Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
권호 표지
DOI QR코드

DOI QR Code

Prevalence and Risk Factors of Intestinal Helminthiasis in Remote Mountainous Villages of Northern Lao PDR: A Cross-Sectional Study

  • Jin, Hanna (Department of Tropical Medicine and Parasitology, Seoul National University College of Medicine, and Institute of Endemic Diseases, Seoul National University Medical Research Center) ;
  • Ryu, Kyungshick (Chonbuk National University Medical School) ;
  • Lee, Dajeong (Department of Tropical Medicine and Parasitology, Seoul National University College of Medicine, and Institute of Endemic Diseases, Seoul National University Medical Research Center) ;
  • Vonghachack, Youthanavanh (Savannakhet Provincial Health Department) ;
  • Choi, Min-Ho (Department of Tropical Medicine and Parasitology, Seoul National University College of Medicine, and Institute of Endemic Diseases, Seoul National University Medical Research Center) ;
  • Hong, Sung-Tae (Department of Tropical Medicine and Parasitology, Seoul National University College of Medicine, and Institute of Endemic Diseases, Seoul National University Medical Research Center) ;
  • Song, Hyun Beom (Department of Tropical Medicine and Parasitology, Seoul National University College of Medicine, and Institute of Endemic Diseases, Seoul National University Medical Research Center)
  • Received : 2020.12.23
  • Accepted : 2021.04.08
  • Published : 2021.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Helminth infections are prevalent in Lao People's Democratic Republic (Lao PDR). This study aimed at determining the prevalence and risk factors of intestinal helminthiasis in remote mountainous villages of northern Lao PDR. During the dry season in January 2017, a cross-sectional survey was conducted in 3 remote mountainous villages in Oudomxay province, Lao PDR. Villagers older than 18 years of age who agreed to submit stool samples or undergo an interview, were recruited. Stool samples from 198 individuals were examined by the Kato-Katz method, and a questionnaire surveyed 161 individuals among them. Univariable and multivariable logistic regression analyses were used to identify risk factors associated with the intestinal helminthiasis. An overall prevalence of intestinal helminthiasis was 75.8%. Hookworm infection was the most common (63.1%), followed by Opisthorchis viverrini/minute intestinal flukes (17.7%), Taenia spp. (15.2%), Trichuris trichiura (2.0%), Ascaris lumbricoides (1.5%), and Enterobius vermicularis (1.0%). Questionnaire analysis revealed sex (male) and absence of latrine to be significant risk factors for hookworm infection and consumption of raw meat for taeniasis. These results suggest that the mountainous area in northern Lao PDR has a different composition of helminth infections from other studies conducted in Lao PDR; a high prevalence of hookworm infection and taeniasis and low prevalence of T. trichiura and A. lumbricoides infections were observed. Also, liver flukes or intestinal flukes were similarly prevalent in the mountainous area.

Keywords

Acknowledgement

We are grateful to the residents of the study villages and to Mr. Santhavisouk Sengchanda, Ms. Olanath Phenedinvay and Ms. Keo Oudone from Faculty of Basic Sciences, University of Health Sciences, Lao PDR and staffs from Provincial Health Department and Beng district hospital, Oudomxay Province, Lao PDR for their assistance in collecting fecal specimens and preparing the KK smears. This study was supported by Dr. LEE Jong-wook-Seoul Project (800-20170058), by SNUCM Undergraduate Research Program, and by Seoul National University Hospital.

