One health approach to trichinellosis risk in borderland highlanders of
northern Thailand
Chalisa Kallayanamitra1 Chalermpol Samranpong4 Bruce A. Wilcox2 Parichat Saenna2 Veerasak Punyapornwithaya3 KhwanchaiKreausukon3 Pisit Leeahtam1 Manoj Potapohn1
1 Faculty of Economics, Chiang Mai University, 2Global Health Asia, Faculty of Public Health, Mahidol University, 3Faculty of Veterinary Medicine, Chiang Mai University,
4Center for Agricultural Resource System Research, Faculty of Agriculture, Chiang Mai University
Project Background Preliminary Results
In the highland areas in Northern Thailand culturally distinctive Animal Husbandry: A range of pig production modes were found, some associated with different levels of
ethnic minorities reside scattered throughout the mountainous Trichinellosis risk. Those of lower risk bore higher costs in terms of capital and time.
Thailand-Myanmar border region. These populations are seen as Food Chain: Our findings suggest that eating raw pork is part of important rituals and belief and likely not
the most disadvantaged and vulnerable groups amongst Thailand’s subject to behavioral modification. However, we found that most villagers were unaware of the association of
rural population. They largely depend upon agriculture for income raw pork consumption and Trichinellosis. A majority of villagers tend to feed their pig with animal parts left
and subsistence. Pig rearing continues to be an important source of over.
food and serves for ritual use, with almost every family keeping pigs. Environment: Due to time constraints, most of the villagers rarely or never remove waste and clean pig
Thus, pig health and production can have a substantial impact on surroundings. Feed scraps attracts more rats and other animals producing a higher chance of exposure to
their livelihoods. Previous studies have reported outbreaks of reservoirs of Trichinella to pigs.
Trichinellosis in Northern Thailand. Yet none differentiate lowland Economy: Villagers generally considered investment in improved husbandry a low priority relative to
from upland outbreaks though these ecosystems and their human competing livelihood needs.
socioeconomic and political circumstances are quite distinct.Our
review of outbreak reports from the past 10 years (2003-2012) Reason for choosing pig housing system Type of pig Accessibility of rat in feed storage Do you usually clean left over feed after feeding? Responsible person for pig health check up Reasons for not using deworming
suggests that more than 90 percent of the outbreaks have occurred Ethnicity of pig raiser
Awareness of housing system
Religion of pig raiser Type of feed Frequency of pig health check up What will you do with your sick pig Deworming
in the highlands with several major foci scattered throughout the Objectives of raising pig
How often you clean pig place?
borderland provinces. Time spent for pig raising:Total time spent on career
Pig housing system Feed handling Animal health practices Waste management
Recognition about rat danger
Revenue received from pig raising:Total revenue ANIMAL HUSBANDRY Formal education level of pig raiser
Source of pig Knowledge of pig raiser
Rearing practices Gender of pig raiser
Figure 1: Trichinellosis in Chiang Mai, Chiang Rai and Mae Hong Son During 2003-2012
Wet garbage handling Environment suitability for Trichinosis circulation Understanding relationship of pig housing and Trichinosis
Source: BOE Thailand (2003-2009) Solid garbage handling Trichinosis recognition
Trichinosis risk in pig Experience in raising pig
Place to slaughter pig
Project Goal and Objectives Carcasses left over handling after slaughtering a pig
Dead animal (cat,dog,rat,etc.) handling
Source of meat
Possibility of being infected Trichinosis in human
Source of information
ENVIRONMENT
Project goal: To understand the transmission of Trichinellosis risk in the Borderland Highlanders as a basis for Dead pig handling
Frequency of cleaning surrounding Food Safety Level
Income level Investment in pig raising
prevention and control measures. Benefit from headman
Rat control Source of fund Family welfare Convenient products Benefit from teacher
Overall objective: To develop a transdisciplinary Specific objectives: Rat abundance Wildlife presence Environment cleanliness Risk of Eating Outside Benefit from pulic health officer
