This study aimed to evaluate the effect of the formative program evaluation on the continuous improvement of a clinical training program for Lao health professionals. The training program was conducted 4 times consecutively for total 48 health professionals, and the formative program evaluation was carried out during the whole process. To evaluate the satisfaction and the transfer of the trainees, the questionnaire survey, the focus group interview, and the trainees' medical records were used. After the end of each batch of the program, the evaluation data were analyzed, and its results were shared with the training management committee and the trainers, who, based on the results, reached a consensus on how to improve the program. The evaluation results and the comparison of them among the four batches of the program showed that there was a continuous increase of the satisfaction and the transfer of the trainees, especially in the early period of the program. The formative program evaluation which was conducted during the whole process of the clinical training program had a positive effect on the improvement of the program, especially in the early phase, by increasing the satisfaction and transfer of the trainees.
Education, Continuing ; Health Personnel/*education ; Humans ; Laos ; *Program Evaluation

Artemisinin-based combination therapy (ACT) resistance is widespread throughout the Greater Mekong Subregion. This raises concern over the antimalarial treatment in Thailand since it shares borders with Cambodia, Laos, and Myanmar where high ACT failure rates were reported. It is crucial to have information about the spread of ACT resistance for efficient planning and treatment. This study was to identify the molecular markers for antimalarial drug resistance: Pfkelch13 and Pfmdr1 mutations from 5 provinces of southern Thailand, from 2012 to 2017, of which 2 provinces on the Thai- Myanmar border (Chumphon and Ranong), one on Thai-Malaysia border (Yala) and 2 from non-border provinces (Phang Nga and Surat Thani). The results showed that C580Y mutation of Pfkelch13 was found mainly in the province on the Thai-Myanmar border. No mutations in the PfKelch13 gene were found in Surat Thani and Yala. The Pfmdr1 gene isolated from the Thai-Malaysia border was a different pattern from those found in other areas (100% N86Y) whereas wild type strain was present in Phang Nga. Our study indicated that the molecular markers of artemisinin resistance were spread in the provinces bordering along the Thai-Myanmar, and the pattern of Pfmdr1 mutations from the areas along the international border of Thailand differed from those of the non-border provinces. The information of the molecular markers from this study highlighted the recent spread of artemisinin resistant parasites from the endemic area, and the data will be useful for optimizing antimalarial treatment based on regional differences.
Cambodia ; Drug Resistance ; Laos ; Myanmar ; Parasites ; Plasmodium falciparum ; Plasmodium ; Thailand

The metacercariae of Centrocestus formosanus, a minute intestinal trematode of mammals and birds, were detected in the freshwater fish, Puntius brevis, from Vientiane Municipality, Lao PDR. The metacercariae were experimentally fed to mice, and adult flukes were recovered in their small intestines 7 days later. The adult flukes were morphologically characterized by having 32 (rarely 34) circumoral spines arranged in 2 alternative rows, a large bipartite seminal vesicle, an oval-shaped ovary, and an X-shaped excretory bladder. Based on these characters, the adults were identified as Centrocestus formosanus (Nishigori, 1924). The taxonomic significance of C. formosanus, in relation to a closely related species, C. caninus (Leiper, 1913), is briefly discussed. It has been first verified by adult worm recovery that C. formosanus is prevalent in Vientiane areas of Lao PDR, taking the freshwater fish, P. brevis, as a second intermediate host.
Animals ; Fish Diseases/*parasitology ; Fishes ; Laos ; Trematoda/*classification/ultrastructure ; Trematode Infections/parasitology/*veterinary

The metacercariae of Centrocestus formosanus, a minute intestinal trematode of mammals and birds, were detected in the freshwater fish, Puntius brevis, from Vientiane Municipality, Lao PDR. The metacercariae were experimentally fed to mice, and adult flukes were recovered in their small intestines 7 days later. The adult flukes were morphologically characterized by having 32 (rarely 34) circumoral spines arranged in 2 alternative rows, a large bipartite seminal vesicle, an oval-shaped ovary, and an X-shaped excretory bladder. Based on these characters, the adults were identified as Centrocestus formosanus (Nishigori, 1924). The taxonomic significance of C. formosanus, in relation to a closely related species, C. caninus (Leiper, 1913), is briefly discussed. It has been first verified by adult worm recovery that C. formosanus is prevalent in Vientiane areas of Lao PDR, taking the freshwater fish, P. brevis, as a second intermediate host.
Animals ; Fish Diseases/*parasitology ; Fishes ; Laos ; Trematoda/*classification/ultrastructure ; Trematode Infections/parasitology/*veterinary

