Liver fluke, Opisthorchis viverrini infection is associated with hepatobiliary diseases including cholangiocarcinoma. The spread of liver fluke infection may occur in Southeast Asia due to increased labour migration among the countries of the ASEAN Economic Community as a result of an open borders policy that started in 2015. Therefore, a migrant health and education programme (MHEP) was organized and delivered by a migrant health and education network team. This study was conducted from March 2018 to October 2019 among migrant labourers from Cambodia, Laos PDR, and Myanmar who work in Nakhon Ratchasima Province, Thailand. Participants experienced a high level of satisfaction with the MHEP and gave the programme positive feedback. The MHEP has achieved its objective to increase the accessibility of health services among migrant populations in factory settings. Sharing this successful programme may also be useful in other areas.

Cholangiocarcinoma (CCA) is a neoplasm known as one of the most common causes of cancer-related deaths in Southeast Asia, particularly in Thailand, Laos, and Cambodia. Prevention and health education are required. Therefore, this study aimed to determine the effectiveness of an educational intervention to prevent CCA among a rural population in Thailand based on the health belief model (HBM) and self-efficacy frameworks. In this quasi-experimental study, 60 participants (30 participants in the experimental group and 30 participants in the control group) were selected in 2017. The educational intervention for the experimental group consisted of seven training sessions (introduction to CCA, risk factors, complications, benefits and barriers to proper consumption of cooked fish, carcinogenic agents, behavioral protection, and self-efficacy in applying preventive behaviors). A questionnaire that consisted of demographic information, knowledge, and HBM constructs (perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy) was used to measure CCA preventive behaviors before and 3 months after the intervention. Data were analyzed using SPSS-22 via chi-squared, paired t-tests, and independent samples t tests at a significance level of 0.5. Three months after the intervention, the experimental group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy, and CCA preventive behaviors compared to the control group. This study showed the effectiveness of the intervention based on the HBM constructs and self-efficacy in the adoption of CCA preventive behaviors 3 months post intervention in the risk group. Thus, these models may serve as a framework for designing and implementing educational interventions for the prevention of CCA.

This study aimed to determine the prevalence and intensity of intestinal helminth infections (IHIs) among rural villagers in Waeng Noi district, Khon Kaen Province, northeastern Thailand. A cross-sectional study was conducted between March 1 and July 30, 2018, among rural villagers from 30 rural villages in 2 subdistricts. The participants were selected from the village enrollment list after proportional allocation of the total sample size. The background characteristic data were collected using a structured questionnaire. Specimens from patients with IHIs were prepared by concentration with a Faecal Parasite Concentrator-Solvent-Free (Mini Parasep® SF), and helminths were then detected using a light microscope. Of the 400 faecal specimens examined, 23 were positive for at least one intestinal helminth, resulting in a prevalence of 5.75%. The most prevalent helminths were Taenia spp., 10 (2.50%); followed by hookworm, 5 (1.25%); Trichuris trichiura, 4 (1.0%); Ascaris lumbricoides, 3(0.50%); and Opisthorchis viverrini, 1 (0.25%). All infected participants had a light intensity of IHI. Location (adjusted OR=2.52; 95% CI=1.30-3.52; P =0.042) showed a significant association with the prevalence of intestinal helminths. This study reveals that IHIs, particularly those with foodborne and soil-transmitted species of helminths, are prevalent in adults in rural subdistricts. A greater focus on interventions to improve personal hygiene and sanitation to prevent the spread of IHIs is required. Further studies should be performed to implement interdisciplinary research approaches in the study area.

