Evaluation of a broadly-based control model of fascioliasis (liver fluke) in central Vietnam

Fascioliasis (liver fluke) has raised significant public health concerns in the 15 regional provinces of Central Vietnam. However, comprehensive strategies for fascioliasis control are not in place with reliance on chemotherapy as the main control measure. This study implemented a broadly-based control model comprising of five main components: vector control, health education, improvement of local health systems, involvement of concerned bodies, and chemotherapy. Following the intervention, significant reductions in seroprevalence (4.2% vs. 8.8%, p<0.05) was found in the Intervention 1 commune (broadly-based model), but not in the Intervention 2 commune (model comprising of human chemotherapy and animal chemoprevention) or the Control commune (Control commune, human chemotherapy only). Improvements in knowledge and practice of fascioliasis control were found in the intervention communes 1 and 2, although there remained significant differences in the levels of awareness in these two cohorts (80.2% vs. 37.5% respectively, p <0.017). Considerable changes in practices were found in the Intervention 1 commune with all poor practice items reduced significantly in comparison with the baseline level (p<0.017). Findings in this study also supported the effectiveness of the recommended chemotherapy (triclabendazole 250mg, 10mg/kg body weight) for selective treatment of fascioliasis. Having established the effectiveness of the broadly-based control model, it is important to explore the factors that enable, or act to impede, the implementation of a broadly based control model.