Abstract
BackgroundHelminthiasis 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.MethodsA 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.ResultsThe 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.ConclusionsThis 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.
Highlights
Helminthiasis is a public health concern in Lao People’s Democratic Republic (Lao PDR, Laos)
There was no significant age difference between genders: the mean age for males was 24.4 years (SD 18.2 years, range 2–81 years, 95% confidence intervals (95% CI) 22.3–26.5) and 26.6 years (SD 18.3 years, range 2–74 years, 95% CI 24.5–28.7) for females; 53.3% belonged to the Laoloum ethnic group
Most of them were in the age groups of 35–44 years (32.8%) and 25–34 years (22.4%); more than two-third of the focus group discussions (FGDs) participants belonged to the Laotheung ethnic group (71.6%) and were Buddhists (71.7%); 55.2% had attended primary school while 40.3% had not attended school at all
Summary
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. Food-borne trematodiases (FBT) are among the neglected tropical diseases [1] and a public health problem in many parts of the world, with a global burden of 665,000 disability adjusted life years [2]. About 750 million people are at risk for FBT, of which. In Southeast Asia, about 67.3 million people are at risk for Opisthorchis viverrini, the most frequently observed FBT. Ten million people are infected in Thailand and Laos [7]. Re-infection rates after treatment with anti-helminthic drugs are rapidly reaching pre-treatment prevalence rates [12] as food and hygiene behaviour patterns remain unchanged, indicating that health education is not effectively addressing the critical issues
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