Development of a Comprehensive Model for the Control of Opisthorchis viverrini in Health Region 10, Ubon Ratchathani

Abstract

This action research aimed to develop a comprehensive model for solving liver fluke Opisthorchis viverrini disease problems. The study area in Health Region 10 is divided into a model development area in Ubon Ratchathani Province, 1 district, and expansion areas in 5 provinces, 1 district each, totaling 6 districts. Target groups included 150 healthcare personnel and local administrative organization networks in model development and expansion areas, and 9,044 people in at-risk communities. Assessment tools comprised questionnaires on liver fluke disease prevention and control behaviors, parasite examination reports, and waste treatment system reports. Data were analyzed using descriptive statistics, while qualitative data employed content analysis and summary.

Results were found the comprehensive liver fluke disease problem-solving model consisted of five steps: (1) knowledge campaign, (2) risk assessment/risk behavior screening, (3) active stool examination for parasite infection, (4) treatment of infected individuals, (5) follow-up for liver fluke reinfection after treatment, and (6) annual liver fluke reinfection monitoring system establishment. After Implementation the model showed liver fluke reinfection rates decreased from 7.54% to 0.19%, while expansion areas decreased from 5.99% to 0.07%. Positive behaviors in low-risk food consumption groups increased from 55.86% to 75.30%, and groups with high intention to quit high-risk food consumption increased from 32.93% to 67.38%. Health knowledge and beliefs significantly improved. Local government participation enabled systematic disease prevention management, increased waste/fecal treatment systems, and prevented parasite egg contamination in environment. This development model's outcomes reflected significant disease burden reduction, demonstrating that comprehensive management integration, community participation, and local network agency involvement can create sustainable change and lead to policy recommendations for further expansion.