Helminth infection in southern Laos: high prevalence and low awareness

Particle and Fibre Toxicology

Peter Odermatt³  Peter van Eeuwijk²  Kongsap Akkhavong⁴  Youthanavanh Vonghachack¹  Vilavanh Xayaseng³  Khampheng Phongluxa³ 

[1] University of Health Science, Ministry of Health, Vientiane, Lao PDR;Institute of Social Anthropology, Basel, Switzerland;University of Basel, Basel, Switzerland;National Institute of Public Health, Ministry of Health, Vientiane, Lao PDR

关键词: Health education;    Latrine use;    Raw fish consumption;    Liver fluke;    Soil-transmitted helminth;    Helminth infection;   

Others  :  823863
DOI  :  10.1186/1756-3305-6-328

 received in 2013-09-25, accepted in 2013-11-10,  发布年份 2013

【 摘 要 】

Background

Helminthiasis is a public health concern in Lao People’s Democratic Republic (Lao PDR, Laos). This study aimed to understand helminth infection and associated risk factors in relation to existing local knowledge, attitudes and practices regarding worm infections in endemic communities.

Methods

A cross-sectional survey was conducted in 10 randomly selected villages in Saravane district, Southern Laos. Two stool samples obtained from 574 members (aged ≥2 years) of selected households were examined using the Kato Katz method. Household heads (n = 130) were interviewed. Eight focus group discussions (FGDs) and direct observations were performed. Uni- and multivariate logistic regression analyses were conducted to predict infection. Content analysis was conducted for qualitative data.

Results

The prevalence of Opisthorchis viverrini, hookworm, Trichuris trichiura, Ascaris lumbricoides and Taenia sp. was 88.7%, 86.6%, 32.9%, 9.8% and 11.5%, respectively. Most individuals were co-infected with O. viverrini and hookworm. More men had multiple helminth infections than did women. Only one-third of household heads had heard about liver fluke before, of which 59.2% associated it with eating raw fish dish. Among the soil-transmitted helminths, roundworm was the most well known (70.8%) but was attributed to raw food consumption (91.3%). Eating raw fish was a common practice (75.4%); few households possessed a latrine (16.1%); less than half of the study participants mentioned health benefits from latrine use and personal hygiene. Focus group discussion participants had a low level of awareness of worm infections; more men liked eating raw fish than did women; some disliked using latrines because they were not used to it and because of their bad smell. Poor personal and village hygiene practices were observed.

Conclusions

This study highlights a high helminth infection rate and poor community awareness of worm infections and associated risk factors. Only a sound awareness of worm infection and the underlying risk factors may prevent infection and re-infection after treatment.

