Vonghachack Youthanavanh, Odermatt Peter, Taisayyavong Keoka, Phounsavath Souphanh, Akkhavong Kongsap, Sayasone Somphou
Swiss Tropical and Public Health Institute, Basel, Switzerland.
University of Basel, Basel, Switzerland.
Infect Dis Poverty. 2017 Sep 4;6(1):131. doi: 10.1186/s40249-017-0343-x.
Prevalence of Opisthorchis viverrini, Schistosoma mekongi and soil-transmitted helminths (STH) remains high in Lao People's Democratic Republic (Lao PDR), despite control efforts including mass-drug administration, education and communication campaigns. New approaches are required to advance helminth control.
An ecohealth study was conducted on two Mekong islands in Southern Laos. Demographic and behavioural data were collected by questionnaire. Human and animal reservoir stools were examined. Bithynia spp. and Neotricula aperta snails were examined using shedding. Fresh water fish were examined using digestion technique. Multivariate random-effects analysis was used to find risk factors associated with helminth infections.
Human infection rates with O. viverrini, hookworm, S. mekongi, Trichuris trichiura, Ascaris lumbricoides and Taenia spp. were 60.7%, 44.1%, 22.2%, 4.1%, 0.6% and 0.1%, respectively. Heavy intensity infections were 4.2%, 3.6% and 1.8% for O. viverrini, S. mekongi and hookworm, respectively. O. viverrini and S. mekongi infection rates among dogs and cats were 25.0% and 14.7%, respectively. Of the cats tested, 53.1% were infected with O. viverrini. Prevalence of O. viverrini and S. mekongi in snails was 0.3% and 0.01%, respectively. Overall prevalence of O. viverrini infection in fresh water fish was 26.9%, with the highest infection rates occurring in Hampala dispa (87.1%), Cyclocheilichthys apogon (85.7%) and Puntius brevis (40.0%). Illiteracy and lower socioeconomic status increased the risk of O. viverrini infection, while those aged 10-16 years and possessing latrines at home were less likely to be infected. Household dogs and cats that consumed raw fish were significantly and positively associated with O. viverrini infection of the household members. For S. mekongi, children under 9 years old were exposed significantly to this infection, compared to older age groups.
There is a pressing need to design and implement an integrated helminth control intervention on the Mekong Islands in southern Lao PDR. Given the highly dynamic transmission of O. viverrini, S. mekongi, STH and extended multiparasitism, annual mass-drug administration is warranted along with environmental modifications, health education and improved access to clean water and adequate sanitation to consolidate morbidity control and move towards elimination.
Our findings presented here are from a cross-sectional study, therefore, it has not been registered.
尽管老挝人民民主共和国（老挝）开展了包括大规模药物给药、教育和宣传活动在内的防控工作，但湄公河狸殖吸虫、湄公血吸虫和土源性蠕虫（STH）的流行率仍然很高。需要新的方法来推进蠕虫控制工作。
在老挝南部的两个湄公河岛屿上进行了一项生态健康研究。通过问卷调查收集人口统计学和行为数据。检查人类和动物宿主的粪便。使用孵化法检查豆螺属和新穴螺。使用消化技术检查淡水鱼。采用多变量随机效应分析来寻找与蠕虫感染相关的危险因素。
湄公河狸殖吸虫、钩虫、湄公血吸虫、鞭虫、蛔虫和带绦虫属的人类感染率分别为60.7%、44.1%、22.2%、4.1%、0.6%和0.1%。湄公河狸殖吸虫、湄公血吸虫和钩虫的重度感染率分别为4.2%、3.6%和1.8%。狗和猫中湄公河狸殖吸虫和湄公血吸虫的感染率分别为25.0%和14.7%。在接受检测的猫中，53.1%感染了湄公河狸殖吸虫。豆螺属和新穴螺中湄公河狸殖吸虫和湄公血吸虫的流行率分别为0.3%和0.01%。淡水鱼中湄公河狸殖吸虫感染的总体流行率为26.9%，在汉氏结鱼（87.1%）、似野结鱼（85.7%）和短须鲃（40.0%）中感染率最高。文盲和社会经济地位较低会增加湄公河狸殖吸虫感染的风险，而10 - 16岁且家中有厕所的人感染的可能性较小。食用生鱼的家犬和家猫与家庭成员的湄公河狸殖吸虫感染显著正相关。对于湄公血吸虫，与年龄较大的群体相比，9岁以下儿童感染这种寄生虫的风险显著更高。
迫切需要在老挝南部的湄公河岛屿上设计并实施综合蠕虫控制干预措施。鉴于湄公河狸殖吸虫、湄公血吸虫、土源性蠕虫的传播高度动态且存在多种寄生虫共感染情况，有必要每年进行大规模药物给药，同时进行环境改造、健康教育并改善清洁水供应和卫生设施，以巩固发病率控制并朝着消除感染的目标迈进。
我们在此呈现的研究结果来自一项横断面研究，因此未进行注册。
