Peñas Johnette A, de Los Reyes Vikki Carr, Sucaldito Ma Nemia L, Ballera Julius Erving D, Hizon Herdie L, Magpantay Rio L, Belizario Vicente Y, Hartigan-Go Kenneth
Department of Health, Philippines.
Western Pac Surveill Response J. 2018 Dec 3;9(4):1-6. doi: 10.5365/wpsar.2017.8.1.009. eCollection 2018 Oct-Dec.
In July 2015, the Philippines conducted a school-based mass drug administration using albendazole for soil-transmitted helminths infection. Reports of adverse events were subsequently made through the event-based surveillance system, mostly from the Zamboanga Peninsula on the island of Mindanao. A team from the Epidemiology Bureau investigated the reports of adverse events following mass drug administration (AEFMDA).
Five schools were identified for the investigation which comprised an unmatched case-control study, key informant interviews and laboratory examinations. AEFMDA cases were students who had sudden onset of abdominal pain, vomiting, diarrhoea, loss of consciousness, headache or dizziness within 24 hours after intake of deworming tablet; controls were healthy students who did not develop signs and symptoms after deworming.
Most (85%) of the 7313 AEFMDA cases reported nationwide were from Zamboanga Peninsula. Most reports were made after rumours of deaths following deworming and of the use of expired drug were spread through the region. Many parents sent their children to hospital, even if asymptomatic. The case-control study found that being an AEFMDA case was associated with no history of previous deworming (odds ratio = 4.08, 95% confidence interval: 1.77-9.42).
The investigation concluded that epidemic hysteria was the cause of the increased number of AEFMDA cases in the Zamboanga Peninsula. The false information, aggravated by social media, caused panic and an increase in reporting. Some cases had no history of deworming, and they may not have been aware that albendazole is safe and that side-effects are expected. Risk communication before, during and after future national deworming programmes are recommended to prevent unnecessary reporting of AEFMDA.
2015年7月，菲律宾开展了一项以学校为基础的群体服药活动，使用阿苯达唑治疗土壤传播的蠕虫感染。随后通过基于事件的监测系统报告了不良事件，大部分报告来自棉兰老岛的三宝颜半岛。流行病学局的一个团队对群体服药后不良事件（AEFMDA）的报告进行了调查。
确定了五所学校进行调查，调查包括一项非匹配病例对照研究、关键信息提供者访谈和实验室检查。AEFMDA病例为服用驱虫片后24小时内突然出现腹痛、呕吐、腹泻、意识丧失、头痛或头晕的学生；对照为驱虫后未出现体征和症状的健康学生。
全国报告的7313例AEFMDA病例中，大部分（85%）来自三宝颜半岛。大多数报告是在驱虫后死亡谣言以及过期药物使用谣言在该地区传播之后做出的。许多家长即使孩子无症状也会送他们去医院。病例对照研究发现，成为AEFMDA病例与既往无驱虫史有关（比值比=4.08，95%置信区间：1.77-9.42）。
调查得出结论，流行性癔症是三宝颜半岛AEFMDA病例数增加的原因。虚假信息因社交媒体而加剧，引发了恐慌并导致报告增加。一些病例无驱虫史，他们可能不知道阿苯达唑是安全的且会有副作用。建议在未来全国驱虫计划之前、期间和之后进行风险沟通，以防止不必要的AEFMDA报告。
