Vonghachack Youthanavanh, Odermatt Peter, Utzinger Jürg, Sayasone Somphou
Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
University of Basel, Basel, Switzerland.
Sci One Health. 2023 Sep 9;2:100038. doi: 10.1016/j.soh.2023.100038. eCollection 2023.
and other intestinal helminth infections remain public health concerns in Lao People's Democratic Republic, especially in remote areas where access to sanitation is limited. We performed an experimental study in four villages where latrine construction was coupled with two rounds of mass drug administration (MDA) with praziquantel and albendazole, and compared with two control villages that only received two rounds of MDA. The prevalence of helminth infections before (baseline) and after (follow-up) intervention were compared. Additionally, the prevalence in intervention and control villages were compared 12 months post-intervention. Kato-Katz, formalin-ethyl acetate concentration and Baermann techniques were employed to assess helminth infections. We found infection prevalence of in the intervention and control villages was 28.6% and 1.8%, respectively. The prevalences of other helminth infections were as follows: , 79.5% and 71.8%; hookworm, 48.8% and 65.6%; and , 43.1% and 38.3%. Other helminth species were detected in less than 5% of the study participants. Latrine intervention coupled with two rounds of MDA in the intervention villages reduced the prevalence of infection by 6.0% (from 28.6% to 22.6%; < 0.001), infection by 11.3% (from 79.5% to 68.2%; < 0.001), hookworm infection by 22.6% (from 48.8% to 26.2%; < 0.001), and infection by 12.0% (from 43.1% to 31.1%; < 0.001). The observed reductions were not significantly different when compared to the control villages, where only two rounds of MDA were implemented ( > 0.05). Study participants in both groups commonly engaged in behaviours such as open defecation, bathing in the Mekong River, consuming raw or undercooked fish dishes and walking barefoot. These practices and behaviours are associated with helminth infections. Concluding, this study showed only a marginal impact associated with latrine use in intervention communities. There is a need for longer term studies with integrated interventions, such as effective health education to foster behavioural changes related to open defecation, raw or undercooked food consumption, wearing protected footwear outdoors, and personal hygiene.
在老挝人民民主共和国，蛔虫感染和其他肠道蠕虫感染仍然是公共卫生问题，尤其是在卫生设施有限的偏远地区。我们在四个村庄开展了一项实验研究，在这些村庄建造厕所并结合两轮使用吡喹酮和阿苯达唑进行大规模药物驱虫（MDA），并与仅接受两轮MDA的两个对照村庄进行比较。比较了干预前（基线）和干预后（随访）蠕虫感染的患病率。此外，在干预后12个月比较了干预村庄和对照村庄的患病率。采用改良加藤厚涂片法、甲醛-乙酸乙酯沉淀法和贝尔曼氏法评估蠕虫感染情况。我们发现，干预村庄和对照村庄的感染患病率分别为28.6%和1.8%。其他蠕虫感染的患病率如下：鞭虫，79.5%和71.8%；钩虫，48.8%和65.6%；以及蛔虫，43.1%和38.3%。在不到5%的研究参与者中检测到了其他蠕虫种类。干预村庄建造厕所并结合两轮MDA，使蛔虫感染患病率降低了6.0%（从28.6%降至22.6%；P<0.001），鞭虫感染患病率降低了11.3%（从79.5%降至68.2%；P<0.001），钩虫感染患病率降低了22.6%（从48.8%降至26.2%；P<0.001），蛔虫感染患病率降低了12.0%（从43.1%降至31.1%；P<0.001）。与仅实施两轮MDA的对照村庄相比，观察到的感染率下降没有显著差异（P>0.05）。两组研究参与者都普遍存在露天排便、在湄公河洗澡、食用生的或未煮熟的鱼菜肴以及赤脚行走等行为。这些行为和习惯与蠕虫感染有关。总之，本研究表明，干预社区使用厕所仅产生了微小影响。有必要开展长期研究并采取综合干预措施，如进行有效的健康教育，以促进与露天排便、食用生的或未煮熟的食物、在户外穿防护鞋以及个人卫生相关的行为改变。