【 授权许可】

   
2013 Phongluxa et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Utzinger J, Bergquist R, Olveda R, Zhou XN: Important helminth infections in Southeast Asia diversity, potential for control and prospects for elimination. Adv Parasitol 2010, 72:1-30.
• [2]Fürst T, Keiser J, Utzinger J: Global burden of human food-borne trematodiasis: a systematic review and meta-analysis. Lancet Infect Dis 2012, 12:210-221.
• [3]Sayasone S, Vonghajack Y, Vanmany M, Rasphone O, Tesana S, Utzinger J, Akkhavong K, Odermatt P: Diversity of human intestinal helminthiasis in Lao PDR. Trans R Soc Trop Med Hyg 2009, 103:247-254.
• [4]Sayasone S, Mak TK, Vanmany M, Rasphone O, Vounatsou P, Utzinger J, Akkhavong K, Odermatt P: Helminth and intestinal protozoa infections, multiparasitism and risk factors in Champasack province, Lao People’s Democratic Republic. PLoS Negl Trop Dis 2011, 5:e1037.
• [5]Keiser J, Utzinger J: Food-borne trematodiasis: current chemotherapy and advances with artemisinins and synthetic trioxolanes. Trends Parasitol 2007, 23:555-562.
• [6]Keiser J, Utzinger J: Efficacy of current drugs against soil-transmitted helminth infections: systematic review and meta-analysis. JAMA 2008, 299:1937-1948.
• [7]Sithithaworn P, Andrews RH, Nguyen VD, Wongsaroj T, Sinuon M, Odermatt P, Nawa Y, Liang S, Brindley PJ, Sripa B: The current status of opisthorchiasis and clonorchiasis in the Mekong Basin. Parasitol Int 2012, 61:10-16.
• [8]Bouvard V, Baan R, Straif K, Grosse Y, Secretan B, El GF, brahim-Tallaa L, Guha N, Freeman C, Galichet L, et al.: A review of human carcinogens-Part B: biological agents. Lancet Oncol 2009, 10:321-322.
• [9]Hotez PJ, Bundy DAP, Beegle K, Brooker S, Drake L, de Silva N, Montresor A, Engels D, Jukes M, Chitsulo L, et al.: Helminth infections: soil-transmitted helminth infections and schistosomiasis. In Disease Control Priorities in Developing Countries. 2nd edition. Edited by Jamison DT. Washington (DC): World Bank; 2006. Chapter 24
• [10]WHO Expert committee: Prevention and control of schistosomiasis and soil-transmitted helminthiasis. World Health Organ Tech Rep Ser 2002, 912:i-vi. 1-57
• [11]WHO/FAO: Joined workshop on food-borne trematode infections in Asia. Hanoi, Vietnam: WHO Report; 2004.
• [12]Lovis L, Mak TK, Phongluxa K, Aye SP, Vonghachack Y, Keiser J, Vounatsou P, Tanner M, Hatz C, Utzinger J, et al.: Efficacy of praziquantel against Schistosoma mekongi and Opisthorchis viverrini: a randomized, single-blinded dose-comparison trial. PLoS Negl Trop Dis 2012, 6:e1726.
• [13]Phan VT, Ersboll AK, Do DT, Dalsgaard A: Raw-fish-eating behavior and fishborne zoonotic trematode infection in people of northern Vietnam. Foodborne Pathog Dis 2011, 8:255-260.
• [14]Cantey PT, Rout J, Rao G, Williamson J, Fox LM: Increasing compliance with mass drug administration programs for lymphatic filariasis in India through education and lymphedema management programs. PLoS Negl Trop Dis 2010, 4:e728.
• [15]Gunawardena S, Ismail M, Bradley M, Karunaweera N: Factors influencing drug compliance in the mass drug administration programme against filariasis in the Western province of Sri Lanka. Trans R Soc Trop Med Hyg 2007, 101:445-453.
• [16]Nuwaha F, Okware J, Ndyomugyenyi R: Predictors of compliance with community-directed ivermectin treatment in Uganda: quantitative results. Trop Med Int Health 2005, 10:659-667.
• [17]Yirga D, Deribe K, Woldemichael K, Wondafrash M, Kassahun W: Factors associated with compliance with community directed treatment with ivermectin for onchocerciasis control in Southwestern Ethiopia. Parasit Vectors 2010, 3:48. BioMed Central Full Text
• [18]Forrer A, Sayasone S, Vounatsou P, Vonghachack Y, Bouakhasith D, Vogt S, Glaser R, Utzinger J, Akkhavong K, Odermatt P: Spatial distribution of, and risk factors for, Opisthorchis viverrini infection in southern Lao PDR. PLoS Negl Trop Dis 2012, 6:e1481.
• [19]Sayasone S, Tesana S, Utzinger J, Hatz C, Akkhavong K, Odermatt P: Rare human infection with the trematode Echinochasmus japonicus in Lao PDR. Parasitol Int 2009, 58:106-109.
• [20]Soukhathammavong P, Odermatt P, Sayasone S, Vonghachack Y, Vounatsou P, Hatz C, Akkhavong K, Keiser J: Efficacy and safety of mefloquine, artesunate, mefloquine-artesunate, tribendimidine, and praziquantel in patients with Opisthorchis viverrini: a randomised, exploratory, open-label, phase 2 trial. Lancet Infect Dis 2011, 11:110-118.
• [21]Lao MOH: Diagnosis and Treatment in district hospitals. Lao PDR: Institut de la Francophonie pour la médicine tropicale, Ministry of Health; 2004.
