Vientiane Municipality Research Articles

A risk scores for predicting prevalence of diabetes in the LAO population

To develop risk scores for predicting the prevalence of diabetes in the Lao population. This was a cross-sectional study of both men and women (age 30 to 70 years) living in rural villages of the Vientiane municipality in the Lao PDR. Multiple logistic regressions with backward stepwise selection were used; the diabetes risk score was derived from the β-coefficient. Performance of the score was determined by the area under the receiver operating characteristic curve (AUC), the sensitivity, the specificity, and the positive predictive value for the specified cut-off value. The prevalence of undiagnosed diabetes was 7%. The factors included in the predictive in model were 17 (40 to 70 years of age) + 14 (high waist circumference) + 11 (hypertension) + 7 (family history of diabetes). A cut-off point of risk scores of 29.5 out of 49 produced the optimal sum, leading to a sensitivity of 0.75, a specificity of 0.55, a positive predictive value of 17.8%, and an AUC of 0.70. Data suggested that the combination of age, waist circumference, hypertension, and family history of diabetes could be utilized to identify Lao individuals at high risk of undiagnosed diabetes. The generalizability for other Lao population needs further investigation.

Ultrasonographic investigation of cholangiocarcinoma in Lao PDR

Opisthorchis viverrini is a group 1 carcinogen that causes cholangiocarcinoma (CCA). Although opisthorchiasis is known to be severely endemic to several areas along the Mekong River in Lao PDR, the CCA status of residents of this region is still under investigation. In this study, we analyzed the results of abdominal ultrasonography (US) performed on 6113 residents in 9 provinces (Vientiane Municipality, Savannakhet, Phongsaly, Khammouane, Saravane, Champasak, Vientiane, Xieng Khuouang, and Luang Prabang provinces) of Lao PDR from 2007 to 2011. Overall, 51 cases (0.83%) were detected with suspected CCA. The CCA rates in Vientiane Municipality and in Savannakhet and Khammouane provinces were 1.45%, 1.58%, and 1.09%, respectively. However, in the other 6 provinces, the rate of CCA averaged only 0.26%. In the 3 provinces with higher rates of CCA, bile duct dilatation (grade ≥ 2) was also significantly more prevalent (P < 0.0001). These results are concordant with previous reports showing a higher endemicity of opisthorchiasis in Vientiane Municipality and in Savannakhet and Khammouane provinces.

The Excess Funds Problem of the Savings Groups in Laos: Case Study of a Village in Vientiane Municipality

(ProQuest: ... denotes non-US-ASCII text omitted.)I IntroductionThe Village Savings and Credit Group (hereinafter, SG) in Laos is basically a closed, village-level financial group. Membership is confined to villagers, and savings mobilization and credit extension are limited to the members. Roughly 70% of profits from credit operations are distributed as dividends once a year to members in proportion to their savings amount. In general, at first, demand for credit exceeds savings and because external institutions generally provide no, or very little, seed funding, so an SG inevitably rations credit.1) Later, as the group develops and savings accumulate to a certain level, savings begin to exceed credit demand. Lowering the interest rate, which is a common adjustment measure, has an apparent inhibitory effect on the development of SGs as a reduced interest rate discourages savings mobilization, although a substantial savings surplus exists among village households. Such SGs suffer from an excess funds problem. We also note the existence of many SGs that suffer from shortage of funds in a prolonged period.To avoid such a scenario, SGs require a system to coordinate the gap between demand and supply among funds-surplus and funds-deficit SGs. When SGs as a whole have excess funds, the surplus money should be transferred to external financial markets. Through such a developmental process, SGs can be integrated into the broader financial system, thus contributing to the development of the nation-wide financial markets. The agricultural cooperatives in Japan, for instance, established the three-tier cooperative system-village-level, prefecture-level, and nation-level-to transfer excess funds from village-level cooperatives to a nation-level cooperative bank (see the first paper in this special issue by Ohno) and thereby supported the formation of the country's more efficient and integrated financial market.In Laos, some SGs, especially those in Vientiane Municipality, began facing an excess funds problem several years after establishment. The present study examines the responses of the various stakeholders-committee members and advisers of an SG, villagers, NGOs (Foundation for Integrated Agricultural and Environmental Management [FIAM] and Community Organizations Development Institute [CODI]),2) and the Lao Women's Union (LWU)-to this problem. This study's major objective is to investigate the excess funds problem, focusing on the aforementioned stakeholders' responses through a detailed case study of a village in Pakngum District, Vientiane Municipality. By analyzing the process of the development of SG, this study also identifies the SG's impact on the village financial market and economy.The paper proceeds as follows. In section 2, we describe the study village on the basis of a household survey of 75 sample households, followed by a discussion of the SG's development and impact on the village economy in section 3. Section 4 presents the process that caused the excess funds problem and the methods by which the SG committee and other stakeholders attempted to manage it. Section 5 presents the conclusions.II Profile of the Study VillageFIAM and CODI began organizing SGs in Vientiane Municipality (hereinafter, Vientiane) in 1997. By December 2003, a total of 217 SGs were formed in Laos, covering nine districts (muang) of which five were in Vientiane (Table 1). A total of 178 SGs existed in Vientiane, concentrating in the Xaythany District (92 villages out of 103) and Pakngum District (53 villages out of 53). Also notable was the amount of savings: as of December 2003, 217 groups had accumulated 5.89 billion kip (averaging 27.2 million kip per group),3) of which 145 groups (roughly two-thirds the groups) in Xaythany and Pakngum Districts had accumulated 4.99 billion kip (84.7%).The study village (ban), Don Neua, is one of the 53 villages in Pakngum District. Supported by CODI, an SG was established in September 2000. …

