Introduction

People in rural areas of Thailand have difficulty accessing good health care and basic health education. Subsequently, some preventable diseases such as parasitic infections are still prevalent in many remote areas of Thailand ₁,₂,₃,₄. Among pathogenic parasitic infections in northeastern region of Thailand, liver flue infection is disease with the highest prevalence. The Ministry of Public Health has set a number of control programs since 1984. However, the coverage of these programs to the far rural area is limited.

Here, we report a survey of prevalence of intestinal parasites among the local population of Lum Pra Due village in the Nakorn Ratchasrima province. The setting is a community in the endemic area of trematode infection without the recent previous history of antihelminthic drug distribution. Stool examinations were performed as indicators of the basic health status of the people in this rural area.

Materials And Methods

Study area and participants

Stool examinations

Data analysis

All data were statistically analysed by the Microsoft Excel 6.0 programs.

Results

Characteristics of study population

Cartons were provided to 153 individuals residing in Lum Pra Due village, Huay Thalaeng District, Nakorn Ratchasrima Province, at the time of our visit. All individuals returned their stool samples the next day. Of the 153 individuals examined for intestinal parasites, 63 were males and 90 were females. The demographic data of all subjects were presented in Table 1.

Figure 1

Table 1: Demographic data and relative prevalence of parasitism.

Parasitism in the studied population

Intestinal parasites were recovered in 104 individuals (Table 1,2), giving the infection rate was 68 %. The rate of infection in male (72 %) was higher than in female (62 %). Most of the infected cases (88 %) were in the age group 41 - 60 years. Single Opisthorchis viverrini infection was found in 7 cases. Combined infection of Opisthorchis viverrini with other non-fluke intestinal parasite was found in 44 cases. Combined infection of minute intestinal fluke with other non-fluke intestinal parasite was found in 85 cases. There were also 5 infected cases with non-fluke parasite.

Figure 2

Table 2: Prevalence of intestinal parasite infection in our study.

Discussion

Parasitic infections affect people in most developing countries worldwide.

For Thailand, parasitic helminths affect more than 35 % of the population₁ . The prevalence rates of intestinal parasitic infections vary from one area to another depending on the degree of personal and community hygiene, and other sanitation and climatic factors ₅

In order to access the parasitic infection status of a population in a village in the endemic area of parasitic disease, in Northeastern of Thailand, without previous history of drug distribution due to the fluke control program, we performed stool examinations. We found that upto 68 % of the studied population harbored parasites. This number was 2 times higher than the national average (35 %) according to the national epidemiological survey of 1996₁. Concerning to our study, the infection rates of minute intestinal fluke (55.6 %) and Opisthorchis viverrini (33.4 %) were very high. These rates were similar to the report before the control program in 1984, which presented the infection rate up to 78.7 %. However, the rate from the survey after the control program reduced to 22.01 %. ₆ Therefore, without the control program, trematode infection is still a major health problem for this community.

Furthermore, in comparison to the previous reports from the remote areas, also without control program for intestinal parasites, of Tak and Khon Kaen Provinces₂,₃ have 46 % and 34 % of their populations carrying at least one parasite, respectively. Obviously, the health intervention program for intestinal parasitic infection control in the remote area is necessary.

Concerning the relation of age group and parasitic infection, our study revealed the high infection rate in age group 41 - 60 years. This result confirmed previous studies, which mentioned the high infection in adult and lower rate in children ₇,₈. Our result showed slightly higher infection among female. However, the sex predominant for parasite infection is still not confirmed. Some reported higher rate in male₉ , the others reported similar rate in both sexes ₇,₈ . The infection may relate to the daily activity of the surveyed subjects than sex.

Parasitic diseases are still diseases of the poor though the diagnosis and treatment for most of them are not difficult. The common consequences of parasitic infections have been shown to affect nutritional status, physical development, mental function, verbal ability and inhibition-control aspects of cognitive behavior in children₁₀,₁₁,₁₂,₁₃ (Tripathy et al, 1971; Tripathy et al, 1972; Nokes et al, 1992; Nokes et al, 1994). However, the morbidity from parasitic infections in mild but chronic. Previous studies have shown that parasitic diseases are still a public health problem (Triteeraprapab et al, 1997; Triteeraprapab et al, 1998; Triteeraprapab et al, 1999). Data from this study suggests that annual health education and control program for the far community as this community is stilled needed. Active strategies to find and reach those far rural villages with low occasion are recommended.

Acknowledgement

Correspondence to

Jamsai Suwansaksri
Department of Clinical Chemistry,
Faculty of Allied Health Science,
Chulalongkorn University,
Bangkok, Thailand 10330