Results of Developing a Liver Fluke Participatory-Prevention Model in Wang Ta Mua Subdistrict, Mueang District, Nakhon Phanom Province

Abstract

Background: Liver fluke infection is a major cause of cholangiocarcinoma and a health problem in the northeastern region of Thailand. In Mueang District, the prevalence of liver fluke infection ranks among the top three highest districts in Nakhon Phanom province.
Objective: To study the outcomes of a developed model for liver fluke prevention through community participation in Wang Ta Mua Subdistrict, Mueang District, Nakhon Phanom Province.
Material and methods: This action research study was conducted with 61 participants, including village health volunteers, public health officers, teachers, monks, a villager representative, a village headman, a subdistrict headman, and members of the Subdistrict Administrative Organization, as well as 33 villagers who had concurrent liver fluke infections. The study consisted of ten operating steps: 1) problem analysis; 2) preparation of action plans; 3) educational activities; 4) disease prevention campaign activities; 5) creating a cooperation network; 6) monitoring infected villagers; 7) conducting a papaya salad cooking and market survey to ensure it was free from raw fermented fish; 8) setting community preventive measures; 9) monitoring, supervising, and evaluating the activities; and 10) exchanging and sharing knowledge. Data were collected using questionnaires, interviews, and observations and were analyzed using descriptive statistics, paired t-tests, and content analysis.
Results: After finishing the model, the target group had significantly higher levels of knowledge, attitudes, behaviors, and participation in liver fluke prevention (p<0.001). The success factors might be explained by the connection between network partners and the unity of people in the community, leading to the participation and mutual acceptance of those involved in all steps of development.
Conclusion: The development of a liver fluke participatory-prevention model in Wang Ta Mua Subdistrict could significantly increase the levels of knowledge, attitudes, behaviors, and participation in disease prevention. The community could create a participatory plan to address the problem using a more systematic operating model.