Performance of Savings Groups in Mountainous Laos under Shifting Cultivation Stabilization Policy

(ProQuest: ... denotes non-US-ASCII text omitted.)I IntroductionIn the late 1990s, village savings and credit groups (hereafter savings groups, or SGs) were introduced from Northeast Thailand to Laos by NGOs-Foundation for Integrated Agricultural and Environmental Management and Community Organizations Development Institute of Thailand-with the cooperation of the Lao Women's Union (LWU), first to villages in Vientiane Municipality and later to hinterland areas where the market economy was less developed (see Ohno and Fujita, special issue introduction paper). Raiffeisen's credit unions in Germany formed the original model for credit unions later developed in other areas, including other European nations, the United States, Japan, and also Northeast Thailand. When credit unions were introduced to these other areas, the economy-even in rural areas-was already commercialized and had a favorable infrastructure, which resulted in the successful growth of credit unions. In contrast, such conditions do not exist in Laos. The rural economy of Laos is still basically subsistenceoriented and largely isolated from urban centers due to poor infrastructure.Luang Prabang Province, which consists mostly of mountainous areas, is a typical case. Until recently, villagers there depended on cultivation under a village-level communal land management system, with staple food (rice) being produced for selfconsumption. Non-rice foods, such as various kinds of vegetables, were collected from the surrounding natural environment. Wild animals and fish were obtained through hunting and catching. Sales of livestock and non-timber products largely met the area's cash needs, and rural livelihoods remained basically in a state of self-sufficiency.1)However, in recent years the situation has gradually changed due to the growing population and increased cash needs among inhabitants, which have put pressure on natural resources. At the First National Forestry Conference, held in 1989, deforestation was officially identified as a major problem threatening the sustainability and stability of natural resource management in Laos (Khamphay and Phouthone 2009). Besides illegal logging, cultivation was identified as a major cause of deforestation. After the conference, a national program for shifting cultivation stabilization, land use planning and land was launched in 1990 and implemented on a trial basis in Luang Prabang and Sayabouly Provinces. Finally, the Seventh Party Congress in 1994 set a policy target to stabilize cultivation by 2005 with complete eradication by 2010, and donors and international organizations provided financial and technical support for implementing the policy in northern Laos (Takahashi and Liang 2010).2)The land use planning (LUP) program aimed at imposing restrictions on villagers' customary land use rights by introducing land use categories such as protection forest and conservation forest. Villagers were allowed to continue cultivation only in specific land categories. After a while, the land allocation (LA) program was introduced and three to five plots of land were equally allocated to every household. When villagers signed the Land Use Agreement,3) they were issued a Temporary Land Use Certificate (TLUC)4) for certifying ownership rights. They were prohibited from cultivating other lands. This implied de facto an introduction of a private landownership system in rural Laos. Villagers traditionally dependent on cultivation in communal land had to abandon it and start permanent upland cultivation. A policy of resettlement of highland people to lowland areas was also incorporated in this LUP/LA program.5)Under such a forced commercialization of livelihood in a short period of time, a critical question is: how did people adapt to the new policy and institutional environment in general, and how could they earn sufficient cash income to purchase rice and other necessities in particular, since it appears to have been difficult to produce enough rice only in the allocated upland fields? …

Infection Status of Zoonotic Trematode Metacercariae in Fishes from Vientiane Municipality and Champasak Province in Lao PDR.

