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• Community health research based on the primary health care approach

• Risk factor analysis and intervention planning for malaria control

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• Association between quality performance scorecard scores and health indicators: an ecological study in the Northern provinces of the Lao People's Democratic Republic.

  Chayvangmanh V, Ahissou NCA, Detleuxay K, Nonaka D

  Tropical medicine and health ( Springer Science and Business Media LLC )  53 ( 1 ) 73   2025.05 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  Abstract Background The Ministry of Health, Lao People's Democratic Republic (Lao PDR), surveyed health centers using the Quality Performance Scorecard (QPS) tool in 2021 to assess the quality of healthcare services at health centers. To validate the QPS tool, this study assessed the association between the QPS scores obtained from each health center and outpatient department (OPD) visits, antenatal care (ANC) coverages, and under-five mortality rates (U5MR) in the health centers' catchment area. Methods This ecological study assessed the association between the QPS scores as an independent variable and OPD visits, coverage of ANC at least one visit (ANC1), coverage of ANC four or more visits (ANC4) and U5MR as a dependent variable, using secondary data collected from the 234 health centers and 31 district health offices in the four northern provinces, such as Huaphan, Xiengkhuang, Oudomxay and Phongsaly. Mixed-effect linear regression was used to assess the association between the independent variable and dependent variables while adjusting for covariates. Results The mean value (standard deviation) was 64.9/100 (14.3) for QPS score, 3.3 (3.6) for U5MR (per 1,000 under-five population), 0.7 (0.5) for OPD visits (per population), 9.6 (6.0) for ANC1 coverage (per estimated number of reproductive-aged women) and 5.7 (4.4) for ANC4 coverage. The QPS scores were significantly independently associated with U5MR (unstandardized regression coefficient: −0.225 and standardized regression coefficient: −0.894), OPD visits (−0.004 and −0.114) and ANC4 coverage (−0.036 and −0.117). Conclusion This study shows that with increasing level of quality of healthcare services as measured by QPS, the U5MR was decreasing. The association demonstrated the ability of the QPS tool to capture the quality of healthcare services at health centers. Although the QPS scores were also negatively associated with OPD visits and ANC4 coverage, these associations were weak and likely confounded by unmeasured factors, or explained by quality care potentially reducing patients’ perceived need for frequents visits. To further validate the QPS tool, a longitudinal study is recommended to confirm the findings and address unmeasured factors.

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• Effect of trust in village health workers on the use of facility-based follow-up postnatal care services in two districts in the Lao People's Democratic Republic

  Ahissou, NCA; Uehara, M; Nonaka, D; Vongphoumy, I; Pongvongsa, T; Ounlienvongsack, K; Phongluxa, K; Kounnavong, S; Kobayashi, J

  TROPICAL MEDICINE AND HEALTH ( Tropical Medicine and Health )  53 ( 1 ) 61 - 61   2025.04 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  BACKGROUND: Despite high coverage of antenatal care services (89.8%) and facility-based deliveries (79.8%), delayed initiation or lack of follow-up postnatal care (PNC) visits remains a challenge in the Lao People's Democratic Republic (Lao PDR). Follow-up PNC encourages healthy lifestyles and monitoring mothers' and newborns' health to decrease postpartum complications and hospital readmissions. While village health volunteers and workers (VHVs/VHWs) are essential for health promotion in Lao PDR, the extent to which mothers' trust in VHVs/VHWs helps promote better service utilization has not been studied. OBJECTIVES: We investigated the trust levels in VHVs/VHWs among ethnic minority mothers and the influence on the use of facility-based follow-up PNC. METHODS: We utilized cross-sectional data from July and August 2024, collected as a baseline survey for a quasi-experimental study conducted in 35 villages across the Sepone and Vilabuly districts. We compared the respondents' PNC usage and characteristics using chi-square tests and Fisher's exact tests. Standard binary logistic regression analyses were conducted to estimate the effects of various factors on the utilization of facility-based follow-up PNC. Trust in VHVs/VHWs was a construct variable based on their provision of emotional support, relevant information, adequate discussion time, effective care, and the likelihood of future pregnancy-related care. RESULTS: The study enrolled 241 mothers (mean age 24 years, SD 5.7), including 110 from Sepone and 131 from Vilabuly. Overall, the follow-up PNC coverage rate was 19.0%, and there was no significant difference between Sepone and Vilabuly, despite variations in access to healthcare and engagement with VHVs/VHWs. High trust in VHVs/VHWs was linked to 12.25 times higher odds of utilizing follow-up PNC than low trust (95% CI 2.2-67.8). In addition, having an older child (9-12 months) and immediate PNC utilization were beneficial for subsequent PNC use. Unexpectedly, contact with VHVs/VHWs during prenatal and/or postnatal periods decreased the odds of utilizing follow-up PNC, with distance to health facilities and adherence to traditional gender norms also having a similar negative effect. CONCLUSIONS: Facility-based follow-up postnatal care was critically low among respondents; however, increasing trust in VHVs/VHWs may foster improvements. Along with increasing contact frequency, offering quality support to mothers through VHVs/VHWs while emphasizing the complementary nature of community-based and facility-based care could be beneficial. Effective interventions may also include enhancing immediate PNC and tackling physical accessibility challenges, as well as restrictive gender norms through male involvement.

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• Effectiveness of Village Health Volunteers/Workers Working as Male-Female Pairs on Women's Use of Postnatal Care Services in Sepone District in Lao People's Democratic Republic: A Protocol for a Quasi-experimental Cluster Study.

