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Strengthening lay health worker surveillance byestablishing mobile phone-based communication
network in Laos1

琉球大学 医学研究科 寄生虫学・国際保健学講座○野中 大輔 1

We conducted a study to assess the usefulness mobile108

ラオス人民民主共和国中部における乾燥ろ紙血を用いた HBs 抗原調査：多段階層化収束抽出法による小児及び母親の陽性率推定1
ラオス人民民主共和国 保健省 国家検査疫学センター、2 ラオス人民民主共和国 保健省 予防接種課、3 東北大学大学院医学系研究科 微生物学分野、4 国立国際医療研究センター 国際医療協力局○Vongphrachanh Phengta1、Xeuatvongsa Anonh2、
押谷 仁 3、蜂矢 正彦 4phone-based communication network established between
village health volunteers (VHVs) and their supervisors in aBackground:While Lao PDR is considered hyperendemic

rural district of Laos, between 2009 and 2010. Mobilefor hepatitis B, the prevalence of hepatitis B has not beenphones with pre-paid cards were distributed to 154 VHVs

wellbetter

understandand 11 health professionals who supervise VHVs. VHVs

epidemiology, prevalence should beestimated.

were told to feel free to use a phone for their work. During

Materials and methods:We conducted a stratified,

the six months after the phone distribution, VHVs mademultistage, cluster sampling survey of hepatitis B surface

364 calls to supervisors: most common purpose for theantigen (HBsAg) positivity among children aged 5-9 years

calls was regular reporting (54.1%), followed by seeking

old and their mothers aged 15-45 years old. Participants

advice on case management, vitamin A distribution, andwere randomly selected from the central region of Laodelivery (20.6%). Supervisors made 478 calls to VHVs

PDR via probability proportionate to size sampling. Blood

mainly for requesting regular report (44.6%) and informing

samples were collected onto filter paper, and subsequently

in advance the schedules of a meeting, training, andanalyzed

outreach activity such as immunization and healthimmunoassay.

check-up (32.2%). Compared to one month before theResults:A total of 911 Mother-and-child pairs werephone distribution, submission of regular report for vital

sampled from 40 villages. We estimated the seroprevalence

event surveillance significantly increased from 51.0% toof HBsAg to be 2.1% (95% CI=0.8-3.4%) among children

80.6%

phoneand 4.1% (95% CI=2.6-5.5%) in their mothers after takingcommunication network facilitated regular reporting,into account the sampling design and the weight of eachseeking advice, and informing schedule of various

sample. There was a positive association between HBsAg

activities. The improved communication had potential topositivity and surgical operations in mothers, and between

translate into better health outcomes among community

the HBsAg status of mothers and their children’s infection

people.

status.

(p=0.04).

The

district-wide,mobileinvestigated.

usingConclusions

Toaandchemiluminescentdiseasemicroparticle

recommendations:The

present

multistage, cluster sampling survey was successfullyconducted. The results demonstrated that Lao PDR has arelatively lower HBsAg prevalence in the general
population compared to surrounding countries. To ensure
the comparability of the prevalence survey to othercountries and to data collected in the future, rapid fieldtests are recommended for nationwide surveys.
共同研究者：駒田謙一, 木多村知美、清原知子、脇田
隆字、杉山真也、溝上雅史