The infection status of fishborne zoonotic trematode (FZT) metacercariae was investigated in fishes from 2 localities of Lao PDR. Total 157 freshwater fishes (17 species) were collected in local markets of Vientiane Municipality and Champasak Province in December 2010 and July 2011, and each fish was examined by the artificial digestion method. Total 6 species of FZT metacercariae, i.e., Opisthorchis viverrini, Haplorchis taichui, Haplorchis yokogawai, Haplorchis pumilio, Centrocestus formosanus, and Procerovum varium, were detected in fishes from Vientiane Municipality. The metacercariae of O. viverrini were detected in 50 (49.5%) out of 101 fishes (6 species), and their average number was 154 per fish infected. The remaining 5 species of heterophyid metacercariae were detected in 36.8%, 65.8%, 9.4%, 23.9%, and 5.1% fishes examined, and their average densities were 12, 1,038, 4, 15, and 13 per infected fish, respectively. In fishes from Champasak Province, 3 species of FZT metacercariae, i.e., O. viverrini, H. taichui, and H. yokogawai, were detected. Only 2 O. viverrini metacercariae were found in only 1 Barbonymus schwanefeldi. The metacercariae of H. taichui and H. yokogawai were detected in 60.0% and 50.0% of fishes examined, and their average densities were 47 and 28 per fish infected. By the present study, it has been confirmed that several species of FZT metacercariae are prevalent in fishes from Vientiane Municipality, with P. varium being a new member of FZT in Lao PDR. In comparison, FZT metacercariae are less prevalent in fishes from Champasak Province.

An Analysis on Borrowing Behavior of Rural Households in Vientiane Municipality: Case Study of Four Villages

Since the late 1990s the savings groups have been introduced in the villages of Laos. This movement has offered new borrowing opportunities for the rural people. Based on household survey using a structured questionnaire in four study villages (N=684) in Vientiane Municipality during 2007–08 we analyzed the role and performance of the savings group in rural financial markets, especially focusing on who borrows, from which sources, and for what purposes by comparing the savings group with informal and formal lenders. Two major findings are as follows. First, three types of lenders (savings groups, formal and informal lenders) have their own particular features, and thereby loan purposes differ significantly. Formal banks offer loans exclusively for production purposes, while informal lenders do for coping with emergencies. Savings groups fall between them. Second, though poor households are reluctant to be a savings group member, once they participate in they actively obtain loans from it. In contrast, though rich households actively participate in the group, they obtain loans less from it. Group members claim that the primary purpose of joining the savings group is to cope with emergencies. When the members obtain loans from the savings group, however, nearly 40% of the loans are used for production purposes, mainly in agriculture. There exists a change between saving purposes and borrowing ones. It is assumed that in villages with the higher loan credit for production purposes, the savings groups show favorable performance, and thus a rapid growth.

Current Status of Human Hookworm Infections, Ascariasis, Trichuriasis, Schistosomiasis Mekongi and Other Trematodiases in Lao People's Democratic Republic

Soil-transmitted helminth (STH) infections, and schistosomiasis and other trematodiases often have a high prevalence in developing countries. Here, we present updated information on the prevalence of these parasites in the Lao People's Democratic Republic (Lao PDR) in 2012, arising from the annual national helminthiasis survey. Fecal specimens were collected from 8,610 inhabitants of 12 provinces and one municipality (Bokeo, Houaphan, Luang Namtha, Luang Prabang, Oudomxay, and Phongsaly Provinces from northern Lao PDR; Bolikhamxay and Xieng Khouang Provinces and Vientiane Municipality from the central part of the country; and Attapeu, Champasak, Saravan, and Sekong Provinces from southern Lao PDR). The overall prevalence of three major STHs, Ascaris lumbricoides, Trichuris trichiura, and hookworms (Necator americanus and Ancylostoma duodenale) were 11.6%, 8.5%, and 25.0%, respectively. Prevalence of Schistosoma mekongi infection was 0.1%, and of miscellaneous trematodiases (including opisthorchiasis) was 14.0%. Clearly, the nationwide parasite control project is still necessary to reduce morbidity caused by helminthic diseases.

