Kompor Pontip, Muang Karn Rattikarn, Norkaew Jun, Kujapun Jirawoot, Photipim Mali, Ponphimai Sukanya, Chavengkun Wasugree, Phong Paew Somkiat, Kaewpitoon Soraya, Rujirakul Ratana, Wakhuwathapong Parichart, Phatisena Tanida, Eaksanti Thawatchai, Joosiri Apinya, Polsripradistdist Poowadol, Padchasuwan Natnapa, Kaewpitoon Natthawut
Master of Public Health, Vongchavalitkul University, Bangkok, Thailand E-mail :
Asian Pac J Cancer Prev. 2016;17(2):685-9. doi: 10.7314/apjcp.2016.17.2.685.
Opisthorchiasis is still a major health problem in rural communities of Thailand. Infection is associated with cholangiocarcinoma (CCA), which is found frequently in Thailand, particularly in the northeastern. Therefore, this study aimed to evaluate the effectiveness of health intervention in the population at risk for opisthorchiasis and CCA. A quasi-experimental study was conducted in Meuang Yang district, Nakhon Ratchasima province, northeastern Thailand, between June and October 2015. Participants were completed health intervention comprising 4 stations; 1, VDO clip of moving adult worm of liver fluke; 2, poster of life cycle of liver fluke; 3, microscopy with adult and egg liver fluke; and 4, brochure with the knowledge of liver fluke containing infection, signs, symptoms, related disease, diagnosis, treatment, prevention, and control. Pre-and-post-test questionnaires were utilized to collect data from all participants. Students paired t-tests were used to analyze differences between before and after participation in the health intervention. Knowledge (mean difference=-7.48, t=-51.241, 95% CI, -7.77, -7.19, p-value =0.001), attitude (mean difference=-9.07, t=-9.818, 95% CI=-10.9, -7.24, p-value=0.001), and practice (mean difference=-2.04, t=-2.688, 95% CI=-3.55, -0.53, p-value=0.008), changed between before and after time points with statistical significance. Community rules were concluded regarding: (1) cooked cyprinoid fish consumption; (2) stop under cooked cyprinoid fish by household cooker; (3) cooked food consumption; (4) hygienic defecation; (5) corrected knowledge campaign close to each household; (6) organizing a village food safety club; (7) and annual health check including stool examination featuring monitoring by village health volunteers and local public health officers. The results indicates that the present health intervention program was effective and easy to understand, with low cost and taking only a short time. Therefore, this program may useful for further work at community and provincial levels for liver fluke prevention and control.
肝吸虫病仍是泰国农村社区的一个主要健康问题。感染与胆管癌（CCA）有关，CCA在泰国很常见，尤其是在东北部地区。因此，本研究旨在评估针对肝吸虫病和CCA高危人群的健康干预措施的效果。2015年6月至10月期间，在泰国东北部呵叻府的孟阳区进行了一项准实验研究。参与者完成了包括4个环节的健康干预：1. 肝吸虫成虫活动的视频片段；2. 肝吸虫生命周期的海报；3. 肝吸虫成虫和虫卵的显微镜观察；4. 包含肝吸虫感染、体征、症状、相关疾病、诊断、治疗、预防和控制知识的宣传册。通过前后测试问卷收集所有参与者的数据。采用学生配对t检验分析参与健康干预前后的差异。知识（平均差值=-7.48，t=-51.241，95%置信区间，-7.77，-7.19，p值=0.001）、态度（平均差值=-9.07，t=-9.818，95%置信区间=-10.9，-7.24，p值=0.001）和行为（平均差值=-2.04，t=-2.688，95%置信区间=-3.55，-0.53，p值=0.008）在前后两个时间点之间发生了具有统计学意义的变化。得出了社区规则，包括：（1）食用煮熟的鲤科鱼类；（2）家庭炊具停止烹饪未煮熟的鲤科鱼类；（3）食用熟食；（4）卫生排便；（5）在每户附近开展纠正知识宣传活动；（6）组织村庄食品安全俱乐部；（7）以及每年进行健康检查，包括粪便检查，由村庄健康志愿者和当地公共卫生官员进行监测。结果表明，目前的健康干预计划有效且易于理解，成本低且耗时短。因此，该计划可能有助于在社区和省级层面进一步开展肝吸虫预防和控制工作。
