Intestinal helminth infections and these diseases control activities in Vietnam
At the workshops on evaluating the prevention of malaria, parasitic and vector-borne diseases in the first 6 months of 2015 held by the institutes of malariology, parasitology and entomology (Ministry of Health-MoH), the control of parasitic diseases, mainly intestinal helminthiases is an important part of the workshops; however, these diseases so far are still listed as neglected tropical diseases (NTDs), which have not been given investment priority and proper prevention scale yet.
The IMPE Quy Nhon held the Workshop on reviewing the control and elimination of malaria and helthminthiasis in the first 6 months of 2015 and plans for the end of 2015 in Central and West-Highland.
Due to the humid tropical climate, culinary traditions, and widespread faecal contamination, intestinal parasitic infections remain endemic in Vietnam as well as the countries of the tropics and subtropics. In Vietnam, the major genera of helminths important for public health are the soil-transmitted helminths (STH) (Ascaris, Trichuris, Ancylostomiasis/Necatoriasis), Enterobius vermicularis, Strongyloidiasis, Gnathostomiasis; food-borne trematodiases (Fascioliasis, Clonorchiasis, Paragonimiasis, Taeniasis); amoebiasis (unicellular parasite); accordingly, the proportion of helminths infection in children is higher than that in adults. The symptoms of these helmiths often develop quietly and donot show up perniciously, thereby they havenot been the major concern of the community as well as managers; however, if these diseases arenot be treated promptly, several pathological signs can be resulted, such as peritonitis, appendicitis, hypochromic anemia, decrease in blood protein and cardiovascular disorders,even fatality.
Deworming for children from 24 to 60 months of age in 21 provinces with the high rate of malnourished children.
A roundworm knot was taken out from a child suffering from intestinal obstruction.
According to the medical statistics the prevalence of helmithiasis in our country is very high with 80% of the population infected with Ascaris, Trichuris 55% and hookworms 35%. The latest survey results of the National Institute of Malariology, Parasitology and Entomology (NIMPE) showed that the rates of STH infection in children aged 12-24 months were 32.6% (137/419) in Dien Bien province and 19% (83/432) in Yen Bai; primary-school students from 1st to 5th grade in some northern provinces of Cao Bang, Thai Nguyen, Thanh Hoa and Ha Nam have the general infection rate of 5 - 19.4%. According to the survey of the Institute of Malariology, Parasitology and Entomology Quy Nhon (IMPE Quy Nhon, the rate of STH infection in childbearing women in Phu Yen province was from 21-26%; the infection rate of helminth eggs on vegetables was 32.8%; 744 cases of Fasciola gigantica infection were detected (IMPE Quy Nhon Clinic 602 cases, Provincial Malaria Control Center of Binh Dinh 131 cases, Quang Nam province 11 cases); the rates of Opisthorchis viverini infection at some study sites of Binh Dinh province were 4-8%; the rates of Cysticercosis infection in Khanh Hoa and Phu Yen were from 5-7%; the infection rate of Toxocara canis/cati infection on vegetables in Binh Dinh was 11.4%.
Eating raw fish results Opisthorchis viverini infection
The helminths control activities in Vietnam in 2015 are to maintain and expand the model for controlling STH in order to reduce the STH infection rate and intensity in children aged 24 to 60 months, grade-schoolers and childbearing women from 15-45 years old; to decrease the rate and intensity of food-borne trematodiases infection to reduce the harmful effect and burden of this disease on the community. In order to implement these objectives, in the first 6 months of 2015, NIMPE in collaboration with the National Institute of Nutrition (NIN) carried out the deworming of children with the results: 98% (1,188,403/1,213,180) of children aged 24-60 months in 20/21 project provinces with high rates of stunting malnutrition; 99.2% (2,458,781/2,477,767) grade-schoolers in 27 provinces under the cooperation project between the World Health Organization (WHO) and USAID/FHI360; 95% (42,304/42,880) of children under the National Project on School Health. on the whole, all the deworming campaigns have met the targets with good results and very few cases occured side effects (adverse effects).
Risk of Toxocara canis / cati infection has become popular.
Despite such results, the prevention of helmithiasis in humans has still faced many difficulties due to high and diversified infection levels; especially in recent years a number of emerging zoonotic helminth infections like Fascioliasis, Taeniasis, Strongyloidiasis, Gnathostomiasis, Toxocariasis, etc. have become a hot issue in Central Vietnam. These helminthiases have caused serious damages as malnutrition, anemia and limited working capacity, even endangered human lives, such as Cysticercosis, Paragonimiasis, Fasciloiasis, etc.
Helminth infection rate remains high due to poor sanitary conditions and difficult economic life.
However, presently helminth infections have still considered as "neglected tropical diseases" (NTDs) because the symptoms develop silently and are easily obscured by many other acute diseases, so they havenot been paid proper attention and got the large-scale control. The helminthiasis control activities have just based on the fundings from WHO and several international projects; the national funds for controlling these diseases are limited and no prevention programs are set out; thereby there are no effective cooperations of all levels, sectors and no active involvement of the community. The plan of helminthiasis prevention for the last 6 months of 2015 is to continue completing the defined anti-helminthiasis targets.
By Assoc.Prof. Trieu Nguyen Trung, Assoc.Prof. Nguyen Van Chuong and Assoc.Prof. Ho Van Hoang (Translated by Huynh Thi An Khang)