Teaching Methods, Approaches and Strategies Found in EFL Classrooms: A Case Study in Lao PDR

Abstract This qualitative research aims to investigate the EFL teaching methods, approaches and strategies which would be found in English as a foreign language classes in Lao PDR. To obtain the data, qualitative research methods, namely, observations and interviews were both administered with 5 English teachers, from schools in Vientiane Municipality, who agreed to participate in the research. The results of the study revealed that Communicative Language Teaching (CLT), Grammar Translation Method (GTM) and Total Physical Response (TPR) were three major methods/approaches found in the foreign language classrooms studied. Regarding the language teaching used, the activities found implemented in primary grade level were limited and short while more various activities were found in the secondary level. Many activities in the secondary schools provided the students more opportunity to communicate and use the language. In addition, the activities in the secondary level appeared to be longer and more complicated than those found in the primary level.

Echinostoma macrorchis in Lao PDR: metacercariae in Cipangopaludina snails and adults from experimentally infected animals.

The echinostome metacercariae encysted in Cipangopaludina sp. snails that were purchased from a market in Vientiane Municipality, Lao PDR, were identified as Echinostoma macrorchis (Digenea: Echinostomatidae) through recovery of adult flukes after experimental infection to rats and a cat. The metacercariae were round, 113-128 (121)×113-125 (120) µm, having a thick cyst wall, a head collar armed with collar spines, and excretory granules. The adult flukes recovered from the rats and cat at day 14 and 30 post-infection, respectively, were elongated, ventrally curved, and 3.9-6.3×0.7-1.1 mm in size. The head collar was distinct, bearing 43-45 collar spines with 5 angle spines on each side. Two testes were large (as the name implies), tandem, and slightly constricted at the middle, with irregular margins. Eggs were operculated, ovoid to elliptical, and 88-95×56-60 µm. In scanning electron microscopy, the head collar was prominent, with 43-45 collar spines. Scale-like tegumental spines were densely distributed on the ventral surface between the oral and ventral suckers. Sensory papillae were distributed mainly on the tegument around the 2 suckers. It is confirmed that E. macrorchis is distributed in Lao PDR using Cipangopaludina sp. snails as the second intermediate host.

Current Status of Human Taeniasis in Lao People's Democratic Republic

Human taeniasis was investigated in Lao People's Democratic Republic (Lao PDR) between 2000 and 2011 as part of the nation's helminthiasis survey. A total of 55,038 inhabitants, including 29,846 school children, were examined using the Kato-Katz and scotch-tape anal swab method, and morphological observation of adult worms. Molecular identification of Taenia tapeworms was performed by multiplex PCR or DNA sequence analysis of the mitochondrial cox1 gene. Taenia eggs were present at a rate of 1.5% (845/55,038) in the subject population. Adult tapeworms were identified as T. solium or T. saginata by analyzing the collectable stool specimens (n=126). Three specimens identified as T. solium were found in Luang Prabang, while the remaining 123 specimens, which were T. saginata, were found in Bokeo, Bolikhamxay, Champasak, Houaphan, Khammouane, Luang Namta, Luang Prabang, Oudomxay, Phongsaly, Saysomboune, Saravane, Savannakhet, Xayaboury, Xekong, Xieng Khouang Province, and Vientiane Municipality.

