Department of Public Health Administration, Health Promotion, Nutrition, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
BMC Public Health. 2018 Oct 19;18(1):1184. doi: 10.1186/s12889-018-6081-6.
Strongyloidiasis is prevalent in northeast Thailand. This study aimed to evaluate the impact of the Health Education and Preventive Equipment Package (HEPEP), a package we developed to improve awareness and aid in the prevention of Strongyloides stercoralis infection among rural communities in northeast Thailand.
This was an intervention trial conducted in 12 villages (six interventions and six controls) in rural areas of northeast Thailand from March 2016 to September 2017. Single stool sample was collected from each participant and examined using agar plate culture (APC) technique. Each participant was interviewed using a pre-tested questionnaire, treated with single dose of ivermectin (200 μg/Kg), and allocated to either the intervention or control group. Members of the intervention group were given "Practices to Prevent Strongyloidiasis" poster and vinyl boards containing information aimed at raising awareness of S. stercoralis and strongyloidiasis. In addition, they were given a poster lecture regarding the lifecycle of S. stercoralis before being treated with ivermectin. Aside from that, they were also given a protective equipment package. Monthly refresher courses were provided by village health volunteers (VHVs) regarding the health information they had received and proper equipment usage. The control group, on the other hand, was only provided with a five-minute lecture regarding strongyloidiasis. Assessment of new infection was conducted 3 months later in 327 and 318 participants in the intervention group and control group, respectively.
The HEPEP had 41% greater efficacy in preventing S. stercoralis infection in the intervention group than the measures taken in the control group (adjusted Odds Ratio (aOR) = 0.59; 95%CI: 0.41 to 0.85, P-value = 0.005). The intervention group also scored significantly higher on all aspects of a test of S. stercoralis knowledge compared with the control group (mean difference (mean dif.) = 2.89, P-value = < 0.05).
The HEPEP was the first model that has been found to be effective in controlling of S. stercoralis in rural communities in the northeast Thailand. The results should encourage policy makers and public health personnel to improve control programs, as well as health promotion, with regard to parasites.
Thai Clinical Trials Registry (TCTR), Medical Research Foundation of Thailand, Medical Research Network of the Consortium of Thai Medical Schools: MedResNet (Thailand) (identification number: TCTR20180404002 ) Registered 4 April 2018 (retrospectively registered).
旋毛虫病在泰国东北部流行。本研究旨在评估健康教育和预防设备包（HEPEP）的效果，这是我们为提高农村社区对泰国东北部的斯氏旋毛虫感染的认识和帮助预防而开发的一个方案。
这是一项在 2016 年 3 月至 2017 年 9 月期间在泰国东北部农村地区的 12 个村庄（6 个干预组和 6 个对照组）进行的干预试验。从每个参与者收集单个粪便样本，并使用琼脂平板培养（APC）技术进行检查。每个参与者都使用预先测试的问卷进行访谈，并接受单次伊维菌素（200μg/Kg）治疗，然后被分配到干预组或对照组。干预组的成员获得了“预防旋毛虫病实践”海报和载有提高对斯氏旋毛虫和旋毛虫病认识信息的乙烯基板。此外，在接受伊维菌素治疗之前，他们还接受了关于斯氏旋毛虫生命周期的海报讲座。除此之外，他们还获得了一个防护设备包。村卫生志愿者（VHVs）每月提供有关他们所收到的健康信息和正确设备使用的复习课程。另一方面，对照组只接受了五分钟的旋毛虫病讲座。在干预组和对照组中，分别有 327 名和 318 名参与者在 3 个月后评估新感染情况。
与对照组相比，HEPEP 预防斯氏旋毛虫感染的效果高出 41%（调整后的优势比（aOR）=0.59；95%CI：0.41 至 0.85，P 值=0.005）。干预组在斯氏旋毛虫知识测试的所有方面的得分也明显高于对照组（平均差异（mean dif.）=2.89，P 值<0.05）。
HEPEP 是第一个被发现对泰国东北部农村社区控制斯氏旋毛虫有效的模式。研究结果应鼓励政策制定者和公共卫生人员改进寄生虫控制方案以及健康促进措施。
泰国临床试验注册处（TCTR），泰国医学研究基金会，泰国医学学校联盟医学研究网络：MedResNet（泰国）（注册号：TCTR20180404002）于 2018 年 4 月 4 日注册（追溯注册）。
