RESUMEN

BACKGROUND: Tha Song Yang District, located on the Thai-Myanmar border, contributes to the second highest cases of amoebic dysentery due to intestinal parasitic infections (IPI). However, there were limited disease prevalence data, specific surveillance systems, and interventions available. OBJECTIVE: This study aimed to explore the epidemiological features of the IPIs and apply the One Health (OH) approach to solve IPI-related problems. METHODS: Prevalence of asymptomatic infections in human and animals, yearly symptomatic cases, and associated risk factors were investigated. The OH intervention included improving the knowledge, attitude, and practice (KAP) of the community, microscopic diagnosis training, and stakeholder engagement for IPI prevention designs. RESULTS: The prevalence of asymptomatic cases was much higher than that of the symptomatic cases. Infective stages of the intestinal parasites were discovered in animal stool and water samples, indicating possible transmission routes. One year after the intervention, there were significant declines in asymptomatic IPIs and symptomatic cases of amoebic dysentery. Significant improvements in KAP and awareness regarding water and manure-waste management of the community were observed. CONCLUSION: We reported the successful application of the OH intervention in reducing the IPI prevalence and mitigating disease-related risks. The intervention might be applied to address other infectious diseases in the future.

Asunto(s)

Parasitosis Intestinales/prevención & control , Salud Única , Estaciones del Año , Animales , Estudios Transversales , Heces/parasitología , Femenino , Humanos , Parasitosis Intestinales/epidemiología , Masculino , Mianmar/epidemiología , Enfermedades Parasitarias en Animales/epidemiología , Enfermedades Parasitarias en Animales/parasitología , Enfermedades Parasitarias en Animales/prevención & control , Prevalencia , Factores de Riesgo , Encuestas y Cuestionarios , Tailandia/epidemiología , Poblaciones Vulnerables

RESUMEN

Immunization is a core component of the human right to health. However, accessibility to the Expanded Program on Immunization (EPI) might be difficult among migrant children. This study aims to assess the vaccination coverage of migrant children under a mobile immunization program, initiated by the Thai government in 2014. A cross-sectional, mixed-methods study was conducted in five districts along the Thailand-Myanmar border during July-December 2018. The immunization history during their first year of life was obtained. Focus group discussions were conducted among stakeholders to explore their satisfaction toward the immunization service. Mothers/guardians of 1707 migrant children participated in the survey, with a 71% response rate. The vaccination coverage increased during 2014-2017. The highest vaccination coverage was observed for Bacillus CalmetteGuérin vaccine, with 83.2% coverage in 2017. The vaccination coverage of three doses of diphtheriatetanuspertussis vaccine and Hepatitis B vaccine and oral polio vaccine increased from 34.8% in 2014 to 56.3% in 2017. For measles-containing vaccine, the vaccination coverage increased from 32.4% in 2014 to 54.6% in 2017. Overall, all stakeholders were satisfied with the immunization service. Increased workload and communication barriers were the main factors that influenced the satisfaction toward the immunization program.