Improved latrines minimally impact Schistosoma mekongi transmission in Mekong islands

Schistosoma mekongi and other intestinal helminth infections remain public health concerns in Lao People's Democratic Republic, especially in remote areas where access to sanitation is limited.We performed an experimental study in four villages where latrine construction was coupled with two rounds of mass drug administration (MDA) with praziquantel and albendazole, and compared with two control villages that only received two rounds of MDA. The prevalence of helminth infections before (baseline) and after (follow-up) intervention were compared. Additionally, the prevalence in intervention and control villages were compared 12 months post-intervention. Kato–Katz, formalin-ethyl acetate concentration and Baermann techniques were employed to assess helminth infections.We found infection prevalence of S. mekongi in the intervention and control villages was 28.6% and 1.8%, respectively. The prevalences of other helminth infections were as follows: Opisthorchis viverrini, 79.5% and 71.8%;hookworm, 48.8% and 65.6%;and Strongyloides stercoralis, 43.1% and 38.3%. Other helminth species were detected in less than 5% of the study participants. Latrine intervention coupled with two rounds of MDA in the intervention villages reduced the prevalence of S. mekongi infection by 6.0% (from 28.6% to 22.6%;P < 0.001), O. viverrini infection by 11.3% (from 79.5% to 68.2%;P < 0.001), hookworm infection by 22.6% (from 48.8% to 26.2%;P < 0.001), and S. stercoralis infection by 12.0% (from 43.1% to 31.1%;P < 0.001). The observed reductions were not significantly different when compared to the control villages, where only two rounds of MDA were implemented (P > 0.05). Study participants in both groups commonly engaged in behaviours such as open defecation, bathing in the Mekong River, consuming raw or undercooked fish dishes and walking barefoot. These practices and behaviours are associated with helminth infections. Concluding, this study showed only a marginal impact associated with latrine use in intervention communities. There is a need for longer term studies with integrated interventions, such as effective health education to foster behavioural changes related to open defecation, raw or undercooked food consumption, wearing protected footwear outdoors, and personal hygiene.

MY CONTRIBUTION TO THE CONTROL OF PARASITIC DISEASES

The parasitic pest is omnipresent in the world providing there are biological communities existing. Almost everywhere on the earth,human health is constantly threatened by some parasites to a greater or lesser degree.In the same way,domestic animals and economic plants have always fallen prey to the scourge.leading to yield reductions.As parasitic diseases are chronic in progress,people often neglect them until they become fatal.China is a country with vast territory and diversity in the

Integrated Eco-Health approach significantly reduces helminth infections in endemic Khong islands with emphasis on Schistosoma mekongi

Background Helminth infections, includingOpisthorchis viverrini, hookworm, andTrichuris trichiura, are prevalent in Khong district, Champasack province, southern Lao People’s Democratic Republic (PDR). Schistosomiasis caused bySchistosoma mekongi is of public health concern on the islands of the Khong district. This study aimed to assess the impact of an Eco-Health/One-Health approach in combination with mass drug administration (MDA) to reduce these helminth infections.Methods We conducted a community intervention using a stepped-wedge trial approach on two endemic islands (Donsom and Donkhone) of the Khong district, Champasack province, Lao PDR, between April 2012 and March 2013. In each study village, 30–40 households were randomly selected. All members of selected households, who were at home during the study period were invited to participate in the study. A baseline study was conducted to assess helminth infections, knowledge attitudes and practices towardSchistosoma mekongi infection, behavior of open defecation and availability of latrine at home. After the baseline (T0), the Eco-Health/One-Health approach was implemented on Donsom (intervention) and Donkhone island (control). An assessment was conducted in 2014 (T1), one year after the completion of intervention implementation, to assess the short-term impact of the Eco-Health/One-Health approach on helminth infections and compare intervention and control islands. Later in 2015, the Eco-Health/One-Health approach was implemented on control island (Donkhone). After the implementation of intervention, the parasitological assessments were conducted annually in humans in 2015 (T2), in 2016 (T3) and in 2017 (T4), and in dogs in 2017 (T4) to evaluate the long-term impact of the intervention on helminth infections. Frequency was used to describe the prevalence of helminth infections. Logistic regression was applied to associate the KAP (knowledge, attitudes, and practices and open defecation behavior) and the reduction of helminth infections between intervention and control islands. The reduction in prevalence pre- and post-intervention was associated using a McNemar test. A two-independent samplet-test was applied to compare the mean eggs per gram (EPG) of helminth infections between control and intervention islands. A paired t-test test was used to compare the mean EPG of stool samples before (baseline) and after (follow-up) interventions for the two islands separately. AP-value lower than 0.05 was considered statistically significant.Results Eco-Health/One-Health approach appears to be associated with reduction in prevalence ofS. mekongi by 9.0% [odds ratio (OR) = 0.49,P = 0.003] compared to the use of mass drug administration alone (control island). Additionally, this intervention package significantly reducedO. viverrini infection by 20.3% (OR = 1.92,P < 0.001) and hookworm by 17.9% (OR = 0.71,P = 0.045), respectively. Annual parasitological assessments between 2012 and 2017 showed that the Eco-Health/One-Health approach, coupled with MDA, steadily reduced the prevalence ofS. mekongi on the intervention island from 29.1% to 1.8% and on the control island from 28.4% to 3.1%, respectively.Conclusions The study findings suggest that the Eco-Health/One-Health approach appears to be associated with a significant reduction in prevalence ofS. mekongi and helminth co-infections, particularly hookworm andT. trichiura. Therefore, implementing the Eco-Health/One-Health approach in schistosomiasis-endemic areas could accelerate the achievement of national goals for transmission interruption by 2025 and elimination by 2030.