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Importance of parasitic foodborne diseases in rural areas of
southern Laos: A long-term case study using an integrated
app...
Emerging health risks
Social ecological system & OneHealth
Ecosystem
(interactions & dynamics)
Social
(interactions & dyna...
Trandisciplinary and cross-sectorial collaboration platform
Administrative/spatialscales
Mutual learning & understanding, ...
Representation
& need
Representation
& need
Representation
& need
Representation
& need
From individuals’
representations…...
Parasitic food-borne diseases (PFBD) in Laos
• PFBD are expected to be widely distributed in Laos.
• PFBD can significant ...
In-depth assessment of PFBD
 On-farm survey (1 province, Savannakhet)
• Serological survey (Trichinella in pigs using ELI...
PRA/PE: Topics of the focus group discussion
• Livelihoods context and common issue of concern
• Social and cultural behav...
PE/PRA  comprehensive info & knowledge gained
General issue Health issue
Common dishes
Causes of the PFBD
Prevention & control
• They do have knowledge, but still take risk.
• Different among the...
o Open defecation
o Waste management
o Free roaming
o Dead animals management
o Slaughtering at unclean places
PRA/PE: Oth...
Serological Results
• 418 samples from 181 households were collected in 19 villages across 3
districts of Savannakhet.
• O...
Seropositivity and age
Seropositivity and housing
Free range:
27.9% (19/68)
Pen: 16.7% (39/234)
Tethered: 13.9% (16/116)
0...
Zoonotic knowledge: 14.4%, 26 of 181 people heard about zoonotic
diseases, but further details were usually not known
Asso...
Villagers perception related to deworming and raw fish/pork
consumption (using Likert scale)
Wrong perception
Perceived co...
Synthesis of results: Knowledge on PFBD (ongoing)
PRA Questionnaire
Interview question Likert scale
- Very limited knowled...
Cross-sectoral platform
Steering committee
Steering committee establishment
• Representatives from 6 ministries, faculties,
and local governors.
•...
Technical working group (TWG)
• Ministries: Agriculture & Forestry,
Defense, Public health, Natural Resource
& Env., Infor...
Feedback meeting @ Khammoune and Savannakhet
24-26 November 2016
• 18 villages from 2 provinces
• 3 representatives from t...
Inceptionmeeting
06,08/15
Administrative level
Local
District/
province
National
Inceptionmeeting(SC)
01/16
PE/PRA
07-12/1...
• The project has been establishing and building a
set of capital essential for the OH issue in Laos (and
in others).
– In...
1. Consolidate the finding and provide concrete evidence to
raise awareness and stimulate the collaborative efforts.
2. Co...
Co-construct a common
understanding
Issue?
• System & holistic approach.
• Participative & adaptive manner.
• Co-learning ...
• How to scale-out such integrated approach & practice?
• How to ensure long-term sustainable outcome and impact?
• How to...
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Importance of parasitic foodborne diseases in rural areas of southern Laos: A long-term case study using an integrated approach

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Presentation by Vannaphone Putthana, Panomsak Promburom, Thipphakone Lacksivy,Dethaloun Meunsen, Amphone Keosengthong, Garance Danner, Khao Keonam, Palamy Changleuxai, Nalita Adsanychanh, Daosavanh Sanamxay, Phongsamouth Suthammavong, Khampasong Ninnasopha, Aurélie Binot, Stephane Herder and Fred Unger at the 4th International One Health Congress and 6th Biennial Congress of the International Association for Ecology and Health (One Health EcoHealth 2016), Melbourne, Australia, 3–7 December 2016.