References

  1. Rim HJ, Chai JY, Min DY, Cho SY, Eom KS, Hong SJ, Sohn WM, Yong TS, Deodato G, Standgaard H, Phommasack B, Yun CH, Hoang EH. Prevalence of intestinal parasite infections on a national scale among primary schoolchildren in Laos. Parasitol Res 2003; 91: 267-272. https://doi.org/10.1007/s00436-003-0963-x
  2. Eom KS, Yong TS, Sohn WM, Chai JY, Min DY, Rim HJ, Jeon HK, Banouvong V, Insisiengmay B, Phommasack B. Prevalence of helminthic infections among inhabitants of Lao PDR. Korean J Parasitol 2014; 52: 51-56. https://doi.org/10.3347/kjp.2014.52.1.51
  3. Vonghachack Y, Odermatt P, Taisayyavong K, Phounsavath S, Akkhavong K, Sayasone S. Transmission of Opisthorchis viverrini, Schistosoma mekongi and soil-transmitted helminthes on the Mekong Islands, Southern Lao PDR. Infect Dis Poverty 2017; 6: 131. https://doi.org/10.1186/s40249-017-0343-x
  4. Conlan JV, Khamlome B, Vongxay K, Elliot A, Pallant L, Sripa B, Blacksell SD, Fenwick S, Thompson RC. Soil-transmitted helminthiasis in Laos: a community-wide cross-sectional study of humans and dogs in a mass drug administration environment. Am J Trop Med Hyg 2012; 86: 624-634. https://doi.org/10.4269/ajtmh.2012.11-0413
  5. Conlan JV, Vongxay K, Khamlome B, Dorny P, Sripa B, Elliot A, Blacksell SD, Fenwick S, Thompson RC. A cross-sectional study of Taenia solium in a multiple taeniid-endemic region reveals competition may be protective. Am J Trop Med Hyg 2012; 87: 281-291. https://doi.org/10.4269/ajtmh.2012.11-0106
  6. Ash A, Okello A, Khamlome B, Inthavong P, Allen J, Thompson RC. Controlling Taenia solium and soil transmitted helminths in a northern Lao PDR village: Impact of a triple dose albendazole regime. Acta Trop 2015. https://doi.org/10.1016/j.actatropica.2015.05.018
  7. MoH L. Infectious and parasitic diseases. In: Diagnosis and Treatment in District Hospitals, Ministry of Health Lao PDR 2nd ed 2004: 109-181.
  8. Hong ST, Choi MH, Kim CH, Chung BS, Ji Z. The Kato-Katz method is reliable for diagnosis of Clonorchis sinensis infection. Diagn Microbiol Infect Dis 2003; 47: 345-347. https://doi.org/10.1016/S0732-8893(03)00113-5
  9. Ploner M. logistf: Firth's bias reduced logistic regression. R package version 1.22. http://CRANR-projectorg/package=logistf. 2016.
  10. Li T, Ito A, Chen X, Long C, Okamoto M, Raoul F, Giraudoux P, Yanagida T, Nakao M, Sako Y, Xiao N, Craig PS. Usefulness of pumpkin seeds combined with areca nut extract in community-based treatment of human taeniasis in northwest Sichuan Province, China. Acta Trop 2012; 124: 152-157. https://doi.org/10.1016/j.actatropica.2012.08.002
  11. Flisser A, Vazquez-Mendoza A, Martinez-Ocana J, Gomez-Colin E, Leyva RS, Medina-Santillan R. Short report: evaluation of a self-detection tool for tapeworm carriers for use in public health. Am J Trop Med Hyg 2005; 72: 510-512. https://doi.org/10.4269/ajtmh.2005.72.510
  12. Bethony J, Chen J, Lin S, Xiao S, Zhan B, Li S, Xue H, Xing F, Humphries D, Yan W, Chen G, Foster V, Hawdon JM, Hotez PJ. Emerging patterns of hookworm infection: influence of aging on the intensity of Necator infection in Hainan Province, People's Republic of China. Clin Infect Dis 2002; 35: 1336-1344. https://doi.org/10.1086/344268
  13. Bethony J, Brooker S, Albonico M, Geiger SM, Loukas A, Diemert D, Hotez PJ. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet 2006; 367: 1521-1532. https://doi.org/10.1016/S0140-6736(06)68653-4
  14. Jiraanankul V, Aphijirawat W, Mungthin M, Khositnithikul R, Rangsin R, Traub RJ, Piyaraj P, Naaglor T, Taamasri P, Leelayoova S. Incidence and risk factors of hookworm infection in a rural community of central Thailand. Am J Trop Med Hyg 2011; 84: 594-598. https://doi.org/10.4269/ajtmh.2011.10-0189
  15. Olsen A, Samuelsen H, Onyango-Ouma W. A study of risk factors for intestinal helminth infections using epidemiological and anthropological approaches. J Biosoc Sci 2001; 33: 569-584. https://doi.org/10.1017/S0021932001005697
