Developing an operational model for the prevention and control of liver fluke disease using the mechanism of the District Quality of Life Development Committee in Kaset Somboon District, Chaiyaphum Province

Abstract

          Opisthorchiasis drives cholangiocarcinoma in Northeast Thailand, the region with peak global incidence of this cancer. In Kaset Somboon, Chaiyaphum, 10.1% of 5,250 residents screened during 2017–2025 carried liver fluke eggs-twice the national threshold-yet prior responses were fragmented single-sector campaigns. This mixed-methods action research developed an integrated control model through the District Quality of Life Development Committee (DHB) mechanism and evaluated knowledge and behavior change in infected residents (one-group pre-test/post-test, October 2025–February 2026). Sixty-one DHB and working-group members provided qualitative data via focus groups, interviews, and observation; 43 infected residents completed validated questionnaires (reliability 0.71 and 0.73). Analyses used paired               t-test, Cohen’s d, content analysis, and triangulation.

          The model integrated five strategies: screening, Health Belief Model-based behavior change, community campaigns, sanitary waste management, and restaurant food-safety standards. Knowledge scores rose from 13.67 to 17.41 (95% CI: 3.05, 4.43; p < 0.001; Cohen’s d = 1.67) and behavior from 2.18 to 2.61 (95% CI: 0.37, 0.49; p < 0.001; Cohen’s d = 2.06) both very large effects. Screening coverage rose 2.5-fold (418 to 1,040), three sanitary waste-disposal facilities were built, and waste management was embedded into the 2026 Chaiyaphum Provincial Development Plan.

          The DHB mechanism bridged health priorities with provincial planning and local budgets, converting sporadic campaigns into structurally supported district policy. Within an EcoHealth/One Health framework, the model disrupts the entire transmission chain and is transferable to other complex problems requiring multi-sector action.