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Importance of parasitic foodborne diseases in rural areas of southern Laos: A long-term case study using an integrated approach

  1. 1. Importance of parasitic foodborne diseases in rural areas of southern Laos: A long-term case study using an integrated approach One Health Ecohealth 2016, 3-7 December 2016, Melbourne, Australia Vannaphone Putthana, Panomsak Promburom, Thipphakone Lacksivy, Dethaloun Meunsen, Amphone Keosengthong, Garance Danner, Khao Keonam, Palamy Changleuxai, Nalita Adsanychanh, Daosavanh Sanamxay, Phongsamouth Suthammavong, Khampasong Ninnasopha, Aurélie Binot, Stephane Herder, Fred Unger
  2. 2. Emerging health risks Social ecological system & OneHealth Ecosystem (interactions & dynamics) Social (interactions & dynamics) Agro-ecosystem(pets&livestocks) • Complex & uncertain • Evolve & change rapidly • Multiple stakeholders + point of view & action
  3. 3. Trandisciplinary and cross-sectorial collaboration platform Administrative/spatialscales Mutual learning & understanding, support, networking, capacity building and collective action for better management. Non-absolute issue owner
  4. 4. Representation & need Representation & need Representation & need Representation & need From individuals’ representations… ..perceive, aware modify individual one to facilitate collective action ? .. a common representation.. ..to co-construct.. Exchanging point of view & knowledge Changes / Outcomes Companion modeling approach
  5. 5. Parasitic food-borne diseases (PFBD) in Laos • PFBD are expected to be widely distributed in Laos. • PFBD can significant impact on human health, livelihood and economy. • Lack of detailed information and evidences. • Assess PFBD distribution in southern Laos. • Understand risk-related perception & practices. • Establish a cross-sectorial collaboration platform to promote feasible prevention & control. Objectives: “Integrated OH approach” into  “practice”
  6. 6. In-depth assessment of PFBD  On-farm survey (1 province, Savannakhet) • Serological survey (Trichinella in pigs using ELISA) • Questionnare, observations and likert scales  Literature review (Laos, last 10 years) • Trichinella, Cysticercosis and O.V.  PRA/PE: 3 provinces x 3 district x 3 villages • Various tools used e.g. FGD, Transsect, ranking ect.  Issue contextualization • Interdisciplinary team (Vet, Med, Soc, Env, Agri, modeling) • Co-construct better understanding
  7. 7. PRA/PE: Topics of the focus group discussion • Livelihoods context and common issue of concern • Social and cultural behavior/practices related to the PFBD • Ecological and livelihood linkages • General problems of the community • Health issue/problem of human and animal • Perception, knowledge, practice related to the PFBD
  8. 8. PE/PRA  comprehensive info & knowledge gained General issue Health issue
  9. 9. Common dishes Causes of the PFBD Prevention & control • They do have knowledge, but still take risk. • Different among the respondants. • Teacher have better knowledge. • Paravet usually know worms but not precisely. Perception, knowledge and practice
  10. 10. o Open defecation o Waste management o Free roaming o Dead animals management o Slaughtering at unclean places PRA/PE: Other risk practices (Observation) • Health and PFBD are low-ranked. • PFBD could be linked to diverse quoted symptoms. • Limited knowledge / wrong perception. • PFBD-related risk practices. PRA/PE: Summary
  11. 11. Serological Results • 418 samples from 181 households were collected in 19 villages across 3 districts of Savannakhet. • Overall serological prevalence for Trichinella in pigs 17.7% (74/418) • Significant difference between districts 9.56% 35.00% 4.10% 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00% Xonnaboury Songkhone Champhone
  12. 12. Seropositivity and age Seropositivity and housing Free range: 27.9% (19/68) Pen: 16.7% (39/234) Tethered: 13.9% (16/116) 0% 10% 20% 30% 40% 50% 60% 2 to<6m 6 to>12m 12m & older Seroprevalence by age class Highest prevalence in pigs 1yr or older: 54% (27/50) 6 to < 12 m