• [22]Rim HJ, Chai JY, Min DY, Cho SY, Eom KS, Hong SI, Sohn WM, Yong TS, Deodato G, Hanne S, et al.: Prevalence of intestinal parasite infections on a national scale among primary schoolchildren in Laos. Parasitol Res 2003, 91:267-272.
• [23]Sayasone S, Odermatt P, Phoumind N, Vongsaravane X, Sensombath V, Phetsouvanh R, Choulamany X, Strobel M: Epidemiology of Opisthorchis viverrini in a rural district of southern Lao PDR. Trans R Soc Trop Med Hyg 2007, 101:40-47.
• [24]Katz N, Chaves A, Pellegrino J: A simple device for quantitative stool thick-smear technique in Schistosomiasis mansoni. Rev Inst Med Trop Sao Paulo 1972, 14:397-400.
• [25]Maleewong W, Intapan P, Wongwajana S, Sitthithaworn P, Pipitgool V, Wongkham C, Daenseegaew W: Prevalence and intensity of Opisthorchis viverrini in rural community near the Mekong River on the Thai-Laos border in northeast Thailand. J Med Assoc Thai 1992, 75:231-235.
• [26]Lovis L, Mak TK, Phongluxa K, Soukhathammavong P, Sayasone S, Akkhavong K, Odermatt P, Keiser J, Felger I: PCR Diagnosis of Opisthorchis viverrini and Haplorchis taichui Infections in a Lao Community in an area of endemicity and comparison of diagnostic methods for parasitological field surveys. J Clin Microbiol 2009, 47:1517-1523.
• [27]Chai JY, Yong TS, Eom KS, Min DY, Jeon HK, Kim TY, Jung BK, Sisabath L, Insisiengmay B, Phommasack B, et al.: Hyperendemicity of Haplorchis taichui Infection among Riparian People in Saravane and Champasak Province, Lao PDR. Korean J Parasitol 2013, 51:305-311.
• [28]Rim HJ, Sohn WM, Yong TS, Eom KS, Chai JY, Min DY, Lee SH, Hoang EH, Phommasack B, Insisiengmay S: Fishborne trematode metacercariae in Luang Prabang, Khammouane, and Saravane Province, Lao PDR. Korean J Parasitol 2013, 51:107-114.
• [29]Jiraanankul V, Aphijirawat W, Mungthin M, Khositnithikul R, Rangsin R, Traub RJ, Piyaraj P, Naaglor T, Taamasri P, Leelayoova S: Incidence and risk factors of hookworm infection in a rural community of central Thailand. Am J Trop Med Hyg 2011, 84:594-598.
• [30]Phommasack B, Saklokham K, Chanthavisouk C, Nakhonesid-Fish V, Strandgaard H, Montresor A, Shuey DA, Ehrenberg J: Coverage and costs of a school deworming programme in 2007 targeting all primary schools in Lao PDR. Trans R Soc Trop Med Hyg 2008, 102:1201-1206.
• [31]Soukhathammavong PA, Sayasone S, Phongluxa K, Xayaseng V, Utzinger J, Vounatsou P, Hatz C, Akkhavong K, Keiser J, Odermatt P: Low efficacy of single-dose albendazole and mebendazole against hookworm and effect on concomitant helminth infection in Lao PDR. PLoS Negl Trop Dis 2012, 6:e1417.
• [32]Steinmann P, Utzinger J, Du ZW, Jiang JY, Chen JX, Hattendorf J, Zhou H, Zhou XN: Efficacy of single-dose and triple-dose albendazole and mebendazole against soil-transmitted helminths and Taenia spp.: a randomized controlled trial. PLoS One 2011, 6:e25003.
• [33]Grundy-Warr C, Andrews RH, Sithithaworn P, Petney TN, Sripa B, Laithavewat L, Ziegler AD: Raw attitudes, wetland cultures, life-cycles: socio-cultural dynamics relating to Opisthorchis viverrini in the Mekong Basin. Parasitol Int 2012, 61:65-70.
• [34]Tomokawa S, Kobayashi T, Pongvongsa T, Nisaygnang B, Kaneda E, Honda S, Moji K, Boupha B: Risk factors for Opisthorchis viverrini infection among schoolchildren in Lao PDR. Southeast Asian J Trop Med Public Health 2012, 43:574-585.
• [35]Prasongwatana J, Laummaunwai P, Boonmars T, Pinlaor S: Viable metacercariae of Opisthorchis viverrini in northeastern Thai cyprinid fish dishes–as part of a rational program for control of O. viverrini-associated cholangiocarcinoma. Parasitol Res 2013, 112:1323-1327.
• [36]Xayaseng V, Phongluxa K, van Eeuwijk P, Akkhavong K, Odermatt P: Raw fish consumption in liver fluke endemic areas in rural southern Laos. Acta Trop 2013, 127:105-111.
• [37]Strandgaard H, Johansen MV, Agaard-Hansen J, Petlueng P, Ornbjerg N: Local perceptions and practices in regard to opisthorchiasis in two villages in Lao PDR. Southeast Asian J Trop Med Public Health 2008, 39:19-26.
• [38]Sithithaworn P, Haswell-Elkins M: Epidemiology of Opisthorchis viverrini. Acta Trop 2003, 88:187-194.
• [39]Kobayashi J, Vannachone B, Sato Y, Manivong K, Nambanya S, Inthakone S: An epidemiological study on Opisthorchis viverrini infection in Lao villages. Southeast Asian J Trop Med Public Health 2000, 31:128-132.
• [40]Sriamporn S, Pisani P, Pipitgool V, Suwanrungruang K, Kamsaard S, Parkin DM: Prevalence of Opisthorchis viverrini infection and incidence of cholangiocarcinoma in Khon Kaen, Northeast Thailand2. Trop Med Int Health 2004, 9:588-594.