Toward integrated opisthorchiasis control in northeast Thailand: The Lawa project

Abstract

Human liver fluke, Opisthorchis viverrini, a food-borne trematode is a significant public health problem in Southeast Asia, particularly in Thailand. Despite a long history of control programs in Thailand and a nationwide reduction, O. viverrini infection prevalence remains high in the Northeastern Provinces. Therefore, a new strategy for controlling the liver fluke infection using the EcoHealth/One Health approach was introduced into the Lawa Lake area in Khon Kaen province where the liver fluke is endemic. A program has been carried using anthelminthic treatment, novel intensive health education methods both in the communities and in schools, ecosystem monitoring and active community participation. As a result, the infection rate in the more than 10 villages surrounding the Lake has declined to approximate one third of the average of 50% as estimated by a baseline survey. Strikingly, the Cyprinoid fish species in the Lake, which are the intermediate host, now showed less than 1% prevalence compared to a maximum of 70% at baseline. This liver fluke control program, named “Lawa model,” is now recognized nationally and internationally, and being expanding to other parts of Thailand and neighboring Mekong countries. Challenges to O. viverrini disease control, and lessons learned in developing an integrative control program using a community-based, ecosystem approach, and scaling-up regionally based on Lawa as a model are described.

Health Behavior Regarding Liver Flukes among Rural People in Nakhon Ratchasima, Thailand

“…Strikingly, the Cyprinoid fish species in the Lake, which are the intermediate host, now showed less than 1% prevalence compared to a maximum of 70% at baseline. Lessons learned in developing an integrative control program using a community-based, ecosystem approach, and scaling-up regionally based on members, village health volunteers, village leaders, and public health officers, and members of sub-district administrative organization (Sripa et al, 2015). In addition, Liver fluke prevention and control in the northeast of Thailand through action research was indicated that village member, leaders, village health volunteers, and members of sub-district administrative organization to enhance people's potential to prevent and control liver fluke infection (Wongba et al, 2011).…”

Epidemiology of Opisthorchis viverrini in an endemic area of Thailand, an integrative approach

“…The other prevention strategies and control programs should be considered to break the epidemiological cycle. Analysis of the risk factors in the villages including the people education is critical element to control and eradicate opisthorchiasis (Petney et al, 2013;Sripa et al, 2015). In conclusion, an integrative approach to O. viverrini infection is essential to achieve the best results on the elimination or reduction of this parasite among the population living in endemic areas.…”

“…Similar features were observed also by Pinloar et al (2013). Study from another Thailand area found that a reduction in the prevalence of O. viverrini in humans to undetectable levels reduced also the prevalence in fi sh to 1 % (Sripa et al, 2015;personal communication). The high, statistically signifi cant correlation between dog, cat and human O. viverrini infection is of particular interest.…”

“…The zoonotic role of dogs should not be underestimated and should be considered in disease control strategies under similar circumstances. As stated by Sripa et al (2015), all aspects of the life cycle/transmission process should be properly determined in regarding the contribution of other fi sh eating vertebrates, but may not have been adequately determined in human-wetland complexes. Moreover, despite parasite load being lower and according to our results dogs can be good indicators for the presence of the Asiatic liver fl uke in endemic areas with similar characteristics to that which we recently studied.…”

People Participation Towards Opisthorchis viverrini Prevention and Control in Chaiyaphum Province, Northeastern Thailand

“…In addition, the liver fluke control programme, named "Lawa model," is now recognized nationally and internationally, and being expanding to other parts of Thailand and neighboring Mekong countries. Challenges to O. viverrini disease control, and lessons learned in developing an integrative control program using a community-based, ecosystem approach, and scaling-up regionally based on Lawa as a model are described (Sripa et al, 2015). From a lesson success model, O. viverrini prevention and control is approaches in the communities through a community participation, here we described the survey data about people participation in Ban Chuan subdistrict administration organization (BCSAO) and Bamnet Narong sub-district municipality (BNSM) where are located in Bamnet Narong district, Chaiyaphum province.…”