Implementation of Health Behavior Education Concerning Liver Flukes among Village Health Volunteers in an Epidemic Area of Thailand

  • Published : 2016.06.01


Background: Liver fluke infection is associated with cholangiocarcinoma; the bile duct cancer found frequently in the northeast and north of Thailand. Prevention and control particularly requires health education and behavior change. Objective: This study aimed to improve health behavior among village health volunteers (VHV) regarding liver fluke exposure in an epidemic area. Materials and Methods: A quasi-experimental study was performed during July 2015 to January 2016 in Sang Kha district of Surin province, Thailand. A total of 67 VHVs underwent a health education program (HEP) and data were collected on knowledge, attitude, and practice (KAP) before and after participation for HEP 3 months with a pre-designed questionnaire. The Students paired T-test was used for comparisons of mean KAP levels before/after the intervention. Results: The results revealed that knowledge (P-value=0.004), attitude (P-value=0.004), and practice level (P-value=0.000) were significantly improved after participation in the HBP. Attitude was significantly associated with knowledge (r=0.266, p<0.05), and practice (r=0.348, p<0.01). Conclusions: The implementation of health education among VHVs is feasible and increases their KAP. This improvement should have potential in liver fluke prevention and control in local communities in rural Thailand.


Supported by : Suranaree University of Technology (SUT)


  1. Best JW (1977). Research in education (3rd ed). Englewood Cliffs, NJ: Prentice-Hall.
  2. Bloom BS (1971). Handbook on formative and summative of student learning. New York: Mc Graw-Hill Book Company.
  3. Duangsong R, Promthet S, Thaewnongiew K (2013). Development of a community-based approach to opisthorchiasis control. Asian Pac J Cancer Prev, 14, 7039-43.
  4. IARC (1994). Infection with liver flukes (Opisthorchis viverrini, Opisthorchis felineus and Clonrochis sinensis). IARC Monogr Eval Carcinog Risks of Hum, 61, 121-75.
  5. Kaewpitoon SJ, Kaewpitoon N, Rujirakul R, et al (2015). The carcinogenic liver fluke opisthorchis viverrini among rural community people in northeast Thailand: a cross- sectional descriptive study using multistage sampling technique. Asian Pac J Cancer Prev, 16, 7803-7.
  6. Kaewpitoon N, Kootanavanichpong N, Kompor P, et al (2015). Review and current status of Opisthorchis viverrini infection at the community level in Thailand. Asian Pac J Cancer Prev, 16, 6825-30
  7. Likert R (1932). A technique for the measurement of attitudes, Archives Psychol, 140, 44-53
  8. Promthet P, Kessomboon P, Promthet S (2015). Communitybased health education and communication model development for opisthorchiasis prevention in a high risk area, Khon Kaen province, Thailand. Asian Pac J Cancer Prev, 16, 7789-94.
  9. Sithithaworn P, Andrews RH, Nguyen VD, et al (2012). The current status of opisthorchiasis and clonorchiasis in the Mekong Basin. Parasitol International, 61, 10-6.
  10. Songserm N, Bureelerd O, Thongprung S, et al (2015). Community participation in cholangiocarcinoma prevention in Ubon Ratchathani, Thailand: relations with age and health behavior. Asian Pac J Cancer Prev, 16, 7375-9.
  11. Sripa B, Brindley PJ, Mulvenna J, et al (2012). The tumorigenic liver fluke Opisthorchis viverrini-multiple pathways to cancer. Trends Parasitol, 28, 395–407.
  12. Sripa B, Kaewkes S, Intapan PM, et al (2010). Food-borne trematodiases in Southeast Asia: epidemiology, pathology, clinical manifestation and control. Adv Parasitol, 72, 305-50.
  13. Sripa B, Pairojkul C 2008. Cholangiocarcinoma: lessons from Thailand. Curr Opin Gastroenterol, 24, 349-56.
  14. Sripa B, Tangkawattana S, Laha T, et al (2015). Toward integrated opisthorchiasis control in northeast Thailand: the Lawa project. Acta Trop, 141, 361-7.
  15. Wongsaroj T, Nithikathkul C, Rojkitikul W, et al (2014). National survey of helminthiasis in Thailand. Asian Biomedicine, 8, 779-83