Liver fluke disease is associated with the consumption of raw fish. One particularly popular dish in northern Thailand is koi pla (raw fish and salad.) The problem is most of the consumed fish are infected with a liver fluke parasite called Opisthorchis viverrini. Consumption of the parasite over the long term leads to cholangiocarcinoma (liver cancer). Many people show no symptoms; those who do suffer with indigestion, malnutrition, organ inflammation. As Digital Journal reported last year when we first profiled the disease, cancer normally develops in those aged 50 and older and survival rates are low.
Such is the extent of the problem, it is estimated that over 80 percent of the population in some villages are infected with the parasite. Due to poor sanitation, the feces of many infected people, as well as animals like cats and dogs, end up in the rivers. This is taken in by fish, and the parasitic cycle repeats.
To address the problem, the International Development Research Centre (IDRC) together with Thailand’s National Health Security Office are proposing a series of measures to cut down the incident rate.
The new strategy is termed the “Lawa Model.”
This involves medical treatment of people and animals, together with community and school-based health education, and ecological measures to clean-up the waters. Treatment is through an anti-parasitic drug called Praziquantel.
Due to the eating of raw fish being entrenched in many local cultures, breaking this tradition is the most challenging. Combinations of approaches are being used, from videos to the singing of folk songs.
A recent experiment with the Lawa Model was tested in 11 villages. The reported success rate was a 70 percent reduction in the infection rate. Based on this a full-blown project has been developed, termed “Innovative Strategies for the Sustainable Control of Asian Schistosomiasis and Other Helminth Zoonoses through Socio-Ecosystem Based Interventions.” The project is set to be rolled out through various communities.
