Helminths – including soil-transmitted helminths (STH) and Opisthorchis viverrini (OV), a liver fluke – are a major public health concern, with some of the highest global burdens occurring in Southeast Asia. Helminth infections are associated with physical and cognitive deficiencies, including stunting, malnutrition, anaemia, and chronic pain [1] [2-4]. In addition, OV is a recognized biological carcinogen, with chronic infections causally linked to cancers of the bile duct and bladder, cholangiocarcinoma [5].

The Lower Mekong Basin, a region encompassing Northeast Thailand, Lao PDR and Cambodia, is particularly vulnerable to helminth infections: reported prevalence of STH infections has reached 31% [6], 70% [7], and 71% [8] in Thailand, Cambodia, and Lao PDR respectively. With respect to OV, at least 10 million people are estimated to be affected in the Lower Mekong Basin, the highest reported burden globally [9, 10]. The main control strategy for both STH and OV infections is mass drug administration, but this does not prevent reinfection. As such, alternative control strategies are needed.

Children are an important target group for helminth prevention and control strategies. Several studies have identified children as at-risk for helminth infections, with high incidence of STH reported among preschool- and school-aged children [11-14]. In addition, schoolchildren are a well-placed group for intervention delivery, with schools acting as an important vehicle for health promotion and health education delivery [15].

The “Magic Glasses” is a school-based cartoon intervention that has had previous success in reducing STH burden and increasing STH knowledge among schoolchildren in China in 2009-2011 [16] and the Philippines [17]. Building off previous interventions, my project includes the development and assessment of two new “Magic Glasses” cartoons, and their acceptability and impact on STH and OV knowledge among schoolchildren in the Lower Mekong Basin.

About Suji

Suji is a PhD candidate at the National Centre of Epidemiology and Population Health. She has previously completed a Bachelor of Science (Psychology)(Honours)/Bachelor of Arts (Political Science), and Master of Public Health (with Commendation) at the ANU, and been involved with research at the former ANU School of Psychology, and the Australian Institute of Health and Welfare. Suji’s thesis is a sub-project of the HELM project (funded by NHMRC e-Asia grant), a multi-component package aimed at eliminating helminths from the Lower Mekong Basin, led by Professor Darren Gray.

References

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3. Gyorkos TW, Gilbert NL. Blood drain: soil-transmitted helminths and anemia in pregnant women. PLoS Negl Trop Dis. 2014;8(7):e2912.

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9. Ziegler AD, Petney TN, Grundy-Warr C, Andrews RH, Baird IG, Wasson RJ, et al. Dams and Disease Triggers on the Lower Mekong River. PLOS Neglected Tropical Diseases. 2013;7(6):e2166.

10. Sripa B, Bethony JM, Sithithaworn P, Kaewkes S, Mairiang E, Loukas A, et al. Opisthorchiasis and Opisthorchis-associated cholangiocarcinoma in Thailand and Laos. Acta Trop. 2011;120 Suppl 1:S158-68.

11. Weatherhead JE, Hotez PJ, Mejia R. The Global State of Helminth Control and Elimination in Children. Pediatr Clin North Am. 2017;64(4):867-77.

12. Ojja S, Kisaka S, Ediau M, Tuhebwe D, Kisakye AN, Halage AA, et al. Prevalence, intensity and factors associated with soil-transmitted helminths infections among preschool-age children in Hoima district, rural western Uganda. BMC Infectious Diseases. 2018;18(1):408.

13. González Quiroz DJ, Agudelo Lopez SdP, Arango CM, Acosta JEO, Bello Parias LD, Alzate LU, et al. Prevalence of soil transmitted helminths in school-aged children, Colombia, 2012-2013. PLOS Neglected Tropical Diseases. 2020;14(7):e0007613.

14. Mationg MLS, Tallo VL, Williams GM, Gordon CA, Clements ACA, McManus DP, et al. The control of soil-transmitted helminthiases in the Philippines: the story continues. Infect Dis Poverty. 2021;10(1):85.

15. World Health Organization. Health promoting schools. Geneva: World Health Organization; 2022. Available from: https://www.who.int/health-topics/health-promoting-schools#tab=tab_2.

16. Bieri FA, Gray DJ, Williams GM, Raso G, Li YS, Yuan L, et al. Health-education package to prevent worm infections in Chinese schoolchildren. N Engl J Med. 2013;368(17):1603-12.

17. Mationg MLS, Williams GM, Tallo VL, Olveda RM, Aung E, Alday P, et al. "The Magic Glasses Philippines": a cluster randomised controlled trial of a health education package for the prevention of intestinal worm infections in schoolchildren. The Lancet Regional Health – Western Pacific. 2022;18.