This case study addresses cross-sectorial management of zoonotic parasitic diseases at provincial and district level in Southern Laos.
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Parasitic Zoonoses Management
LAO LONG-TERM STUDY ON ZOONOTIC DISEASES OF LIVESTOCK (with a focus on parasitic diseases)
"Contribute to a better management of zoonotic diseases in Laos with a focus on parasitic food-borne diseases for commnunities and at a provincial level"
The parasitic zoonoses are neglected diseases and endemic in the Lao People’s Democratic Republic. The most commonly associated food with parasites includes food from animal origins, such as chicken, pork, beef…, and environment. Livestock animal including pigs, cattle, and poultry serve as a major reservoir of the parasites because of the life cycle of parasites have several hosts that are able to affect and/or spread to other species. Parasites occurrence results in increased loss of body weight gain, treatment costs, severity of illness, and affective to human health.
According to the proposal that has been set up in year 1, we revised the objectives of the Lao case study and undertake outcome mapping and participatory modeling in order to propose an updated conceptual model framing our activities.
As a result, the Lao team decided to focus on providing an overview on extend and burden of parasitic zoonoses in Laos (with a focus on Southern Laos) and better understanding local stakeholders’ knowledge, perceptions and practices linked to parasitic foodborne diseases along the pigs and fish commodity chains and on the diseases’ drivers. This improved interdisciplinary knowledge will be valorized to propose control options and recommendations in the framework of a cross-sectoral collaboration platform developed by the project.
A literature review has been conducted in order to better understand the burden of parasitic zoonoses in Laos and to provide additional information about pig production systems. It highlighted that Trichinellosis & Taeniosis/Cysticercoses were food-borne parasites of global concerns, but widely neglected and beneficiating from sporadic donor funding schemes. In Laos, the passive surveillance system is characterized by poor reporting system. Most of the available information is related to the prevalence of these diseases but few is known about the socio-cultural aspects, a cost benefits analysis, and successful interventions implemented using a One Health framework. Broadly, there is more information and knowledge related to fish borne zoonoses and human public health sector.
In order to better document local stakeholders’ knowledge, perceptions and practices linked to parasitic foodborne diseases (PFBD) along the pigs and fish commodity chains, we have conducted Participatory Rural Appraisal (PRA) and Participatory Epidemiology (PE) in 9 villages of 3 different provinces (Khammoune, Savannakhet and Champasak) of Southern Laos in order to better understand local stakeholders’ knowledge, perceptions and practices linked to PFBD, and also to compare the literature review with field results. The PRA/PE finding’s analysis conducted in 2016 emphasizes on perception, knowledge and practice of the people that shape the risk context of PFBD. Along the analysis process, the progress was reported to the Technical Working Groups board that have been setup under the authority of a “One health PFBD” inter-ministerial platform and feedback and suggestion on the further activities was also obtained. Three feedback meetings have been organized in the 3 targeted provinces. Posters showing PE/PRA activities and result of each target villages were produced and provided to the village representatives. The participants agreed to the research finding and supported further collaboration for cross-sectoral collaboration efforts at provincial and district level.
The PRA and PE studies revealed that the 2 main health problems, according to the stakeholders, are linked to the liver and the stomach (76.5%), roundworms and tapeworms are commonly mentioned but local stakeholders have no knowledge or a wrong perception of the causes and prevention methods against parasites diseases. The PRA and PE surveys also highlighted that the main risk behaviour was the consumption of raw food (pig, beef, fish and vegetables).
A specific study about the prevalence of trichinella were done in the Savannakhet province, collecting pig blood samples as well as a questionnaire to better understand the environment and context. The study revealed a 17.7% of trichinella prevalence in pigs in the area, which is higher than the last found prevalence (9.3%), the sero-prevalence was also higher in local and/or cross breed pigs and increasing with age. A significant high prevalence was found in one particular district (songkhone) highlighting the fact that there is important differences between districts in the same province. Moreover, in this particular district, the proportion of pigs using free range is higher than the other district.
In terms of capacity building, this case study enhanced, through the PRA and PE, the interdisciplinary team working, transdisciplinary effort and experience, project planning and management and the collaboration between universities’ laboratories (TDR-L from Khon Kaen and NUoL). In fact, a collaboration has been initiated with the Tropical Disease Research center (TDR) of KKU (in Thailand) and NUOL to foster the cross- sectorial approach at local level( province, district, village) and develop a common understanding, perception and view about parasitic zoonotic diseases (one issue). Therefore, the successful experience of the KKU TDR in the framework of the LAWA ECOHEALTH project about liver fluke control in rural areas has been shared with NUOL staff, national and provincial Lao officers (this first exchange session has been organized in parallel of the NTDASIAS conference in Khon Kaen).
It also permitted the setting of a a cross-sectorial inter-ministerial platform (involving national and provincial stakeholders) as well as a steering committee between the faculties, local governors and 6 Lao ministries, driving some related technical working groups.These entities are supposed to supervise activities implemented with local stakeholders and to foster the cross-sectorial approach for an improved management of PFBDs.
This networking and exchange of experience, in particular regarding the communication tools and methods implemented within the LAWA project, will be shared in order to contribute to the ComAcross Lao partners’ capacity building and to the training of the village health workers. This activity will be managed by the cross-sectorial ministerial Lao platform and its technical working groups in year 3.
Cross-sectoral collaboration on zoonotic diseases in small holder and livestock system in Laos:
- To provide an overview on the burden of parasitic zoonoses in Laos from secondary data.
- To improve animal health and productivity by a better knowledge of disease drivers and suitable control options related to animal health, public health and well being.
- To identify parasitic zoonosis distribution for prioritised parasites in animal and human populations in the southern part of Laos.
- To reduce animal and human health risks of food borne diseases through a better understanding of risk factors.
- To develop a cross-sectoral collaboration platform and dissemination strategy.
- To better understand farmers’ knowledge, perceptions and practices linked to parasitic food-borne diseases along the pig and fish commodity chains.
Notes: Other non-zoonotic infectious diseases might be the main concern that affects human well-being; Cross-sectoral encompasses the multi-disciplinary aspects such as small scale farming systems, free range systems and fewer vaccination programmes and parasite control programmes.
NUoL is coordinating the setting up of a governmental platform involving 6 ministries. The role of this platform is:
A cross-sectorial workshop has been held in Vientiane on 25th January involving officials from 4 Ministries and from the 3 Provinces where ComAcross is operating.
Parasitic foodborne zoonoses are endemic neglected diseases with a high public health burden in Laos.