Relationship of intestinal parasites to the environment and to behavioral factors in children in the Bolikhamxay Province of Lao PDR

From March to July 1998 the infection rates of 732 children aged below 15 years were assessed. The investigation was conducted in selected villages of the Bolikhamxai Province in Lao PDR. Socio-economic conditions and behavioral pattern were studied. The three soil-transmitted helminths, Ascaris lumbricoides, Trichuris trichiura and hookworm were found with prevalence rates of 67.14, 17.49 and 12.83%, respectively. Infection rates with other intestinal parasites were negligible. Of the children investigated, 56.7% harbored one and 20.45% more than one parasite. Except for hookworms, no statistically significant differences were found between genders. The probability of being infected with A. lumbricoides is associated with living in mountainous areas. For hookworms, infection is associated with staying in the plains. A river in the vicinity of the village is linked with the probability of being infested with Trichuris trichiura. Not to belong to a family with the ability to own expensive items increases the probability by almost two times of getting infested with A. lumbricoides. Unhygienic behavioral factors were important in increasing the probability of suffering from A. lumbricoides and T trichiura infection. Behavioral factors did not seem to be related to hookworm infections. It was concluded that after mass treatment, besides promoting the construction of toilets, it is also important to improve personal hygiene so that a lasting impact on the infection rate of the most prevalent parasites in Lao PDR could be achieved. Measures to control parasitic infections do not have to be postponed until a marked improvement of the economic situation has occurred.     

A cross-sectional community study of post-traumatic stress disorder and social support in Lao People's Democratic Republic

Objective

To estimate post-traumatic stress disorder (PTSD) symptoms in those injured and not injured by landmines or unexploded ordnance (UXO) in rural Lao People''s Democratic Republic and to determine whether the perception of social support was associated with PTSD symptom severity.

Methods

A community survey was conducted among 190 people injured by landmines or UXO and 380 age-, sex- and neighbourhood-matched non-injured individuals in the Sepone district of Savannakhet Province, the part of the Lao People''s Democratic Republic most heavily bombed during the Viet Nam War. Using the Harvard Trauma Questionnaire and the Medical Outcomes Study Social Support Survey, trained health-care workers conducted face-to-face interviews to assess PTSD symptoms and level of perceived social support. Multiple linear regression was performed to explore the association between social support and other factors and PTSD.

Findings

The prevalence of PTSD was higher among the injured (10%) than among the non-injured (4%), but the level of perceived social support was not significantly different between the two groups. A higher level of perceived social support was associated with milder symptoms of PTSD. Women, older people and those with a formal education were more often and more severely affected by PTSD.

Conclusion

The perception of strong social support might help to alleviate the symptoms of PTSD among people injured by landmines or UXO in rural parts of the Lao People''s Democratic Republic. Psychosocial interventions should be incorporated in assistance for the injured because they have more severe and longer-lasting symptoms of PTSD than the non-injured.