Associated factors with adherence to antiepileptic drug in the capital city of Lao PDR

Available medical care for epilepsy and antiepileptic drugs (AED) are provided in Vientiane Municipality by district hospitals supported by a non-governmental organization, which is referred to as a community-based intervention (CB), and reference hospital which is referred to as hospital-based interventions (HB). Identifying underlying factors of AED adherence is of public health interest. A community-based cross-sectional survey among randomly selected patients with epilepsy (PWE) who were being cared in Vientiane Municipality was undertaken in 2010. The Morisky scale was used to assess the level of adherence. Univariate and multivariate logistic regression analyses were performed to address predictive factors. Overall, 99 PWE were included in the study. Overall adherence was estimated at 57.6%, 57.1% and 58.0% for the HB and CB group, respectively. High level of adherence was related to illiteracy, being on monotherapy and experiencing fewer seizures. Implementing closer medical care at primary level to PWE improves the likelihood of reducing primary and secondary treatment gap which is related to PWEs' adherence. An active intervention through a downstream channel of training of medical health staff from reference level to community level enhances the prescription of adequate AED, the improvement of the quality of relation between PWE and medical staff.

Centrocestus formosanus(Heterophyidae): Human Infections and the Infection Source in Lao PDR

In Lao People's Democratic Republic (PDR), we detected 7 patients infected with Centrocestus formosanus (1-122 adult specimens) after praziquantel treatment and purgation, together with several other trematode species including Opisthorchis viverrini and Haplorchis taichui. The patients were all men, 23-42 yr-of-age. Three subjects were from Vientiane Municipality and 1 each were from Khammouane, Saravane, Champassak, and Xiengkhouang Province. The patients had frequently eaten raw freshwater fish and were experiencing variable degrees of epigastric pain and indigestion accompanied by occasional diarrhea, although the relationship of these symptoms with C. formosanus infection was unclear. Centrocestus formosanus specimens were ovoid, 0.46 mm (0.41-0.52 mm) long, and 0.18 mm (0.16-0.20 mm) wide (n = 10) and were equipped with 32 circumoral spines on the oral sucker. The uterine eggs were 33.2 μm long (31.8-34.9 μm) and 18.5 μm wide (17.4-19.8 μm) (n = 20). Analysis of the nucleotide sequence of the 18S ribosomal RNA gene of our specimens (Laotian isolate) revealed 100% homology with that of an isolate from the United States reported in GenBank. Several species of freshwater fish collected from Xiengkhouang Province revealed a 17.0% prevalence (9 of 53 fish examined) for C. formosanus metacercariae. The results suggest that human C. formosanus infections have been masked by other trematode infections.

Fishborne Trematode Metacercariae Detected in Freshwater Fish from Vientiane Municipality and Savannakhet Province, Lao PDR

Freshwater fish from Vientiane Municipality and Savannakhet Province, Lao PDR were examined by the muscle compression and artificial digestion methods to know the infection status with trematode metacercariae. In the fish from Savannakhet, 2 species of metacercariae, Opisthorchis viverrini and Haplorchis taichui, were detected. O. viverrini metacercariae were found in 6 species of fish, Puntius brevis, Hampala dispar, Esomus metallicus, Mystacoleucus marginatus, Puntioplites falcifer, and Cyclocheilichthys armatus. H. taichui metacercariae were detected in 3 species of fish, P. brevis, P. falcifer, and M. marginatus. In the fish from Vientiane, 4 species of metacercariae, O. viverrini, H. taichui, Haplorchis yokogawai, and Centrocestus formosanus, were detected. Among them, O. viverrini metacercariae were found in 7 species of fish, Onychostoma elongatum, C. armatus, H. dispar, P. brevis, Cyclocheilichthys repasson, Osteochilus hasseltii, and Hypsibarbus lagleri. The metacercariae of H. taichui were detected in 6 species of fish, C. repasson, O. elongatum, C. armatus, H. dispar, Labiobarbus leptocheila, and Cirrhinus molitorella. The metacercariae of H. yokogawai were found in 9 species of fish, C. repasson, O. elongatum, C. armatus, H. dispar, Labiobarbus leptocheila, O. hasseltii. C. molitorella, Hypsibarbus wetmorei, and H. lagleri. The metacercariae of C. formosanus were detected in 4 species of fish, C. repasson, P. brevis, O. hasseltii, and C. molitorella. From these results, it is confirmed that fishborne trematode metacercariae, i.e. O. viverrini, H. taichui, H. yokogawai and C. formosanus, are prevalent in various species of freshwater fish from Savannakhet Province and Vientiane Municipality, Lao PDR.

