A Community-based Health Watch Network in Northeastern Thailand: A Liver Fluke (O. viverrini) Pilot Study

Human liver flukes, O. viverrini, O. felineus and C. sinensis remain important public health problems in many parts of the world. Recent reports suggested that about 35 million people are infected with C. sinensis globally; with up to 15 million human infections in China and another 8--10 million individuals infected with O. viverrini in Thailand and Laos Three years ago Dr. Sripa and colleagues initiated a pilot project (The Lawa Model) in the Lawa Lakes region of Khon Kaen employing this integrated, bottom-up approach. Targeting one village initially with praziqantel treatment and an intensive education curriculum (IEC), the prevalence of liver infection declined from 67% to 16% in the third year with minimal re-infection. An intensive ""liver fluke-free school"program was added in schools around Lawa Lake, which included stool examination, treatment, health education, exhibitions and curriculum focusing on liver fluke infection and liver cancer (grades 4-6). The baseline infection prevalence in 9 schools was initially 9.2% (of 1,136 children) and has now been reduced to zero. This year 9 schools were certified as liver fluke free schools.