  16. Traub RJ, Robertson ID, Irwin P, Mencke N, Andrew Thompson RC. The prevalence, intensities and risk factors associated with geohelminth infection in tea-growing communities of Assam, India. Trop Med Int Health 2004; 9: 688-701. https://doi.org/10.1111/j.1365-3156.2004.01252.x
  17. Phommasack B, Saklokham K, Chanthavisouk C, Nakhonesid-Fish V, Strandgaard H, Montresor A, Shuey DA, Ehrenberg J. Coverage and costs of a school deworming programme in 2007 targeting all primary schools in Lao PDR. Trans R Soc Trop Med Hyg 2008; 102: 1201-1206. https://doi.org/10.1016/j.trstmh.2008.04.036
  18. World Health Organization. Control of Foodborne Trematode Infections: Report of a WHO Study Group. Geneva, Switzerland. World Health Organization. 1995, pp 1-157. https://apps.who.int/iris/handle/10665/41544
  19. Laymanivong S, Hangvanthong B, Keokhamphavanh B, Phommasansak M, Phinmaland B, Sanpool O, Maleewong W, Intapan PM. Current status of human hookworm infections, ascariasis, trichuriasis, schistosomiasis mekongi and other trematodiases in Lao People's Democratic Republic. Am J Trop Med Hyg 2014; 90: 667-669. https://doi.org/doi:https://doi.org/10.4269/ajtmh.13-0636
  20. Sohn WM, Yong TS, Eom KS, Min DY, Lee D, Jung BK, Banouvong V, Insisiengmay B, Phommasack B, Rim HJ, Chai JY. Prevalence of Haplorchis taichui among humans and fish in Luang Prabang Province, Lao PDR. Acta Trop 2014; 136: 74-80. https://doi.org/10.1016/j.actatropica.2014.04.020
  21. Yoon HJ, Ki M, Eom K, Yong TS, Chai JY, Min DY, Rim HJ, Sohn WM, Insisiengmay B, Phommasack B. Risk factors for Opisthorchis viverrini and minute intestinal fluke infections in Lao PDR, 2009-2011. Am J Trop Med Hyg 2014; 91: 384-388. https://doi.org/10.4269/ajtmh.13-0596
  22. Forrer A, Sayasone S, Vounatsou P, Vonghachack Y, Bouakhasith D, Vogt S, Glaser R, Utzinger J, Akkhavong K, Odermatt P. Spatial distribution of, and risk factors for, Opisthorchis viverrini infection in southern Lao PDR. PLoS Negl Trop Dis 2012; 6: e1481. https://doi.org/10.1371/journal.pntd.0001481
  23. Phongluxa K, Xayaseng V, Vonghachack Y, Akkhavong K, van Eeuwijk P, Odermatt P. Helminth infection in southern Laos: high prevalence and low awareness. Parasit Vectors 2013; 6: 328. https://doi.org/10.1186/1756-3305-6-328
  24. Conlan J, Khounsy S, Inthavong P, Fenwick S, Blacksell S, Thompson RCA. A review of taeniasis and cysticercosis in the Lao People's Democratic Republic. Parasitol Int 2008; 57: 252-255. https://doi.org/http://dx.doi.org/10.1016/j.parint.2008.04.002
  25. Chai JY, Yong TS, Eom KS, Min DY, Shin EH, Banouvong V, Insisiengmay B, Insisiengmay S, Phommasack B, Rim HJ. Prevalence of the intestinal flukes Haplorchis taichui and H. yokogawai in a mountainous area of Phongsaly Province, Lao PDR. Korean J Parasitol 2010; 48: 339-342. https://doi.org/10.3347/kjp.2010.48.4.339
  26. Rim HJ, Sohn WM, Yong TS, Eom KS, Chai JY, Min DY, Lee SH, Hoang EH, Phommasack B, Insisiengmay S. Fishborne trematode metacercariae in luang prabang, khammouane, and saravane province, lao PDR. Korean J Parasitol 2013; 51: 107-114. https://doi.org/10.3347/kjp.2013.51.1.107
  27. Pawlowski Z, Schultz MG. Taeniasis and cysticercosis (Taenia saginata). Adv Parasitol 1972; 10: 269-343. https://doi.org/10.1016/S0065-308X(08)60176-1
  28. Hall A, Latham MC, Crompton DW, Stephenson LS. Taenia saginata (Cestoda) in western Kenya: the reliability of faecal examinations in diagnosis. Parasitology 1981; 83: 91-101. https://doi.org/10.1017/S003118200005006X
  29. Raoul F, Li T, Sako Y, Chen X, Long C, Yanagida T, Wu Y, Nakao M, Okamoto M, Craig PS, Giraudoux P, Ito A. Advances in diagnosis and spatial analysis of cysticercosis and taeniasis. Parasitology 2013; 140: 1578-1588. https://doi.org/10.1017/S0031182013001303
  30. Okello A, Ash A, Keokhamphet C, Hobbs E, Khamlome B, Dorny P, Thomas L, Allen J. Investigating a hyper-endemic focus of Taenia solium in northern Lao PDR. Parasit Vectors 2014; 7: 134. https://doi.org/10.1186/1756-3305-7-134