This study aimed to determine the prevalence and intensity of intestinal helminth infections (IHIs) among rural villagers in Waeng Noi district, Khon Kaen Province, northeastern Thailand. A cross-sectional study was conducted between March 1 and July 30, 2018, among rural villagers from 30 rural villages in 2 subdistricts. The participants were selected from the village enrollment list after proportional allocation of the total sample size. The background characteristic data were collected using a structured questionnaire. Specimens from patients with IHIs were prepared by concentration with a Faecal Parasite Concentrator–Solvent-Free (Mini Parasep® SF), and helminths were then detected using a light microscope. Of the 400 faecal specimens examined, 23 were positive for at least one intestinal helminth, resulting in a prevalence of 5.75%. The most prevalent helminths were Taenia spp., 10 (2.50%); followed by hookworm, 5 (1.25%); Trichuris trichiura, 4 (1.0%); Ascaris lumbricoides, 3(0.50%); and Opisthorchis viverrini, 1 (0.25%). All infected participants had a light intensity of IHI. Location (adjusted OR=2.52; 95% CI=1.30–3.52; P =0.042) showed a significant association with the prevalence of intestinal helminths. This study reveals that IHIs, particularly those with foodborne and soil-transmitted species of helminths, are prevalent in adults in rural subdistricts. A greater focus on interventions to improve personal hygiene and sanitation to prevent the spread of IHIs is required. Further studies should be performed to implement interdisciplinary research approaches in the study area.

Opisthorchis viverrini is a serious problem in Thailand, Cambodia, the Lao People's Democratic Republic and Vietnam. Active surveillance and eradication of O. viverrini is required. A cross-sectional study of 403 immigrant workers was conducted between October 2016 and June 2017 in Nakhon Ratchasima, Thailand. Stool samples were analysed via the formalin-ether concentration technique, with subsequent data analysis performed using descriptive statistics and logistic regression. Overall infection was 24.1% and the results reveals an O. viverrini infection rate was 11.9%. O. viverrini infection was identified in 25.6% of Cambodians, 15.3% of Laotians and 3.6% workers from Myanmar sampled. The majority of infections were found in males, aged e"40 years and working as labourers. Raw or undercooked cyprinoid fish consumption was associated with an elevated risk for O. viverrini infection (ORadj = 2.2, 95% CI = 1.2-4.0). Other intestinal helminthic infections were hookworm (5.5%), Trichuris trichiura (5.2%), Strongyloid stercoralis (0.5%), Ascaris lumbricoides (0.5%) and Taenia spp. (0.5%), respectively. This is the first study to report O. viverrini among immigrant workers in Thailand; therefore, active surveillance is needed among migrant workers to identify and treat O. viverrini infection.

OBJECTIVE:This study aimed to detect gastrointestinal helminth infection in migrant workers in Thailand.METHODS:A cross-sectional survey study was conducted in 403 migrant workers in the factories of Nakhon Ratchasima Province, northeastern Thailand during October 2016 to June 2017. Gastrointestinal helminth infections were detected by the formalin ether acetate concentration technique and microscopy. The data were analyzed using the χ2-test and logistic regression.RESULTS:The rate of gastrointestinal helminth infection was 24.07%. The most common species involved in infection was O pisthorchis viverrini (11.91%), followed by hookworm (5.46%), Trichuris trichiura (5.21%), Strongyloides stercoralis (0.5%), Ascaris lumbricoides (0.5%), and Taenia spp. (0.5%). The majority of infections were found in men aged ≥40 years, married participants, uneducated participants, laborers, those who worked for 1 year, and those who had an income of 9000 to 12,000 THB.CONCLUSIONS:Gastrointestinal helminth infection is still found in migrant workers. Therefore, active surveillance is required in this large group for investigating and eradicating this type of infection.

The carcinogenic liver fluke, Opisthorchis viverrini, is a serious health problem in Southeast Asia where infectionis associated with cholangiocarcinoma, a major cause of death in Thailand. This cross-sectional study aimed to screenfor O. viverrini infection among a Thai rural population of 560 individuals from Nakhon Ratchasima, Khonkaen, andChaiyaphum provinces with a verbal screening test with a mobile application (OvApp). Faecal samples were alsoprocessed with a mini-parasep sf parasite faecal concentrator. The infection rate of O. viverrini was found to be 2.86%.The majority of infections were detected in males aged 41–50, with primary school being their highest education level, andwho were engaged in agricultural occupations. In screening for O. viverrini infection, the OvApp had a high sensitivity(87.5%), specificity (94.6%), negative predictive value (98.9%), and accuracy (98.6%). The positive predictive valuewas 70.0% for the OvApp. The observed agreement was substantial for this application (k-value = 0.64) indicated thatit is a potentially useful tool for decreasing the cost of large-scale O. viverrini screening.

