Integrated Eco-health control package significantly reduces helminth infections in endemic Khong islands with particular emphasis on Schistosoma mekongi

Abstract

Back ground : Schistosomiasis, caused by Schistosoma mekongi, remains public health concern on islands in the Khong district, Champasack province, Southern Lao PDR. Other helminth infections, including Opisthorchis viverrini, hookworm, and Trichuris trichiura, are also prevalent on these islands. This study aimed to assess the impact of an Eco-health/One-health intervention package combined with mass drug administration (MDA) on these helminth infections. Methods We conducted a community intervention using a stepped-wedge trial approach on two endemic islands (Donsom and Donkhone) of the Kong district, Champasack province, Lao PDR, between April 2012 and March 2013. After the baseline (T0), the eco-health/one-health intervention package was implemented on Donsom (intervention) and Donkhone island (control). An assessment was conducted in 2014 (T1), one year after the completion of intervention implementation, to assess the short-term impact of the Eco-health/One-health intervention package on helminth infections and compare intervention and control islands. Later in 2015, the Eco-health/One-health intervention package was implemented on control island (Donkhone). After the implementation of intervention, the parasitological assessments were conducted annually in humans in 2015 (T2), in 2016 (T3) and in 2017 (T4), and in dogs in 2017 (T4) to evaluate the long-term impact of the intervention on helminth infections. Results Results showed that the Eco-health/One-health intervention package significantly reduced the infection with S. mekongi by 9.0% compared to the use of mass drug administration alone (control island). Additionally, this intervention package significantly reduced O. viverrini infection by 20.3% and hookworm by 17.9%. Annual parasitological assessments between 2012 and 2017 showed that the eco-health/one-health intervention package, coupled with MDA, steadily reduced the prevalence of S. mekongi on the intervention island from 29.1–1.8% and on the control island from 28.4–3.1%, respectively. Conclusion The study findings suggest that the Eco-health/One-health intervention significantly contributes to the prevalence reduction of S. mekongi and helminth co-infections, particularly hookworm and T. trichiura. Therefore, implementing the Eco-health/One-health intervention in schistosomiasis-endemic areas could accelerate the achievement of national goals for transmission interruption by 2025 and elimination by 2030.