Enhancing the Effectiveness of Whitmore Disease Prevention Health Education in Flood-Prone Rural Vietnam

By Dr. Nguyen Thanh Gia and Team

Editor: Anti Rismayanti, SEAOHUN Regional Program Manager

Under the SEAOHUN One Health Research and Training (OHRT) Awards Program, our team embarked on a transformative project aimed at addressing Whitmore disease in the flood-prone district of Thua Thien Hue province, central Vietnam. Whitmore disease (Melioidosis), caused by the bacterium Burkholderia pseudomallei, is prevalent in areas frequently affected by flooding, presenting significant public health challenges due to its high fatality rate and lack of vaccine. Vietnam's central region, characterized by heavy seasonal rains and agricultural-based livelihoods, presents unique challenges in disease prevention and control, especially for under-recognized diseases like Whitmore.

Implementation Experience

The project was implemented through a structured approach comprising three main activities: a baseline survey, a brief intervention, and a post-intervention evaluation. We began by developing and validating survey tools, then conducted data collection involving 300 participants in rural flood-prone areas. These surveys measured knowledge, attitudes, and practices (KAP) related to Whitmore disease. Following the baseline assessment, we designed an intervention based on the social-ecological model. This included training local health workers and volunteers, distributing educational posters and leaflets, hosting community meetings, and facilitating discussions on prevention strategies. We collaborated closely with community health centers, local authorities, and academic institutions to ensure relevance and reach.

Enhancement of One Health Knowledge and Skills

The project significantly enriched our team's One Health competencies, both technically and socially. We developed expertise in epidemiological survey methods, intervention planning, and comprehensive data analysis. Furthermore, essential soft skills like stakeholder engagement, effective communication, and teamwork were reinforced through active community participation and interaction with local health professionals. For example, our team enhanced its capacity in designing and executing intervention studies and managing large-scale community health surveys. Team members reported improved abilities in translating complex health information into locally comprehensible content, an essential skill for any successful One Health practitioner working at the community level.

Impact on One Health Education and Practice

The outcomes of this initiative have far-reaching implications for education and public health practice. Faculty members at OHUN member universities will leverage insights from our project to refine curricula, emphasizing practical applications of One Health principles, especially regarding infectious disease prevention strategies like those for Whitmore. For instance, course modules will now include case studies based on our intervention process and findings. Health professionals in governmental agencies can integrate our project's findings into policy-making and enhance their public health strategies to better manage infectious diseases through improved community health education approaches. Already, our collaboration with local health centers has influenced their routine health messaging and community engagement strategies.

Anticipated Impact on Target Groups

Looking forward, our project is expected to foster increased awareness and adoption of preventive practices against Whitmore disease among the local communities. Initial post-intervention results demonstrated a marked improvement, with the awareness of Whitmore as a dangerous disease rising from 21.3% at baseline to 64.3% after intervention. Knowledge of disease transmission routes and prevention practices also significantly increased. Participants reported better understanding of the importance of hygiene, such as washing hands after exposure to soil or flood water, using protective equipment like gloves and boots, and avoiding wading through floodwaters with open wounds. There was also a noted increase in healthcare-seeking behavior, with more individuals stating they would visit a health facility if they experienced relevant symptoms.

Contribution to the Advancement of One Health

Our initiative significantly contributes to the advancement of One Health in Vietnam by demonstrating the effectiveness of integrated health education programs employing social-ecological intervention models. It emphasizes the importance of interdisciplinary collaboration, community engagement, and culturally relevant educational materials in addressing complex health challenges within vulnerable communities. The project reinforces the relevance of One Health in non-epidemic, everyday health settings—particularly in underserved and high-risk areas. It also illustrates how simple, cost-effective measures like community education and stakeholder mobilization can yield significant public health improvements.

Insights and Lessons Learned

Key lessons from the project underline the importance of robust stakeholder engagement, precise planning, and culturally sensitive education. We found that working collaboratively with local health professionals and clearly communicating project objectives were crucial in ensuring community buy-in and sustainability of outcomes. Training local health workers and volunteers also proved essential in overcoming challenges like limited pre-existing disease awareness. Another critical insight was the effectiveness of combining multiple communication channels—from face-to-face discussions to visual posters and leaflets—to cater to different literacy levels. Moreover, involving trusted community figures like local leaders and health workers enhanced the credibility of our messages.

Conclusion

The SEAOHUN OHRT Awards Program provided a significant platform for practical application of One Health principles, improving public health education and disease prevention efforts against Whitmore in rural, flood-prone areas. Our experience offers valuable insights into addressing similar health challenges through interdisciplinary collaboration and robust community involvement, setting a precedent for future health initiatives across Vietnam.

We believe that by sharing these findings and approaches, our project can inspire similar initiatives in other One Health networks and countries facing the burden of neglected infectious diseases.

Project Team Leader: Dr. Nguyen Thanh Gia, PhD, Lecturer, Department of Nutrition-Environmental and Occupational Health, Faculty of Public Health, Hue University of Medicine and Pharmacy.

Team Members:

• Dr. Dang Thi Anh Thu, MD, PhD, Dean, Faculty of Public Health.

• Dr. Le Dinh Duong, PhD, Department of Biostatistics and Epidemiology.

• Dr. Le Thi Bao Chi, MD, PhD, Head, Department of Medical Microbiology.

• Network/Country: VOHUN – Vietnam

University: Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue City, Vietnam