Phongluxa Khampheng, van Eeuwijk Peter, Soukhathammavong Phonepasong Ayé, Akkhavong Kongsap, Odermatt Peter
National Institute of Public Health, Ministry of Health, Ban Kaognot, Sisattanak District, Vientiane Capital, Lao People's Democratic Republic; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland.
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland; Institute of Social Anthropology, University of Basel, Münsterplatz 19, CH-4051 Basel, Switzerland.
Acta Trop. 2015 Jan;141(Pt B):281-8. doi: 10.1016/j.actatropica.2014.03.022. Epub 2014 Apr 5.
Multiple helminth infections are very common in communities of southern Laos. Preventive chemotherapy in combination with health education is the mainstay of control. We assessed the knowledge, perceptions and practices of rural communities related to endemic helminthiasis and their control during a mass drug administration (MDA) campaign. Short interviews with household heads (n=192), direct observations and discussions with attendees of MDAs, and in-depth interviews with local opinion leaders (n=21) were carried out. Quantitative and qualitative data analysis was performed. Results showed that opinion leaders and villagers were well aware of the importance of attending MDA. Leaders perceived the effectiveness of MDA against severe schistosomiasis and appreciated that it was provided for free and in their village. They encouraged villagers to attend it. Anticipated adverse events of praziquantel was a barrier for participation. A majority of leaders purchased deworming tablet (mebendazole, albendazole) in a local pharmacy for deworming when MDA is absent in their villages (19/21). Most leaders (20/21) had a good knowledge on severe schistosomiasis though only a few of them (5/21) described its cause correctly. They knew little about the disease consequences of liver fluke (3/21) and soil-transmitted helminth (4/21) infections but more about their causes. A high risk for worm infection was observed: consumption of raw or insufficiently cooked fish (100%), frequent physical contacts with Mekong River water (76.0%) and low number of latrines (14.5%). In conclusion, MDA is widely accepted in affected communities. Avoiding severe schistosomiasis was the main motivation to comply. Participation rates increased significantly with drugs provided free of charge in the villages. Better knowledge on the consequences of worm infections and on its modes of transmission will foster the distribution and acceptance of appropriate preventive treatment and other measures in helminth-endemic communities. Where multiple infections require several drugs for MDA, preceding health education and information about MDA and its benefits are a prior condition.
多重蠕虫感染在老挝南部社区非常普遍。预防性化疗结合健康教育是防控的主要手段。我们在一次群体药物驱虫活动中评估了农村社区与地方性蠕虫病及其防控相关的知识、认知和行为。对户主进行了简短访谈（n = 192），对群体药物驱虫活动的参与者进行了直接观察和讨论，并对当地意见领袖进行了深入访谈（n = 21）。进行了定量和定性数据分析。结果显示，意见领袖和村民都充分意识到参加群体药物驱虫活动的重要性。领袖们认识到群体药物驱虫活动对重症血吸虫病的有效性，并赞赏其在本村免费提供。他们鼓励村民参加。吡喹酮预期的不良事件是参与的一个障碍。大多数领袖（19/21）在本村没有群体药物驱虫活动时会在当地药店购买驱虫药（甲苯达唑、阿苯达唑）进行驱虫。大多数领袖（20/21）对重症血吸虫病有较好的了解，尽管只有少数人（5/21）能正确描述其病因。他们对肝吸虫（3/21）和土源性蠕虫（4/21）感染的疾病后果了解甚少，但对其病因了解较多。观察到蠕虫感染的高风险因素：食用生的或未充分煮熟的鱼（100%）、频繁与湄公河水有身体接触（76.0%）以及厕所数量少（14.5%）。总之，群体药物驱虫活动在受影响社区被广泛接受。避免重症血吸虫病是依从的主要动机。在村里免费提供药物时参与率显著提高。对蠕虫感染后果及其传播方式有更好的了解将促进在蠕虫地方性流行社区分发和接受适当的预防性治疗及其他措施。在多重感染需要几种药物进行群体药物驱虫时，之前的健康教育以及关于群体药物驱虫活动及其益处的信息是一个先决条件。