The Dr. LEE Jong-wook—Seoul Project (DLSP) in the Lao People'0s Democratic Republic (PDR) is a long-term development cooperation initiative aimed at upgrading the medical education capacity at the University of Health Sciences (UHS) in the Lao PDR. Under the project, eight faculty members from UHS were trained at the Seoul National University College of Medicine for a 12-month period during 2010–2011. Using a training-of-trainers model, we estimated the effect of DLSP on the learning outcomes of students, which was measured using the standard test scores of the students. The questionnaire developed by the Medical Education Assessment Consortium in Korea was given to the students and both the percent-correct and standardized scores were examined. The evaluation strategy was to compare the learning outcomes of the students taught by the trainees with those that were not and to compare the medical topics taught by the trainees with other topics. It was found that the first group of trainees in the DLSP was associated with an increase of 1.5 in the percent-correct test scores for basic medicine. While the interpretation requires caution, it is consistent with the view that a training program for faculty members could be effective in improving the teaching capacity of medical schools in developing countries.
Developing Countries ; Education ; Education, Medical ; Educational Measurement ; Humans ; Korea ; Laos ; Learning ; Schools, Medical ; Seoul ; Students, Medical

In the present study, we report on the occurrence of paramphistomes, Fischoederius cobboldi and Paramphistomum epiclitum, in Lao PDR with the basis of molecular data. Parasite materials were collected from bovines bred in Ban Lahanam area, Savannakhet Province, Lao PDR at Lahanam public market. Morphological observations indicated 2 different species of paramphistomes. The mitochondrial gene cox1 of the specimens was successfully amplified by PCR and DNA sequencing was carried out for diagnosis of 11 specimens. Pairwise alignment of cox1 sequences were performed and confirmed F. cobboldi and P. epiclitum infecting bovines in Laos. Although there were many limiting points, as the small number of worm samples, and the restricted access of the animal host materials, we confirmed for the first time that 2 species of paramphistomes, F. cobboldi and P. epiclitum, are distributed in Lao PDR. More studies are needed to confirm the paramphistome species present in Savannakhet and its hosts to clear the natural history of these parasites of ruminants in the region and measure the impact of this parasite infection in the life and health of the local people.
Animals ; Cattle ; Diagnosis ; Genes, Mitochondrial ; Helminths ; Laos ; Natural History ; Paramphistomatidae* ; Parasites ; Polymerase Chain Reaction ; Rumen* ; Ruminants ; Sequence Analysis, DNA

PURPOSE: The current study was conducted for evaluation and comparison of dietary behavior and food intake in different regions of Lao PDR. METHODS: The survey was conducted on 979 people aged 40~59 years old living in 25 urban provinces and 25 rural provinces in four districts (VTE Capital-Chanthabuly, Xaysetha, VTE Province-Phonhong, and Thoulakhom) of Laos. General demographic information, health status, and dietary behavior were surveyed using a questionnaire. RESULTS: The literacy ratio (p = 0.000), education level (p = 0.000), asset ownership level (p = 0.000), and government and private employee ratio (p = 0.000) were higher in urban subjects compared with rural subjects. The mean value of weight (p = 0.000), waist circumference (p = 0.000), and diastolic blood pressure (p = 0.009) and alcohol consumption (p = 0.000), self-rated health status (p = 0.001), and the rate of obesity (p = 0.000) were significantly higher in urban subjects compared with rural subjects. However, the rate of current smoker was significantly higher in the rural group (p = 0.023). Meals are becoming more westernized by higher frequency of eating out, consumption of fatty meat and fried or stir-fried food in urban areas compared to rural areas. Urban subjects had relatively better balanced meals compared to rural subjects whereas they consumed insufficient meals per day and consumed meals irregularly compared to rural subjects. Intake of fruit and milk was significantly higher in urban subjects compared with rural subjects. However, the intake of vegetables was significantly higher in rural areas than urban areas. CONCLUSION: The result of this study showed that the traditional Lao diet is being replaced by an unhealthy western dietary pattern, which may be a risk factor for increasing development of non-communicable disease (NCD) in Lao PDR. Planning of proper personalized nutritional intervention and education in each area is needed to decrease the health risks of NCD.
Alcohol Drinking ; Blood Pressure ; Diet* ; Eating* ; Education ; Fruit ; Humans ; Laos ; Meals ; Meat ; Milk ; Obesity ; Ownership ; Risk Factors ; Vegetables ; Waist Circumference

