Community Participation in Cholangiocarcinoma Prevention in Ubon Ratchathani, Thailand: Relations with Age and Health Behavior

  • Songserm, Nopparat (Department of Community Health, Faculty of Public Health, Ubon Ratchathani Rajabhat University) ;
  • Bureelerd, Onanong (Department of Community Health, Faculty of Public Health, Ubon Ratchathani Rajabhat University) ;
  • Thongprung, Sumaporn (Department of Community Health, Faculty of Public Health, Ubon Ratchathani Rajabhat University) ;
  • Woradet, Somkiattiyos (Department of Public Health, Faculty of Health and Sports Science, Thaksin University) ;
  • Promthet, Supannee (Department of Epidemiology, Faculty of Public Health, Khon Kaen University)
  • Published : 2015.11.04


A high prevalence of Opisthorchis viverrini infection is usually found in wetland geographical areas of Thailand where people have traditional behavior of eating uncooked freshwater fish dishes which results in cholangiocarcinoma (CCA) development. There were several approaches for reducing opisthorchiasis-linked CCA, but the prevalence remains high. To develop community participation as a suitable model for CCA prevention is, firstly, to know what factors are related. We therefore aimed to investigate factors associated with the community participation in CCA prevention among rural residents in wetland areas of Ubon Ratchathani, Thailand. This was a cross-sectional analytic study. All participants were 30-69 years of age, and only one member per house was invited to participate. A total of 906 participants were interviewed and asked to complete questionnaires. Independent variables were socio-demographic parameters, knowledge, health belief and behavior to prevent CCA. The dependent variable was community participation for CCA prevention. Descriptive statistics were computed as number, percentage, mean and standard deviation. Associations were assessed using logistic regression analysis with a P-value <0.05 considered statistically significant. Of all the participants, more than 60% had regularly participated in activities to prevent CCA following health officials advice. Age and health behavior to prevent CCA were factors associated with community participation for CCA (p<0.001). Both factors will be taken into consideration for community participation approaches for CCA prevention through participatory action research (PAR) in future studies.


Community participation;cholangiocarcinoma;prevention;Thailand


  1. Duangsong R, Promthet S, Thaewnongiew K (2013). Development of a community-based approach to opisthorchiasis control. Asian Pac J Cancer Prev, 14, 7039-43.
  2. Gordis L (2004). Epidemiology. 3rd ed. Philadelphia, Elsevier Saunders.
  3. Grundy-Warr C, Andrews RH, Sithithaworn P, et al (2012). Raw attitudes, wetland cultures, life-styles: Socio-cultural dynamics relating to Opisthorchis viverrini in the Mekong basin. Parasitology Int, 61, 65-70.
  4. Jongsuksuntigul P, Imsomboon T (1998). Epidemiology of opisthorchiasis and national control program in Thailand. Southeast Asian J Trop Med Public Health, 29, 327-32.
  5. Jongsuksuntigul P, Imsomboon T (2003). Opisthorchiasis control in Thailand. Acta Trop, 88, 229-32.
  6. Kamsa-ard S, Wiangnon S, Suwanrungruang K, et al (2011). Trends in liver cancer incidence between 1985 and 2009, Khon Kaen, Thailand: cholangiocarcinoma. Asian Pac J Cancer Prev, 12, 2209-13.
  7. Khuhaprema T, Attasara P, Sriplung H, Wiangnon S, Sangrajrang S (2013). Cancer in Thailand, Vol. VII, 2007-2009. Bangkok, Bangkok Medical Publisher.
  8. Manwong M, Songserm N, Promthet S, Matsuo K (2013). Risk factors for cholangiocarcinoma in the lower part of Northeast Thailand: a hospital-based case-control study. Asian Pac J Cancer Prev, 14, 5953-6.
  9. Parkin DM, Srivatanakul P, Khlat M, et al (1991). Liver cancer in Thailand. I. A case-control study of cholangiocarcinoma. Int J Cancer, 48, 323-8.
  10. Parkin DM, Ohshima H, Srivatanakul P, Vatanasapt V (1993). Cholangiocarcinoma: epidemiology, mechanisms of carcinogenesis and prevention. Cancer Epidemiol Biomarkers Prev, 2, 537-44.
  11. Promthet S, Wiangnon S, Senarak W, et al (2012). Evaluation of health education in the multi-professional intervention and training for ongoing volunteer-based community health programme in the north-east of Thailand. Asian Pac J Cancer Prev, 13, 1753-5.
  12. Saranrittichai K, Senarak W, Promthet S, et al (2012). Health behavior after multiprofessional intervention and training for ongoing volunteer-based community health programme intervention in the North-East of Thailand: what changed and what not? Asian Pac J Cancer Prev, 13, 4801-5.
  13. Senarak W, Chirawatkul S, Markovic M (2006). Health promotion for middle-aged Isan women, Thailand: a participatory approach. Asian Pac J Cancer Prev, 7, 55-9.
  14. Sithithaworn P, Andrews RH, Van De N, et al (2012). The current status of opisthorchiasis and clonorchiasis in the Mekong Basin. Parasitology Int, 61, 10-6.
  15. Songserm N, Promthet S, Sithithaworn P, et al (2012). Risk factors for cholangiocarcinoma in high-risk area of Thailand: Role of lifestyle, diet and methylenetetrahydrofolate reductase polymorphisms. Cancer Epidemiol, 36, 89-94.
  16. Sriamporn S, Pisani P, Pipitgool V, et al (2004). Prevalence of Opisthorchis viverrini infection and incidence of cholangiocarcinoma in Khon Kaen, Northeast Thailand. Trop Med Int Health, 9, 588-94.
  17. Sripa B, Kaewkes S, Sithithaworn P, et al (2007). Liver fluke induces cholangiocarcinoma. PLoS Med, 4, 201.
  18. Sripa B, Tangkawattana S, Laha T, et al (2015). Toward integrated opisthorchiasis control in northeast Thailand: the Lawa project. Acta Trop, 141, 361-7.
  19. Thaewnongiew K, Singthong S, Kutchamart S, et al (2014). Prevalence and risk factors for Opisthorchis viverrini infections in Upper Northeast Thailand. Asian Pac J Cancer Prev, 15, 6609-12.
  20. Vatanasapt V, Uttaravichien T, Mairiang E, et al (1990). Cholangiocarcinoma in north-east Thailand. Lancet, 335, 116-7.
  21. Wattanayingcharoenchai S, Nithikathkul C, Wonsaroj T, Royal L, Reungsang P (2011). Geographic information system of Opisthorchis viverrini in northeast Thailand. Asian Biomedicine, 5, 687-91.
  22. Wongba N, Thaewnongiew K, Phathee K, et al (2011). Liver fluke prevention and control in the Northeast of Thailand through action research. Asian Pac J Cancer Prev, 12, 1367-70.

Cited by

  1. Nurses and Television as Sources of Information Effecting Behavioral Improvement Regarding Liver Flukes in Nakhon Ratchasima Province, Thailand vol.17, pp.3, 2016,
  2. Effectiveness of a Health Educational Program Based on Self-Efficacy and Social Support for Preventing Liver Fluke Infection in Rural People of Surin Province, Thailand vol.17, pp.3, 2016,
  3. Prevalence and Factors Associated with Opisthorchis viverrini Infection in Khammouane Province, Lao PDR vol.17, pp.3, 2016,
  4. Implementation of Health Behavior Education Concerning Liver Flukes among Village Health Volunteers in an Epidemic Area of Thailand vol.17, pp.4, 2016,