  13. 13. Zoonotic knowledge: 14.4%, 26 of 181 people heard about zoonotic diseases, but further details were usually not known Associated diseases stated (out of 26 repondent): • Bird flu (4/26), Liver fluke/liver disease (3/26), Rabies (1/26), Denghi (1/26) Other selected results 72.4% 1.7% 1.7% 2.6% 18.1% 3.4% Reasons for not deworming pigs Dont know about it have no deworm drug Have no money no need pig look healty raising short time Use of dewormer in pigs 6.1% (11/181 farmers) Reason for not using: - Dont know about is (72.4%) - No need as pigs look healthy (18.1%)
  14. 14. Villagers perception related to deworming and raw fish/pork consumption (using Likert scale) Wrong perception Perceived correctly, (but still take risk)
  15. 15. Synthesis of results: Knowledge on PFBD (ongoing) PRA Questionnaire Interview question Likert scale - Very limited knowledge on cause and prevention -Worms are common for vilagers but not known as health issue - Very limited knowledge on cause and prevention - Only 1.5%, link raw pork consumption to PFBD Perception that worms are not harmful for humans (85% agreement)
  16. 16. Cross-sectoral platform
  17. 17. Steering committee Steering committee establishment • Representatives from 6 ministries, faculties, and local governors. • Informed/updated on the project approach and progress made. • Agreed on duties and commitment to advise, interface with policy level. • Extend one health effort network.
  18. 18. Technical working group (TWG) • Ministries: Agriculture & Forestry, Defense, Public health, Natural Resource & Env., Information, Culture & Tourism, Education & Sport, U. of Health Science, 3 Faculties (Env, Soc, Agri) • Well informed and agree to the project approach & process. • Committed to provide technical advise and support.
  19. 19. Feedback meeting @ Khammoune and Savannakhet 24-26 November 2016 • 18 villages from 2 provinces • 3 representatives from the TWG • 15 representatives from the provincial sectors.  Knowledge verification (get feedback from the stakeholders)  Exchange and improve knowledge.  Inform the research direction and activity plan.  Build trust, keep connection and networking with the stakeholders.
  20. 20. Inceptionmeeting 06,08/15 Administrative level Local District/ province National Inceptionmeeting(SC) 01/16 PE/PRA 07-12/16 SCmeeting 01/17 SCmeeting TWGmeeting2 Studytour,KKU 01/16 07/16 10/16Technicaltraining 10/16 TWGmeeting1 06/16 Feedback Inter-sectoral collaboration Sampling &HHsurvey 07/16
  21. 21. • The project has been establishing and building a set of capital essential for the OH issue in Laos (and in others). – Interdisciplinary research team, transdisciplinary efforts – Valid scientific knowledge for evidence based recommendations – Capacity building (research team, local partners, SC and TWG) – Cross-sectoral collaboration platform (SC and TWG established and linked to the local offices) • An innovation of developing and implementing integrated methodological framework and cross- sectoral collaboration platform for OH issue Summary
  22. 22. 1. Consolidate the finding and provide concrete evidence to raise awareness and stimulate the collaborative efforts. 2. Co-design & develop the communication & intervention • Technical training to the local staffs. • Co-design & develop communication tool (school, locals). • Designate a local cross ministerial working group. 3. Pilot info & knowledge dissemination and collective management. 4. Proposed to the SC and conveyed to policy maker. 5. Co-develop a practical cross-sectoral platform guideline to guarantee the continuation of the OH effort. 6. M & E on the outcomes to broaden the communication and community of practice. Ways forward
  23. 23. Co-construct a common understanding Issue? • System & holistic approach. • Participative & adaptive manner. • Co-learning by doing. • Interdiscplinary team • Trust and partnership “That is our desirable future ” “We need changes” • What changes? how? • Who changes? How? • How to sustain? Concrete evidence • PRA/PE • Sero-sampling Agree and propose future improvements SC TWG
  24. 24. • How to scale-out such integrated approach & practice? • How to ensure long-term sustainable outcome and impact? • How to engage target stakeholders involved in the processes? Challenges Thank you very much! ຂອບໃຈຫຼ າຍໆເດີ້

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