  Ahissou NCA, Uehara M, Nonaka D, Vongphoumy I, Pongvongsa T, Ounlienvongsack K, Phongluxa K, Kounnavong S, Kobayashi J

  Cureus   17 ( 4 ) e82786   2025.04 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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• Asymptomatic malaria infections and associated risk factors in malaria-eliminating settings of Nong District, Savannakhet Province, Lao People's Democratic Republic

  Bouwe, T; Nonaka, D; Buchy, P; Hansana, P; Khamlome, B; Chayvangmanh, V; Ahissou, NCA; Chindavongsa, K; Pongvongsa, T; Banouvong, V; Iwagami, M

  TROPICAL MEDICINE AND HEALTH ( Tropical Medicine and Health )  53 ( 1 ) 24 - 24   2025.02 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  BACKGROUND: As the Lao People's Democratic Republic is nearing malaria elimination, asymptomatic malaria infections remain a challenge to address. Control measures focusing on symptomatic persons do not effectively work for asymptomatic infections which often go undetected by conventional diagnostic tools. It is therefore crucial to understand the burden of asymptomatic malaria for tailored interventions to eliminate the disease. This study assessed the prevalence of asymptomatic malaria infections with associated risk factors in an endemic district of Savannakhet province. METHODS: In March 2024, a cross-sectional study was conducted in three villages of Nong District. Blood samples were collected from the fingertips of the participants for Plasmodium parasite identification using microscopy and Loop-mediated Isothermal Amplification (LAMP); those aged 13 years and above were also interviewed. Mann-Whitney U test and Fisher's exact test were performed to compare the medians of different age and temperature groups and determine the association between predictor variables and outcome variables respectively. RESULTS: A total of 622 individuals participated in this survey; Plasmodium parasites were detected in 2.1% (13/622) of participants. The prevalence of asymptomatic malaria was 1.8% (11/622). Plasmodium vivax accounted for 15.4% (2/13) of all positive cases. The remaining species could not be identified. Farmers aged 15 years and above accounted for 81.8% of the asymptomatic infections. Ninety percent (90%) of the participants used bed nets in the village. Among interviewed participants, 23.6% reported not using mosquito bed nets in the forest; 21.3% of the participants who had been to the forest were nighttime forest workers. CONCLUSIONS: This study revealed a prevalence of 1.8% of asymptomatic malaria infections in the study areas with the majority of the infections clustered among farmers, and an important proportion of these populations not using protective measures in the forest. These findings showed that malaria reservoirs are notable with a lack of use of protective measures, which could threaten malaria control and elimination efforts. Therefore, malaria elimination in Lao PDR by 2030 would need interventions targeting high-risk adult populations for screening with sensitive tools coupled with sensitization on protective measures and asymptomatic malaria.

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• Do they really boil their drinking water? a descriptive study in a rural district of the Lao people's democratic republic

  Kawamoto, S; Nonaka, D; Inthavong, N

  TROPICAL MEDICINE AND HEALTH ( Tropical Medicine and Health )  52 ( 1 ) 60 - 60   2024.09 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  BACKGROUND: For safe drinking water, household water treatments (HWT) is important to reduce the risk of diarrhea in low-and-middle countries including Lao People's Democratic Republic (Lao PDR). However, the measurement of HWT relies chiefly on self-report in most nationwide surveys. Thus, the validity of self-reported measurement is of concern. The objective of this study was to determine the proportion of households with the presence of boiled water among households that report boiling practices in a rural area of the Lao PDR. METHODS: This study was conducted with randomly selected 108 households in the four villages in the catchment area of the two health centers, in Xepon district of the Savannakhet province, between September and October 2023. The inclusion criterion of the households was the households that report boiling as HWT. Surveyors conducted interviews with an adult household member and observations on boiled water through household visits, using a questionnaire. Descriptive statistics were conducted to summarize the collected information using the frequency with proportion for categorical variables and the median with interquartile range for continuous variables. Bivariate analyses were conducted to assess an association between each of the factors and the presence of boiled water, using Fisher's exact test. RESULTS: Among the 108 households that reported boiling practice, 91 households were able to show the surveyor self-reported boiled water. Thus, the proportion of households with the presence of boiled water was 90.1% (95% confidence interval: 82.5-95.1%). Households with a fixed schedule of boiling were significantly more likely to present boiled water, compared to households without (94.5% vs. 50.0%). Not all household members do not necessarily drink boiled water: approximately a quarter (25.7%) of the participants reported that some household members drink unboiled water. CONCLUSIONS: This study showed that among households that reported boiling drinking water, 90.1% were able to present a container with self-reported boiled water. It suggests that the self-reported measure of boiling practices can be valid in the study villages.

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Grant-in-Aid for Scientific Research 【 display / non-display 】

Grant-in-Aid for Scientific Research 【 display / non-display 】

• Grant-in-Aid for Scientific Research(C)

  Project Year: 2025.04  -  2028.03 

  Direct: 2,100,000 (YEN)  Overheads: 2,730,000 (YEN)  Total: 630,000 (YEN)

• Grant-in-Aid for Scientific Research(C)

  Project Year: 2019.04  -  2022.03 

• Grant-in-Aid for Scientific Research(C)

  Project Year: 2016.04  -  2019.03 

  Direct: 2,700,000 (YEN)  Overheads: 810,000 (YEN)  Total: 3,510,000 (YEN)

Preferred joint research theme 【 display / non-display 】

Preferred joint research theme 【 display / non-display 】

• Impacts of U.S. bases on the health of Okinawa people

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