Sustainable Prevention of Cholangiocarcinoma Through Community Participation in a High-incidence Area in Thailand.

Nopparat Songserm,Somkiattiyos Woradet,Banchop Sripa,Akhtar Ali

doi:10.31557/apjcp.2020.21.3.777

Abstract

Opisthorchiasis and cholangiocarcinoma (CCA) are major public health problems in Northeast Thailand, especially in Ubon Ratchathani, which are the alluvial plains. Those with poor food habits are mostly at risk of having diseases. This study was a participatory action research (PAR) aimed to define the models/plans for CCA prevention. The samples consisted of 40 community representatives. The data were collected by the PAR method. Qualitative data were analyzed by content analysis. The samples coordinately analyzed and prioritized the problems and presented information to the community. The plans consisted of (1) cultivating the right values and behaviors of eating food safe from CCA in children, (2) supervising the shops not to sell foods that are the main risk factors for CCA, (3) supporting the community leaders to act as good role models to the people, (4) assigning every housewife to cook clean and safe food from CCA, and (5) encouraging the villagers to have knowledge and awareness, which can protect them from CCA. After the community designed these plans, responsible persons were assigned to implement them. Two years later, researchers evaluated the outcome. The average scores on knowledge and attitude toward CCA were significantly higher than before implementation. For the impact of projects, prevalence of opisthorchiasis in 2016 was significantly lower than that in 2014. CCA prevention by community participation employed a combination of quantitative and qualitative studies. This study has been successful and sustainable since the community has human resources, budget, and appropriate management of the project.

Highlights

Cholangiocarcinoma (CCA) is still a major public health problem among Thais, especially in the northeast, which is the area with the highest incidence of disease in the world (Vatanasapt et al, 1990)
The survey consisted of three parts: (1) general information of people and context of the area; (2) risk factors for CCA; and (3) health determinants related to CCA
participatory action research (PAR) was employed in a high-incidence area

Summary

Introduction

Cholangiocarcinoma (CCA) is still a major public health problem among Thais, especially in the northeast, which is the area with the highest incidence of disease in the world (Vatanasapt et al, 1990). Based on data from the National Cancer Institute in 2001-2003, the incidence of CCA in Thailand was 38.6 and 14.6 per 100,000 in males and females, respectively (Khuhaprema et al, 2010). In 2004-2006, the trend was likely to increase in both males and females to 42.8 and 18.2, respectively (Khuhaprema et al, 2012). When separately described by region, the northeast had the highest incidence rates, which were 83.4 and 39.6 per 100,000 in males and females, respectively. In 2001-2003, the incidence rates were 74.9 and 34.7and increased in 2004-2006 to 80.6 and 41.6 per 100,000 males and females, respectively (Khuhaprema et al, 2010; Khuhaprema et al, 2012).

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Conclusion