Carcinogenic liver fluke is still an issue of great concern in some countries of Southeast Asia, particularly in Thailand, Cambodia, the Lao People's Democratic Republic, and Vietnam. The infection, caused by Opisthorchis viverrini, is associated to cholangiocarcinoma and is endemic among human populations for whom raw fish is frequently consumed. Prevention and health education are required. Therefore, this study aimed to evaluate the effectiveness of educational intervention to improve knowledge among primary schoolchildren based on animation-assisted education. In this study, 80 participants (40 participants in the experimental group and 40 participants in the comparison group) were selected in 2018. The effectiveness of an interactive animation program in improving the knowledge of students studying liver fluke was determined based on scores on tests given before and immediately after completion of a 4.29-min animated program on the liver fluke life cycle, risk factors, disease, diagnosis, treatment, prevention, and control. Data were analyzed using SPSS-22 via paired t tests and independent samples t tests at a significance level of 0.05. A marked and significant improvement was observed in the immediate posttest compared with the pretest scores. More importantly, the students who had used the animated program achieved a significantly higher score on the final test than the comparison group. The results offered in the first report show that the use of the animated program facilitated education about liver fluke. It is strongly believed that animations are good supplementary learning materials for students, particularly for learning about serious concepts.

Background: Opisthorchis viverrini is a serious health problem in Southeast Asia. The infection is associated with cholangiocarcinoma. Therefore, this study was aimed to detect O. viverrini infections among the ASEAN population in Thailand. Methods: A cross-sectional study was conducted among 249 individuals from ASEAN populations in Thailand including Thai, Laotian, Cambodian, and Myanmar. Participants were screened using the O. viverrini verbal screening test (OvVST). Fecal samples were processed by the miniparasep sf parasite fecal concentrator. Results: The infection rate of O. viverrini was 27.21%. The majority of infections was detected in females, in the age group 31-40 yr old, in the primary school education level, and in the occupation of labor. By country, O. viverrini infection was detected more often in the Lao PDR (30.77%). In screening for O. viverrini infection, OvVST had a high sensitivity (93.48%), specificity (86.70%), NPV (98.32%), and accuracy (87.95%). The PPV was 61.43% for OvVTS. The observed agreement was substantial for OvVST (k-value = 0.64). Conclusion: O. viverrini infections are still detected in ASEAN countries therefore large scale active surveillance is required. OvVST had a high sensitivity, specificity, and accuracy for screening the risk groups for O. viverrini.

Background and Aim: CD44 cancer stem cell is another marker of the gastrointestinal cancer, including gastric cancer. The aim of this study was to investigate the expression of CD44 cancer stem cells in tissues from the gastrointestinal or surgical patients, including the association of CD44 cancer stem cell expression and clinical symptoms in patients with chronic gastritis, precancerous and gastric cancer. Materials and Methods: Biopsy specimens were obtained from Esophagogastroduodenoscopy and surgery. The gastric lesions were divided into 3 groups according to the stage of the disease. The first group is the chronic gastritis. The second group is the precancerous gastric lesion, including gastric atrophy and intestinal metaplasia. The third group is gastric cancer. The CD44 cancer stem cell expression was done by using immunohistochemistry techniqe. Results: A total 106 patients were included in this study. 68 male and 38 female. Mean age 57±2, including 33 in group 1, 31 in group 2 and 42 in group 3. CD44 cancer stem cell were expression 6.06% in group 1 22.58% in group 2 and 73.81% in group 3. significant high expression in gastric cancer patients OR = 2.98; 95% CI = 1.21-4.86; p = 0.024. Conclusion: Studies show that the expression of CD44 cancer stem cells is associated with the severity of the inflammation and changes of the gastric tissue to gastric cancer. Some patients in group 1 and group 2 who expression of the CD44 cancer stem cell were at risk or high risk for developing gastric cancer. The information above can be used to develop effective patient care. Close follow up should be recommended for high risk patients.