Centrocestus formosanus (Digenea: Heterophyidae) Encysted in the Freshwater Fish, Puntius brevis, from Lao PDR

The metacercariae of Centrocestus formosanus, a minute intestinal trematode of mammals and birds, were detected in the freshwater fish, Puntius brevis, from Vientiane Municipality, Lao PDR. The metacercariae were experimentally fed to mice, and adult flukes were recovered in their small intestines 7 days later. The adult flukes were morphologically characterized by having 32 (rarely 34) circumoral spines arranged in 2 alternative rows, a large bipartite seminal vesicle, an oval-shaped ovary, and an X-shaped excretory bladder. Based on these characters, the adults were identified as Centrocestus formosanus (Nishigori, 1924). The taxonomic significance of C. formosanus, in relation to a closely related species, C. caninus (Leiper, 1913), is briefly discussed. It has been first verified by adult worm recovery that C. formosanus is prevalent in Vientiane areas of Lao PDR, taking the freshwater fish, P. brevis, as a second intermediate host.

Availability and Costs of Antiepileptic Drugs and Quality of Phenobarbital in Vientiane Municipality, Lao PDR

Purpose: In developing countries, availability and quality of drugs are critical factors for effective management and control of epilepsy. This study investigated the availability and costs of antiepileptic drugs (AEDs), and the quality of phenobarbital in Vientiane Municipality, Lao PDR. Methods: In March 2004, we enrolled all pharmacies (categories I and II) of four central districts of Vientiane eligible to sell AEDs. Two hundred and eight pharmacies of category III (75.1% of all registered pharmacies) were excluded as the sale of AEDs was not authorized. All pharmacists were interviewed with a standard questionnaire. Whenever phenobarbital was available, a sample was purchased and assayed by liquid chromatography. Phenobarbital was defined as being of correct quality if the active substance average content corresponded to ±15% of the indicated amount. Results: 66 pharmacies were enrolled (13 and 45 of categories I and II, respectively, and 8 hospital pharmacies). Six generics of AEDs were found (phenobarbital, phenytoin, valproic acid, clonazepam, carbamazepine, diazepam) and all pharmacies sold at least 1 AED. The 2 most widely available drugs were diazepam (5 mg) and phenobarbital (100 mg), present in 87.9 and 53.0% of the pharmacies, respectively. All 34 phenobarbital samples examined showed a correct concentration of the active compound. However, the concentration of phenobarbital 100 mg tablets produced in Lao PDR (mean concentration 94.7 mg) was significantly lower (p = 0.005) than the imported equivalent (mean concentration 99.7 mg). The direct drug costs of a yearly treatment with phenobarbital were estimated to be at least 25.2 USD. Conclusions:A variety of AEDs are present. Their availability, particularly of phenobarbital, is restricted to higher-category pharmacies and within those it is rather limited. To meet the costs of AEDs in this setting is a major challenge for people with epilepsy. However, the quality of the available phenobarbital was rather satisfactory.

Social Support for Children with Cerebral Palsy in Vientiane Municipality, Lao P.D.R.

Social Support for Children with Cerebral Palsy in Vientiane Municipality, Lao P.D.R.

Health-care waste management in Lao PDR: a case study

This study investigated the health-care waste (HCW) management at each health-care facility level at two selected sites in the Lao People's Democratic Republic (Lao PDR): Vientiane Municipality; and Bolikhamxay province. It focused on the amount of HCW, its segregation and the factors influencing HCW management, particularly segregation procedures. A high proportion of incorrectly segregated medical waste was found at each level of health-care facility. Re-segregation revealed 39, 62, 57 and 37% at national hospital, provincial hospital, district hospital and health centre level, respectively, was poorly segregated. The mean of generated HCW was 0.62 kg/bed per day (Vientiane Municipality) and 0.38 kg/bed per day (Bolikhamxay) at two study sites. A higher proportion of medical waste (MW) from the inpatient department at the primary health-care level was found. Thus, HCW management at primary health-care facilities needs more attention and should be better understood.

