problems. The participants said that fish considered suitable for raw fish dishes were those with scales and of larger size. Feeding raw fish to small children was restricted, but there was no clear age standard for when children were permitted to begin eating raw fish dishes. In addition to typical koi pa and larp pa, participants mentioned other raw fish preparations, including pa te (thinly sliced raw fish) and pa chum (raw fish dipped in a hot pot). They also described the use of wasabi as a condiment for raw fish. Sharing food, including raw fish dishes, was described as a common social practice in the community, and refusing such sharing was considered difficult. The findings suggest that raw fish consumption is shaped by local contexts. Understanding these contexts may help inform the development of culturally appropriate, community-specific interventions.