Toward integrated opisthorchiasis control in Northeast Thailand : the Lawa project
2014
Sripa, Banchob | Tangkawattana, Sirikachorn | Laha, Thewarach | Kaewkes, Sasithorn | Mallory, Frank F. | Smith, John F. | Wilcox, Bruce A.
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Show more [+] Less [-]tHuman liver fluke, Opisthorchis viverrini, a food-borne trematode is a significant public health problem inSoutheast Asia, particularly in Thailand. Despite a long history of control programmes in Thailand and anationwide reduction, O. viverrini infection prevalence remains high in the Northeastern Provinces. There-fore, a new strategy for controlling the liver fluke infection using the EcoHealth/One Health approach wasintroduced into the Lawa Lake area in Khon Kaen province where the liver fluke is endemic. A programmehas been carried using anthelminthic treatment, novel intensive health education methods both in thecommunities and in schools, ecosystem monitoring and active community participation. As a result, theinfection rate in the more than 10 villages surrounding the Lake has declined to approximate one thirdof the average of 50% as estimated by a baseline survey. Strikingly, the Cyprinoid fish species in the Lake,which are the intermediate host, now showed less than 1% prevalence compared to a maximum of 70%at baseline. This liver fluke control programme, named “Lawa model,” is now recognized nationally andinternationally, and being expanding to other parts of Thailand and neighbouring Mekong countries.Challenges to O. viverrini disease control, and lessons learned in developing an integrative control pro-gramme using a community-based, ecosystem approach, and scaling-up regionally based on Lawa as amodel are described.
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