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

• Published in: Infectious diseases of poverty 2024-08, Vol.13 (1), p.57-15, Article 57
• Main Authors: Sayasone, Somphou, Vonghachack, Youthanavanh, Xia, Shang, Lv, Shan, Zhou, Xiao-Nong, Odermatt, Peter
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Animals; Anthelmintics - therapeutic use; Child; Child, Preschool; Female; Health aspects; Helminthiasis - epidemiology; Helminthiasis - prevention & control; Humans; Infection; Islands - epidemiology; Laos - epidemiology; Male; Mass Drug Administration - methods; Medical research; Medicine, Experimental; Middle Aged; One Health; Opisthorchis viverrini; Parasite control; Prevalence; Sanitation; Sanitation and hygiene; Schistosoma - physiology; Schistosoma mekongi; Schistosomiasis - epidemiology; Schistosomiasis - prevention & control; Soil-transmitted helminth; Water; Young Adult
• ISSN: 2049-9957; 2049-9957
• DOI: 10.1186/s40249-024-01226-z

Helminth infections, including Opisthorchis viverrini, hookworm, and Trichuris trichiura, are prevalent in Khong district, Champasack province, southern Lao People's Democratic Republic (PDR). Schistosomiasis caused by Schistosoma 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. 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 toward Schistosoma 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 sample t-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. A P-value lower than 0.05 was considered stat