This quasi-experimental research aimed to study the effect of health behavior modification program in relation to knowledge, self-efficacy, expectation, and practice for liver fluke prevention among the risk group from Bueng Samrong sub-district, Kaeng Sanam Nang district, Nakhon Ratchasima province, Northeast Thailand. The total of 66 participants was assigned to experimental and comparison group, 33 participants in each group, 12-weeks intervene period. The experimental group was received health behavioral modification programs based on health education, self-efficacy, motivation, social support and networking. Pre-and-post-tests were measured using predesigned questionnaires. The comparative analysis was analyzed by paired sample t-test and independent sample t-test at the 0.05 level of significance. The results revealed that the experimental group had significantly greater knowledge, self-efficacy, expectation, and practice for liver fluke prevention than those in the comparison group (p < 0.05). In conclusion, this was a successful health education program for liver fluke avoidance. Participants were gained the correct knowledge and had the higher self-efficacy, expectation, and practice regrading liver fluke prevention. Therefore, it may useful for further behavior modification in the other epidemic areas.

Opisthorchis viverrini is a major health problem in many part of Southeast Asia. Therefore, this study aimed to detect Opisthorchis viverrini infection among migrant workers in Thailand by using three coprological concentration methods. A cross-sectional study was conducted among 147 migrant workers in Thailand. Fecal samples were processed by the modified formalin ether concentration technique, the Kato Katz thick smear, and the miniparasep solvent free parasite fecal concentrator. Specificities, sensitivities, negative predictive values, positive predictive values, Kappa indexes were analyzed with SPSS version 22. The infection rate with opisthorchiasis was 27.2%. The parameters measured for the modified formalin ether concentration technique, Kato Katz thick smear, and mini-parasep solvent free parasite fecal concentrator methods respectively were as follows: infection rates (23.1%, 12.9%, and 22.4%), sensitivities (85.0%, 47.5%, and 82.5%), specificities (100%, 100%, and 100%), positive predictive values (100%, 100%, and 100%), and negative predictive values (94.7%, 83.6%, and 93.9%). The kappa index value of diagnostic agreement between formalin ether concentration technique and mini-parasep solvent free parasite fecal concentrator showed substantial agreement for O. viverrini. In conclusion, the calculated analytical sensitivity, and negative predictive values indicate that modified formalin ether concentration technique and mini-parasep solvent free parasite fecal concentrator are more accurate in detecting O. viverrini infections. The study indicates that the mini-parasep solvent free parasite fecal concentrator method was the method with high potential to be used in routine laboratory and community diagnosis for opisthorchiasis.

Opisthorchis viverrini is a major health problem in many part of Southeast Asia. Therefore, this study aimed to detect Opisthorchis viverrini infection among migrant workers in Thailand by using three coprological concentration methods. A cross-sectional study was conducted among 147 migrant workers in Thailand. Fecal samples were processed by the modified formalin ether concentration technique, the Kato Katz thick smear, and the miniparasep solvent free parasite fecal concentrator. Specificities, sensitivities, negative predictive values, positive predictive values, Kappa indexes were analyzed with SPSS version 22. The infection rate with opisthorchiasis was 27.2%. The parameters measured for the modified formalin ether concentration technique, Kato Katz thick smear, and mini-parasep solvent free parasite fecal concentrator methods respectively were as follows: infection rates (23.1%, 12.9%, and 22.4%), sensitivities (85.0%, 47.5%, and 82.5%), specificities (100%, 100%, and 100%), positive predictive values (100%, 100%, and 100%), and negative predictive values (94.7%, 83.6%, and 93.9%). The kappa index value of diagnostic agreement between formalin ether concentration technique and mini-parasep solvent free parasite fecal concentrator showed substantial agreement for O. viverrini. In conclusion, the calculated analytical sensitivity, and negative predictive values indicate that modified formalin ether concentration technique and mini-parasep solvent free parasite fecal concentrator are more accurate in detecting O. viverrini infections. The study indicates that the mini-parasep solvent free parasite fecal concentrator method was the method with high potential to be used in routine laboratory and community diagnosis for opisthorchiasis.