framework using a One Health approach. This • Recruit a multidisciplinary team and informants Benefit from private sector's and public sector services Benefit from animal health officer
framework considers interaction of highlanders with the • Develop an integrative framework
Ethnicity of food preparing person Frequency eating outside Place of eating outside Benefit from local public health volunteer
Religion
FOOD CHAIN Benefit from local animal health volunteer
pigs they grow and their environment as a single Frequency of having meat (Carnivore/omnivore) in a year Meat Preparation
system. We identified four subsystems to investigate • Identify research methods and tools ECONOMY/WELFARE
Benefit from police
Benefit from Heifer
Occasions for killing pig
Trichinellosis risk; • Implement a pilot study Gender of food preparing person Raw/undercooked preference
Benefit from sub-district officer
Benefit from district officer
Reasons describing eating habit
• Animal husbandry Awareness of eating raw/undercooked meat
Frequency of police service Frequency of headman service
• Food chain Formal education of food preparing person Frequency of Heifer service
Frequency of district officer service
Frequency of teacher service
Frequency of pulic health officer service
• Environment
Knowledge of danger of having raw/undercooked meat Knowledge of food preparing person
Frequency of sub-district officer service Frequency of animal health officer service
• Economy Frequency of local animal health volunteer service Frequency of local pulic health volunteer service
Figure 4: Trichinellosis Risk Framework
Conclusion and Discussion
A One Health-based transdisciplinary framework to understand highlander Trichinellosis risk can be
developed and implemented that integrates animal husbandry, food-chain, environment and economy.
These subsystems are entirely interdependent, and thus must be considered as an integrated whole when
devising disease interventions. The preliminary results are being used as basis for expanding the research to
Figure 2: Subsystems for Trichinellosis Risk Investigation Based on a One Health-Based Transdisciplinary Approach
include a component of participatory prevention and control measures aimed at reducing Trichinella
Research Methodology transmission in the Borderland Highlander’s villages.
Population: Two highlander villages, including one that experienced an outbreak.
• Huai Ma Fueang Village (experienced an outbreak): 118 Households
• Huai Chan Si Village: 84 Households
Sampling design: Simple random selection
• Huai Ma Fueang Village: 28 Households
• Huai Chan Si Village: 26 Households
Data collection: Develop, test and conduct survey instrument
• Household survey
• Environment survey
• Institution survey
Data analysis: We use a Bayesian Belief Network model of Trichinellosis risk developed by experts to explain
relationship of the risk factors.
Acknowledgements
We gratefully acknowledge the administrative assistance of Ecohealth-One Health Research Center, Faculty of Veterinary
Medicine, Chiang Mai University; research funds from the EcoZD program of the International Livestock Research Institute (ILRI);
guidance and advice provided by Fred Unger (ILRI) and Jeff Gilbert (ILRI); veterinary technical advice from Jenny Steele
(Tufts University), Karin Hamilton (University of Minnesota), Warangkhana Chaisowwong (CMU), Jan Hinrichs (FAO),
Wichak Tidchai (DLD Thailand), Pranee Rodtian (DLD Thailand);and field logistical assistance of Isaree Khreusirikul
(Heifer International Thailand). We are especially indebted to the headmen of our two study villages, Abhinan Taotao and
Lisor Jalor. Field assistance was provided by Sinh Dang Xuan, Farong Xu, Vu Thi Thu Tra, Hataichanok Wasasiri,
Suputsorn Chatsiriyingyong, Pornwimon Pata, Sarocha Sukrinprom, Chanakan Khumpilai, Bhurichaya Pholsote,
Pimchanok Muangchaimoon, Warinda Somrith (Faculty of Veterinary Medicine, CMU), Phiangkwaun Padeang, Phuttipong
Pookjohn and Nonprabha Buranawut (Faculty of Economics, CMU); GIS and mapping support was provided by
Kongchak Jaidee, Global Health Asia, Faculty of Public Health, Mahidol University.
We are also grateful for the travel support to the lead author provided by USAID RESPOND.
Figure 3: Visited Households in Huai Ma Fueang Village and Huai Chan Si Village for Collecting Pig Data
October 2012