Soil-transmitted helminth and other intestinal parasitic infections among school children in indigenous people communities in Davao del Norte, Philippines.

A significant portion of the population in the Philippines consists of indigenous people (IP) groups, approximately 9% or 8.1 million. Data on the health status of these groups are very limited including the status of soil-transmitted helminth (STH) infections. Provision of such data will be of great importance in the formulation of policy on control and prevention of these diseases in this group. This study was conducted in selected villages/barangays in the municipalities of Carmen, Kapalong, San Isidro and Sto. Tomas in the Province of Davao del Norte in Southern Mindanao, Philippines. Parasitologic assessment was performed using Kato-Katz to qualify and quantify STH infections, while nutritional status assessment was based on hemoglobin determination and on nutritional status indicators, i.e., weight-for-age (WFA), height-for-age (HFA), and body mass index (BMI) for age derived from anthropometric measurements. A total of 572 school children participated in the survey, 264 (46.2%) of whom belonged to a specific IP group. Results showed that 34.1% of the school children had at least one STH infection while 5.9% had heavy intensity infections. Cumulative prevalence in IP school children was significantly higher than in non-IP children with rates at 39.0% and 29.9%, respectively (P = 0.021). Overall prevalence of school children with below normal WFA was 29.9%, while prevalence of those with below normal HFA and BMI for age was 42.8% and 14.9%, respectively. Of those examined, 8.3% had below normal hemoglobin levels. There was no significant difference observed between the nutritional status parameters of IP and non-IP school children. The parasitologic parameters reported in this study signify the need to pay more attention to IP children who are at higher risk of morbidity due to helminth infections. Access of IP communities to quality health services, which include mass drug administration (MDA) and health education on a regular basis, must be ensured. Further studies to determine factors that contribute to the higher prevalence of STH among IP groups are recommended.

Belizario VY Jr ，Totañes FI ，de Leon WU ，Lumampao YF ，Ciro RN ... -  《-》

Soil-transmitted helminthiases in secondary school students in selected sites in two provinces in the Philippines: policy implications.

The latest World Health Organization (WHO) strategic plan for eliminating soil-transmitted helminthiases (STHs) as a public health problem in children puts the emphasis on school-age children. On the other hand, the Philippine national helminth control program excludes secondary school students in mass deworming for STH. This study determined the prevalence and intensity of STH in a sample of 633 students (14-15 years old) in selected secondary schools in two Philippine provinces. Stool specimens were processed following the Kato-Katz technique and examined for the presence of helminth ova. Overall cumulative prevalence of STH was 31.3%, while prevalence of moderate-heavy-intensity infections was 7.7%, well beyond the WHO target of ≤1% for reducing morbidity in school-age children. Recommendations were made to update the Philippine helminth control program and to re-examine the WHO strategic plan so that helminth prevention and control strategies may also be emphasized for secondary school students especially in high-prevalence areas.

Belizario V Jr ，Chua PL ，Liwanag HJ ，Naig JR ，Erfe JM ... -  《-》

Child development center-based sentinel surveillance of soil-transmitted helminthiases in preschool-age children in selected local government units in the Philippines.

Soil-transmitted helminthiasis (STH) remains a public health concern in developing countries, such as the Philippines. Preschool-age children (PSAC) are among the high-risk groups for STH. Data on the status of STH in PSAC are needed to help guide policy formulation and program implementation; however, in the usual setting, such data may remain limited. This study aimed to describe the parasitologic status of PSAC in selected local government units (LGUs) in the Philippines through sentinel surveillance methodology in a child-development center (CDC)-based setting. This cross-sectional study, which included 1732 PSAC in selected barangays (a village or the smallest administrative unit in the country) in the provinces of Cavite, Guimaras, Iloilo, Negros Occidental, and Davao del Norte and cities of Iloilo and Lapu-Lapu in the Philippines, utilized Kato-Katz technique to determine parasitologic status. A single Kato-Katz smear was prepared from the adult-thumb sized stool sample submitted by each participant. Ten percent of Kato-Katz slides examined by field microscopists were re-examined by a reference microscopist as part of quality control. Results showed a prevalence of any STH infection and a moderate-heavy ((M-H)) intensity prevalence of 24.9% and 10.3%, respectively. Five cases of schistosomiasis were found in Lapu-Lapu City and Davao del Norte. While the Philippines' Department of Health (DOH) - Integrated Helminth Control Program (IHCP) target for prevalence of any STH of less than 50% was attained, none of the barangays or villages met the World Health Organization (WHO) target for (M-H) intensity STH prevalence of less than 1%, despite the program being implemented for almost a decade. Sentinel surveillance in PSAC, possibly adopting a CDC-based approach, may be implemented biannually in the Philippines and other countries where a similar early child care development system exist to generate data needed to guide policy formulation and program implementation. Preventive chemotherapy through facility-based mass drug administration (MDA), such as CDC-based MDA, may be explored to improve the mode of MDA delivery and coverage in PSAC.

Delos Trinos JPCR ，Belizario VY Jr ，Sison OT ，Erasmo JN ，Te MJ ，Modequillo MC ... -  《-》

Parasitological and nutritional status of school-age and preschool-age children in four villages in Southern Leyte, Philippines: Lessons for monitoring the outcome of Community-Led Total Sanitation.

While preventive chemotherapy remains to be a major strategy for the prevention and control of soil-transmitted helminthiases (STH), improvements in water, sanitation, and hygiene (WASH) comprise the long-term strategy to achieve sustained control of STH. This study examined the parasitological and nutritional status of school-age and preschool-age children in four villages in Southern Leyte, Philippines where two of the villages attained Open-Defecation-Free (ODF) status after introduction of Community-Led Total Sanitation (CLTS). A total of 341 children (89.0% of the total eligible population) submitted stool samples which were examined using the Kato-Katz technique. Results showed that 27.9% of the total stool samples examined had at least one type of STH (cumulative prevalence), while 7.9% had moderate-heavy intensity infections. Between the two villages where CLTS was introduced, Buenavista had a significantly higher cumulative prevalence of STH at 67.4% (p<0.001) and prevalence of moderate-heavy intensity STH at 23.5% (p=0.000), while Caubang had a significantly lower cumulative prevalence at 4.9% and prevalence of moderate-heavy intensity at 1.8%. On the other hand, the non-CLTS villages of Bitoon and Saub had similar rates for cumulative prevalence (16.7% and 16.8%, respectively; p=0.984) and prevalence of moderate-heavy intensity STH (2.0% and 3.1%, respectively; p=1.000). The findings may be explained by factors that include possible reversion to open defecation, non-utilization of sanitary facilities, and mass drug administration (MDA) coverage, although further studies that can accurately assess the impact of CLTS are recommended. While this study was descriptive, the data indicate no clear pattern among the parasitological and nutritional parameters, as well as the presence of CLTS in the village, suggesting the need to monitor the ODF status of villages on a regular basis even after the end of CLTS activities to ensure the sustainability of the CLTS approach. In order to achieve effective control of STH, deeper collaboration between the WASH and STH sectors are recommended where partners can work together in the area of monitoring and evaluation that may include improved parasitological and nutritional status in high-risk groups, as well as sustainable behavior change as outcome indicators.

Belizario VY Jr ，Liwanag HJ ，Naig JR ，Chua PL ，Madamba MI ，Dahildahil RO ... -  《-》

Soil-transmitted helminthiasis: a critical but neglected factor influencing school participation of Aboriginal children in rural Malaysia.

Ahmed A ，Al-Mekhlafi HM ，Azam MN ，Ithoi I ，Al-Adhroey AH ，Abdulsalam AM ，Surin J ... -  《-》