Freshwater fish from Vientiane Municipality and Savannakhet Province, Lao PDR were examined by the muscle compression and artificial digestion methods to know the infection status with trematode metacercariae. In the fish from Savannakhet, 2 species of metacercariae, Opisthorchis viverrini and Haplorchis taichui, were detected. O. viverrini metacercariae were found in 6 species of fish, Puntius brevis, Hampala dispar, Esomus metallicus, Mystacoleucus marginatus, Puntioplites falcifer, and Cyclocheilichthys armatus. H. taichui metacercariae were detected in 3 species of fish, P. brevis, P. falcifer, and M. marginatus. In the fish from Vientiane, 4 species of metacercariae, O. viverrini, H. taichui, Haplorchis yokogawai, and Centrocestus formosanus, were detected. Among them, O. viverrini metacercariae were found in 7 species of fish, Onychostoma elongatum, C. armatus, H. dispar, P. brevis, Cyclocheilichthys repasson, Osteochilus hasseltii, and Hypsibarbus lagleri. The metacercariae of H. taichui were detected in 6 species of fish, C. repasson, O. elongatum, C. armatus, H. dispar, Labiobarbus leptocheila, and Cirrhinus molitorella. The metacercariae of H. yokogawai were found in 9 species of fish, C. repasson, O. elongatum, C. armatus, H. dispar, Labiobarbus leptocheila, O. hasseltii. C. molitorella, Hypsibarbus wetmorei, and H. lagleri. The metacercariae of C. formosanus were detected in 4 species of fish, C. repasson, P. brevis, O. hasseltii, and C. molitorella. From these results, it is confirmed that fishborne trematode metacercariae, i.e. O. viverrini, H. taichui, H. yokogawai and C. formosanus, are prevalent in various species of freshwater fish from Savannakhet Province and Vientiane Municipality, Lao PDR.
Animals ; Fish Diseases/epidemiology/*parasitology ; Fishes ; Fresh Water ; Laos/epidemiology ; Trematoda/anatomy & histology/classification ; Trematode Infections/epidemiology/parasitology/*veterinary

PURPOSE: Medical professionals from Korea and Laos have been working together to develop a continuing professional development training program covering the major clinical fields of primary care. This study aimed to evaluate the effectiveness of the program from 2013 to 2014 using the Kirkpatrick model. METHODS: A questionnaire was used to evaluate the reaction of the trainees, and the trainers assessed the level of trainees' performance at the beginning and the end of each clinical section. The transfer (behavioral change) of the trainees was evaluated through the review of medical records written by the trainees before and after the training program. RESULTS: The trainees were satisfied with the training program, for which the average score was 4.48 out of 5.0. The average score of the trainees' performance at the beginning was 2.39 out of 5.0, and rose to 3.88 at the end of each section. The average score of the medical records written before the training was 2.92 out of 5.0, and it rose to 3.34 after the training. The number of patient visits to the district hospitals increased. CONCLUSION: The continuing professional development training program, which was planned and implemented with the full engagement and responsibility of Lao health professionals, proved to be effective.
Education* ; Health Occupations ; Hospitals, District ; Humans ; Korea ; Laos* ; Medical Records ; Physician Assistants* ; Primary Health Care ; Program Evaluation

The echinostome metacercariae encysted in Cipangopaludina sp. snails that were purchased from a market in Vientiane Municipality, Lao PDR, were identified as Echinostoma macrorchis (Digenea: Echinostomatidae) through recovery of adult flukes after experimental infection to rats and a cat. The metacercariae were round, 113-128 (121)x113-125 (120) microm, having a thick cyst wall, a head collar armed with collar spines, and excretory granules. The adult flukes recovered from the rats and cat at day 14 and 30 post-infection, respectively, were elongated, ventrally curved, and 3.9-6.3x0.7-1.1 mm in size. The head collar was distinct, bearing 43-45 collar spines with 5 angle spines on each side. Two testes were large (as the name implies), tandem, and slightly constricted at the middle, with irregular margins. Eggs were operculated, ovoid to elliptical, and 88-95x56-60 microm. In scanning electron microscopy, the head collar was prominent, with 43-45 collar spines. Scale-like tegumental spines were densely distributed on the ventral surface between the oral and ventral suckers. Sensory papillae were distributed mainly on the tegument around the 2 suckers. It is confirmed that E. macrorchis is distributed in Lao PDR using Cipangopaludina sp. snails as the second intermediate host.
Animal Experimentation ; Animal Structures/anatomy & histology ; Animals ; Biometry ; Cats ; Echinostoma/anatomy & histology/*isolation & purification ; Laos ; Microscopy/methods ; Parasitology/methods ; Rats ; Snails/*parasitology