Abstract
Leptospirosis is an endemic disease with moderate to high incidence in Mahasarakham province, Thailand. The present study was designed to assess the policy implementation mission regarding leptospirosis prevention and control from the national level to the local administrative levels, through a One Health perspective. A qualitative study was conducted, using documentation review, individual in-depth interviews with public health officers, local government officers, livestock officers who developed policy implementation tools or have responsibilities in leptospirosis prevention and control. The results show that Thailand has progressively developed a leptospirosis prevention and control policy framework at the national level, transferring the responsibility of its implementation to the local level. The province of Mahasarakham has decided to foster cooperation in leptospirosis prevention and control at the local level. However, there are insufficient linkages between provincial, district and sub-district departments to ensure comprehensive disease prevention activities at the local level concerning leptospirosis patients and the whole population.
Highlights
Leptospirosis is an important zoonotic disease and is considered as one of the most widespread zoonoses in the world [1,2,3,4].The disease is caused by several spirochete species of the genus Leptospira [5]
The study population included the head of the Department of Disease Control, the officer of Coordination Unit for One Health, public health officers, livestock officer and local government officers of Mahasarakham, to describe the factors that have enabled or constrained the planning and implementation of policies regarding leptospirosis prevention and control
With the movement of decentralization in Thailand, the Government decided that each provincial governor would be Chief Executive Officer (CEO) administering all activities within his/her jurisdiction on an integrated manner
Summary
Leptospirosis is an important zoonotic disease and is considered as one of the most widespread zoonoses in the world [1,2,3,4].The disease is caused by several spirochete species of the genus Leptospira [5]. Infected patients can develop severe symptoms characterized by hepatic, renal, or hemorrhagic manifestations which can lead to death [6,7]. Thailand is located in the tropical zone with important soil moisture and high rainfalls during the wet season, which favors leptospire transmission. The first isolation of leptospires from human patients in Thailand was reported in 1942 [8]. Leptospirosis incidence shows a strong seasonality with a high incidence during the wet season [9]
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