A field survey studying intestinal parasites in humans and microbial pathogen contamination at environment was performed in a Laotian rural village to identify potential risks for disease outbreaks. A parasitological investigation was conducted in Ban Lak Sip village, Luang Prabang, Lao PDR involving fecal samples from 305 inhabitants as well as water samples taken from 3 sites of the local stream. Water analysis indicated the presence of several enteric pathogens, i.e., Aeromonas spp., Vibrio spp., E. coli H7, E. coli O157: H7, verocytotoxin-producing E. coli (VTEC), Shigella spp., and enteric adenovirus. The level of microbial pathogens contamination was associated with human activity, with greater levels of contamination found at the downstream site compared to the site at the village and upstream, respectively. Regarding intestinal parasites, the prevalence of helminth and protozoan infections were 68.9% and 27.2%, respectively. Eight helminth taxa were identified in fecal samples, i.e., 2 tapeworm species (Taenia sp. and Hymenolepis diminuta), 1 trematode (Opisthorchis sp.), and 5 nematodes (Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis, trichostrongylids, and hookworms). Six species of intestinal protists were identified, i.e., Blastocystis hominis, Cyclospora spp., Endolimax nana, Entamoeba histolytica/E. dispar, Entamoeba coli, and Giardia lamblia. Questionnaires and interviews were also conducted to determine risk factors of infection. These analyses together with a prevailing infection level suggested that most of villagers were exposed to parasites in a similar degree due to limited socio-economic differences and sharing of similar practices. Limited access to effective public health facilities is also a significant contributing factor.
Adenoviridae ; Aeromonas ; Ancylostomatoidea ; Ascaris lumbricoides ; Blastocystis hominis ; Cestoda ; Cyclospora ; Disease Outbreaks ; Endolimax ; Entamoeba ; Entamoeba histolytica ; Giardia lamblia ; Helminths ; Human Activities ; Humans ; Hymenolepis ; Parasites ; Prevalence ; Protozoan Infections ; Public Health ; Risk Factors ; Rivers ; Shigella ; Strongyloides stercoralis ; Trichuris ; Vibrio ; Water*

Objective: we aimed to assess the knowledge, attitude and practice (KAP) of healthcare providers (HCP) towards cervical cancer (CC) screening and to identify possible factors associated with its low utilization among women presenting at gynaeco-obstetrics units in the Lao PDR. Methods: A cross-sectional study was conducted between March - June 2018 on a sample of 85 (HCP) at gynaecology units in two provincial and eleven district hospitals in Luang Prabang (LPB) and Salavan (SLV) Provinces. Results: Of the 85 HCP, 63.4% were from SLV and 36.6% from LPB. 81% were females and mean ager was 32 years. Only 7% of them had good knowledge, 18.8% had good CC screening attitudes and only 1.2% had good CC screening practices. 36.2% of female HCP had been screened for CC and 48.3% had not been screened because they thought only those who had symptoms and risk factors should go for. The most common reasons for not conducting routine CC screening of patients were: lack of medical equipment (53.7%), and incompetent techniques (43.3%). HCP graduates and post graduates had a higher knowledge score (aOR = 4.09, 95% CI: 1.43-11.66, P = 0.008), and attitude score (aOR = 5.54, 95% CI: 1.55-19.75, p=0.008). Those, who had been working for more than 10 years, were more likely to have higher attitude scores (aOR = 6.07, 95% CI: 1.36-27.15, p =0.018). Conclusions: CC screening knowledge among HCP is generally fair. However, CC screening attitudes are still poor. Re-orientation courses on CC screening for HCP are urgently needed in order to move forward to the next steps in CC screening programs.

Objective: This study aimed to determine sensitivity, specificity, and accuracy of RDT used in 4 health care centres in Vientiane capital versus ELISA. Methods: A study was then conducted among 1,729 patients who underwent three different RDTs for surface antigen of hepatitis virus (Boson, CTK and Coretest) in two public central hospitals and two private clinics in Vientiane Capital, to compare sensitivity, specificity, and accuracy of RDTs versus ELISA. Results: The mean age (95%CI) of the patients was 28.7 years old and the sex ratio was balanced. 13.71% of the patients had positive HBsAg as detected by ELISA, while this was only 8.9% for RDTs. All three types of RDTs had a sensitivity of 54% and specificity of 97%. There was no difference in accuracy, sensitivity, specificity, positive and negative predictive values between RDTs. Conclusions This study revealed higher prevalence of HBsAg among young adults who were present in health care facilities in Vientiane than previously described in Laos. All three RDTs studied had low sensitivity but high specificity; therefore, they are likely to miss many cases of Hepatitis B infection and should be replaced or backed up by more accurate methods.