Mixed infections with Opisthorchis viverrini and intestinal flukes in residents of Vientiane Municipality and Saravane Province in Laos

Faecal examinations for helminth eggs were performed on 1869 people from two riverside localities, Vientiane Municipality and Saravane Province, along the Mekong River, Laos. To obtain adult flukes, 42 people positive for small trematode eggs (Opisthorchis viverrini, heterophyid, or lecithodendriid eggs) were treated with a 20-30 mg kg(-1) single dose of praziquantel and purged. Diarrhoeic stools were then collected from 36 people (18 in each area) and searched for helminth parasites using stereomicroscopes. Faecal examinations revealed positive rates for small trematode eggs of 53.3% and 70.8% (average 65.2%) in Vientiane and Saravane Province, respectively. Infections with O. viverrini and six species of intestinal flukes were found, namely, Haplorchis taichui, H. pumilio, H. yokogawai, Centrocestus caninus, Prosthodendrium molenkampi, and Phaneropsolus bonnei. The total number of flukes collected and the proportion of fluke species recovered were markedly different in the two localities; in Vientiane, 1041 O. viverrini (57.8 per person) and 615 others (34.2 per person), whereas in Saravane, 395 O. viverrini (21.9 per person) and 155207 others (8622.6 per person). Five people from Saravane harboured no O. viverrini but numerous heterophyid and/or lecithodendriid flukes. The results indicate that O. viverrini and several species of heterophyid and lecithodendriid flukes are endemic in these two riverside localities, and suggest that the intensity of infection and the relative proportion of fluke species vary by locality along the Mekong River basin.

Meeting the Contraceptive Needs of Unmarried Young People: Attitudes of Formal and Informal Sector Providers in Vientiane Municipality, Lao PDR

In Lao PDR, evidence is emerging of considerable sexual activity among unmarried youth, but contraceptive services remain inadequate to meet their needs. This study explored the attitudes of formal and informal sector providers in serving the contraceptive needs of unmarried youth in Vientiane Municipality, their perceptions of quality of care, confidentiality and privacy, level of comfort in discussing sexual matters, and any differences between providers in the two sectors. In-depth interviews were carried out with 56 key informants, followed by a quantitative survey of 150 formal sector and 100 informal sector providers. We found ambivalence and discomfort among providers in communicating with unmarried youth and providing contraceptives to them, and low priority placed on their right to privacy and confidentiality. Providers tended to attribute difficulties almost entirely to young people's inhibitions and unwillingness to listen. Less than 60% of formal sector providers would supply contraceptives to unmarried youth, compared to 80% of informal providers, but the latter were more likely to charge a fee for supplies. Both formal and informal sector providers need training in communication and counselling skills for serving unmarried youth. Programmes must ensure that unmarried youth have access to good quality contraceptive services and supplies.

Prevalence of intestinal parasite infections on a national scale among primary schoolchildren in Laos.

In order to investigate the epidemiological situation of intestinal parasite infections in Laos, parasitological surveys were carried out on a national scale including 17 provinces and the Vientiane Municipality. A total of 29,846 stool specimens were collected from primary schoolchildren from May 2000 to June 2002 and examined once with the cellophane thick smear technique. The cumulative egg positive rate for intestinal helminths was 61.9%. By species, the rate for Ascaris lumbricoides was 34.9%, hookworm 19.1%, Trichuris trichiura 25.8%, Opisthorchis viverrini 10.9%, Taenia spp. 0.6% and Hymenolepis spp. 0.2%. The northern mountainous regions such as Phongsaly, Huaphan or Saysomboune Province showed a higher prevalence (over 70%) of soil- transmitted helminths. The regions along the Mekong River such as Khammuane, Saravane or Savannakhet Province showed a higher prevalence (over 20%) of fish-borne parasites. On the other hand, Schistosoma mansoni eggs were detected in 1.7% of schoolchildren only in Champassak Province, a previously endemic area. The highest prevalence was noted in Phongsaly Province (96.0%) and the lowest in Bolikhamxay Province (27.5%). An additional small-scale survey by cellophane anal swab detected Enterobius vermicularis eggs in 35.7% of 451 schoolchildren aged 6-8 years in Khammuane, Vientiane, Champassak Province and the Vientiane Municipality. Meanwhile, the mean blood haemoglobin level of hookworm-infected children was not lower than that of children not infected with hookworm, suggesting that nutritional factors are more important than parasite infection per se. Nevertheless, the above results indicate that a nationwide parasite control project is necessary to reduce possible morbidity due to parasitic diseases in the country.