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Abstract Body

Spatial epidemiology of helminth infections in the Mekong Region

Helminthic infections are one of the Neglected Tropical Diseases (NTDs) affecting rural communities in low and middle-income countries. The Lower Mekong Basin comprising Thailand, Lao PDR, Cambodia, and Vietnam, have high reported prevalence of infection with human liver fluke and soil-transmitted helminths (STH). Opisthorchiasis caused by O. viverrini has been a major public health problem in this region for decades. Heavy and chronic O. viverrini infections often result in liver cirrhosis, portal hyperplasia, and cholangiocarcinoma (CCA). Epidemiological studies suggest that O. viverrini infection is concentrated most heavily in the Lower Mekong Subregion. Spatial mapping using Getis-Ord statistics confirmed the existence of local clustering of O. viverrini infection along the Mekong River. The high prevalence of O. viverrini infection continues in Lao PDR and central Vietnam. STH, i.e. hookworms, Ascaris lumbricoides, Trichuris trichiura, and Strongyloides stercoralis, are more important among children and in poor or malnourished populations in affecting morbidity and mortality. STH appears to be prevalent in the Lower Mekong Basin. In Thailand O. viverrini and hookworms are major helminthiases highlighted with different prevalence and geographical distribution. In Northeast Thailand, O. viverrini and S. stercoralis are highly prevalent and the most common among people working in agriculture who walk barefoot in the fields and have a penchant for eating raw or undercooked fish. The correct understanding of the spatial epidemiology and distribution of O. viverrini and STH is an important step to design and implement control and prevention programs.