Control of Soil-transmitted Helminths through Primary Health Care Activities

Abstract

Abstract

The Helminthiasis Control Program in Thailand, run by the Ministry of Public Health, reduced the high prevalence of liver fluke infection to 9.6%, and hookworm infection to 11.4%, within 25 years. However, Opisthorchis infections in endemic areas remained high (47.6%), and in the south, where soil-transmitted helminthes are abundant, the prevalence among schoolchildren was 27.7%. In rural areas, many problems were easily solved when people realized the hazardous effects on the community. The Primary Health Care Development Center in the region is responsible for promoting health activities in the village, to provide better lifestyles and good health for the people with the help of health volunteers. Our study aimed to control helminth infections in the community with the aid of village health volunteers. The passing of roundworms by infected children showed that helminth infections persisted in the community, and greatly affected the growth and development of the youth. If they wanted their children to be free from infection, all infected persons had to be treated. We offered them diagnosis by stool examination and treatment of infected cases. Village health volunteers were responsible for the distribution and collection of stool containers among the population. The results showed that in Phangsing Village, the number of stool samples collected was quite low. Many people refused to submit samples for examination. The prevalence of helminth infection had not decreased. Environmental sanitation in the village was poor and no improvement was noted during the study. In another village, Ban Nai Thung, more people submitted stool samples. After treatment, many people collected stool samples for examination, to confirm that they were free from infection. In this area, prevalence decreased from 67.1 to 40.8% within 18 months. In this particular area, the village health volunteers also refused to work for us after a few days, but we offered some incentives to them so that the project could be conducted. Collecting stool samples was hard work for the village health volunteers. They spent many days collecting stool containers and sometimes very few people returned them. This showed that village health volunteers were probably useful for several health activities, but not so useful for collecting stool samples in the community.

Keywords: soil-transmitted helminths; control; primary health care activities