Model Development for Opisthorchiasis Prevention and Control in High Risk Areas

Abstract

Opisthorchiasis has been an important public health problem, and highest prevalence has been reported in the Northeastern region of Thailand due to the culture of consuming raw fish. Development of prevention and control model has been very challenging. This research aimed to develop a community model for opisthorchiasis prevention and control. The areas and samples were purposive selected from 3 villages, one from each of 3 provinces in the Northeast (Khon Kaen, Mahasarakam and Kalasin). The samples were persons who cook in household, health personnel from health promotion hospital, teachers, village leader and sub-district organization personel, altogether 360 people (120 samples per village). The research was conducted in 3 phases: (1) assessment of community behavior and existing prevalence of opisthorchis infestation; (2) intervention phase by motivating self-learning among the samples through a continuous process of planing, operating, reflection, and result-based adjustment of the plan; and (3) evaluation phase. Three focus group discussions and one in-depth interview of 20 persons were conducted. Data were collected by using questionnaire, which included knowledge, perception, behavior, individual intention to stop consumption of raw fish, and stool examination; and were analyzed by descriptive statistics as well as the paired t-test for pre- and post-test scores. It was found that before the intervention, the samples had misperception in raw fish consumption and treatment concept. After the implemntation of the model, improvement on perception, awareness, empowerment, participation and sharing in community problem solving were observed. As a result, raw fish consuption had been significantly reduced (p<0.001). In conclusion, the model for opisthorchiasis prevention and control was found to be effective and should be promoted in other communities.