Health status of children living in a squatter area of Manila, Philippines, with particular emphasis on intestinal parasitoses.

In 1988 a study was performed in a squatter area of Manila, Philippines. Three substudies were carried out: (1) an analysis of the reported health situation and the available health services for the population of Smokey Mountain, (2) a vaccination coverage survey and (3) a cross-sectional stool sample survey. Respiratory infections, diarrhea, measles and malnutrition were the most frequently reported causes of ill-health and death. Not only governmental but also various non-governmental health services have been developed over the last few years. Better coordination and cooperation between the various health care providers, furtherance of community participation, improvements in the performance of the community health volunteers and stronger emphasis on preventive health care (such as health education) are suggested. The vaccination coverage cluster survey performed among children aged 1-2 years revealed that 24% of the surveyed children were fully immunized and 19% not immunized at all. The drop-out rates of children vaccinated through non-governmental organizations were significantly lower than those of the children vaccinated through a governmental agency. The cross-sectional stool sample survey performed among 238 children aged 8 months to 15 years revealed that 96% of the surveyed children were harboring intestinal parasites. Most common was Trichuris and Ascaris. The prevalence of hookworm was 10%, and those of Entamoeba histolytica and Giardia lamblia 21% and 20%, respectively. Most children (84%) were affected by multiparasitism. The need to adapt the concept of Primary Health Care to the context of the urban poor and not only to provide health services but also to change social and economic conditions is emphasized.