Integrated opisthorchiasis control through the EcoHealth/one health approach: 15 years of success and experiences with the Lawa model.

Opisthorchis viverrini infection remains a major health problem in Northeast Thailand and the Mekong region impacting over 12 million and causing bile duct cancer. Using an EcoHealth/One Health approach at Lawa Lake in Thailand, our integrated control program achieved a substantial reduction in liver fluke prevalence from 60 % to <5 % over 15 years. Key interventions included chemotherapy, collaboratively designed health education, ecosystem modification, and community participation. Infections in intermediate hosts, Bithynia snails and Cyprinoid fish, are now undetectable. Improved community knowledge resulted in healthier practices. The "Lawa Model", a recognized model for liver fluke control, is now a training hub being scaled up in Thailand and the Mekong region. This program demonstrates how One Health strategies can address complex health and ecological challenges and aligns with WHO recommendations. The success of the Lawa Model demonstrates the efficacy of integrated One Health interventions against endemic parasitic diseases.