Here we investigated CD44 protein expression and its polymorphisms in patients with chronic gastritis, precancerous gastric lesions, and gastric cancer; and we evaluated our result with the risk of CD44 protein expression and clinicopathological characteristics. Our results obtained by analyzing 162 gastric cancer patients, 125 chronic gastritis, and 165 precancerous gastric lesions from three study centers in Thailand showed that CD44 expression was significantly higher in patients with precancerous gastric lesions and gastric cancer while patients with chronic gastritis were negative for CD44 staining (p = 0.036). We further observed the significant association of variant genotype; gastric cancer patients carrying AG or GG of CD44 rs187116 had more increased risk of CD44 expression than wild-type (WT) carriers (AG: odds ratio (OR) = 5.67; 95% CI = 1.57-7.23; p = 0.024 and GG: OR = 8.32; 95% CI = 2.94-11.42; p = 0.016), but no significant difference in the risk of CD44 expression due to polymorphism in patients with precancerous gastric lesions. Our results suggested that CD44 expression could be used as a marker for the prediction of gastric cancer development, particularly in patients with precancerous gastric lesions carrying AG or GG, who were selected to surveillance follow-up for gastric cancer prevention.

BACKGROUND:Colorectal polyps are common in Thailand, particularly in the northeastern region. The present study aimed to determine any correlation between Helicobacter pylori-associated gastritis and colorectal polyps in the Thai population.MATERIALS AND METHODS:A total of 303 patients undergoing esophagogastroduodenoscopy with colonoscopy for investigation of chronic abdominal pain participated in this study from November 2014 to October 2015. A diagnosis of Helicobacter pylori associated gastritis was made if the bacteria were seen on histopathological examination and a rapid urease test was positive. Colorectal polyps were confirmed by histological examination of colorectal biopsies. Patient demographic data were analyzed for correlations.RESULTS:The prevalence of colorectal polyps was 77 (25.4%), lesions being found more frequently in Helicobacter pylori infected patients than non-infected subjects [38.4% vs. 12.5%; Odds Ratio (OR) (95% CI): 2.26 (1.32 - 3.86), p < 0.01]. Patients with Helicobacter pylori - associated gastritis were at high risk of having adenomas featuring dysplasia [OR (95% CI): 1.15 (1.16 - 7.99); P = 0.02]. There was no varaition in location of polyps, age group, sex and gastric lesions with respect to Helicobacter pylori status.CONCLUSIONS:This study showed that Helicobacter pylori associated gastritis is associated with an increased risk of colorectal polyps, especially adenomas with dysplasia in the Thai population. Patients with Helicobacter pylori-associated gastritis may benefit from concurrent colonoscopy for diagnosis of colorectal polyps as a preventive and early treatment for colorectal cancer.

This cross-sectional descriptive and qualitative study was aimed to study the people participation and their approaches toward the human carcinogenic liver fluke, Opisthorchis viverrini, prevention and control in Ban Chaun sub-district administrative organization (BCSAO) and Bamnet Narong sub-district municipality (BNSM), Bamnet Narong district, Chaiyaphum Province, Thailand between June 2013 and February 2014. Participants were purposive selected, included chiefs of sub-district administrative organizations, sub-district municipalities, sub-district health promotion hospitals (SHPHs), heads of village, and a further sample was selected with a multi- stage random sampling for public health volunteers, and villagers. The pre-designed questionnaire contained items for individualized status and the participatory steps of sharing ideas, decision-making, and planning, procession, evaluation, and mutual benefit, for the project O. viverrini prevention and control (POPC). In-depth interviews were used for collection of need approaches to POPC. With 375 participants who completed the questionnaire, it was found that people had a high level regarding to participate in the POPC, particularly in the process stage (X_ =3.78, S.D. = 0.56), but the lowest level was found in sharing ideas, decision making, and planning step (X_ =3.65, S.D. = 0.63). By comparison, participant status and organization did not significantly differ with people participation. In each step, Ban Chaun sub-district had a high level of participation in the step of sharing ideas, decision making, and planning toward POPC, more than Bamnet Narong sub-district municipality (t=2.20, p=0.028). Approaches for POPC in Ban Chaun sub-district and Bamnet Narong sub-district municipality included requirements for budget support, annual campaigns for liver fluke prevention and control, campaign promotion, risk group observation, home visiting, community rules regarding reducing raw fish consumption in their communities, and a professional public health officer for working in their communities, BCSAO, BNSM, and SHPH, for O. viverrini prevention and control. This study indicates that people realize that eradication of the liver fluke needs a continuous people participation for O. viverrini prevention and control in their communities.