Controlling parasites, understanding practices

The biosocial complexity of a One Health intervention for neglected zoonotic helminths in northern Lao PDR

Dados Bibliográficos

ID4596992
AutoresKevin Bardosh (0000-0003-2973-5708, University of Edinburgh, autor correspondente), Phouth Inthavong (Ministry of Agriculture and Forestry), Sivilai Xayaheuang (Animal, Food and Health Sciences), Anna L Okello, Anna Okello (Animal, Food and Health Sciences)
Ano2014
Volume120
Páginas215-223
Data de publicação2014-11-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoSocial Science & Medicine (JOURNAL)
Identificadores do periódicoISSN: 0277-9536 • E-ISSN: 1873-5347
EditoraElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2014.09.030
PMID25261615
OpenAlexW2163192072
IdiomaEN
Citações recebidas10
Referências citadas40

A parasitological survey in northern Lao PDR showed a remote ethnic minority village to be hyper-endemic for Taenia solium, a Neglected Tropical Disease (NTD) that impacts human and pig health. An intervention combining human Mass Drug Administration (MDA) with porcine vaccination and antihelmintic treatment was then implemented, targeting both T. solium and other soil-transmitted helminths. To understand the biosocial complexity of this integrated One Health intervention, we conducted a rapid ethnographic study exploring the transmission dynamics of T. solium and locally acceptable long-term control options. Informed by two years of project work in the village, this included six focus group discussions, 35 semi-structured interviews, a latrine survey, a school-based education meeting, participant observation and many unstructured interviews conducted over two weeks in October 2013. We found that risk behaviours were mediated by various social determinants including limited market access, interrelationships between alcohol, ancestral sacrifices and the consumption of raw pork, seasonal variations and poor latrine coverage. Only sixteen percent of households had latrines, attributed to the unacceptability of dry latrines, lack of water access, poor building techniques and poverty. Whilst women could explain T. solium transmission, most men and children could not, revealing that distributed posters/leaflets relied too heavily on text and ambiguous images. Compliance with MDA was high due to trust between project staff and village leaders. However understandings of pharmacology, minor side effects, human migration and children's fear of worms may lead to resistance in future programmes. Our research highlights the complexities of controlling T. solium and other soil-transmitted helminths in a remote ethnic minority village and the need to integrate biomedical and participatory approaches. Although we showcase the heuristic value of using rapid ethnography to inform intervention strategies as part of a One Health/NTD agenda, we also identify several possible paradoxes and conundrums in embedding locally-grounded biosocial analysis into NTD programmes. These need to be acknowledged and negotiated by multidisciplinary teams

Biosocial theory · Environmental health · Focus group · Helminthiasis · Intervention (counseling · Latrine · Neglected tropical diseases · Pathology · Personality · Public health · Sanitation · Socioeconomics · Sociology · Taenia solium · Animal Disease Management and Epidemiology · Medicine · Nursing · Parasites and Host Interactions · Psychology · Social Psychology · Zoonotic diseases and public health · Immunology