Ladia Mary Ann J, Belizario Vicente Y, Lacuna Jana M, Durano Lourivy P, Alonte Allen I
Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila.
Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila.
Acta Med Philipp. 2023 Jul 27;57(7):24-30. doi: 10.47895/amp.vi0.4996. eCollection 2023.
As part of the evaluation of control programs recommended by WHO, this study describes the local implementation of schistosomiasis (SCH) and soil-transmitted helminthiasis (STH) morbidity control as well as water, sanitation, and hygiene (WASH) interventions post calamity. It likewise determines the challenges, areas for improvement, and good practices in SCH and STH morbidity control strategies in Haiyan-stricken areas in Eastern and Western Samar, the Philippines.
Twenty key informant interviews and eight focus group discussions documented the implementation of SCH and STH control strategies in Eastern Visayas. Data analysis was done manually by a multi-disciplinary team.
Mass drug administration (MDA) in schools and communities was conducted for morbidity control. MDA for STH for pre-school-age children was integrated into the program, while a schoolbased teacher-assisted approach was used for school-age children. WASH facilities, such as sanitary toilets, were constructed through the initiatives of the local government units (LGUs) and other private sectors. Partnerships with Plan International Philippines helped in the implementation of WASH through the conduct of Community-led Total Sanitation. Health advocacies helped instill behavioral change in the community. SCH surveillance was conducted annually while STH surveillance was irregularly implemented. Data on MDA coverage were validated through Rapid Coverage Assessment before final reporting. Discrepancies were observed due to typographical errors and the inclusion of teachers and transient migrants in the reports submitted. Challenges in the implementation of MDA include delays in drug delivery, lack of human resources, non-compliance of participants, and drug unpalatability. Challenges in WASH included the lack of hand washing facilities, inaccessibility to safe water, as well as non-utility of sanitary toilets. Strengthening health advocacy and education may help address these challenges.
The involvement and partnership of various stakeholders such as LGUs, WASH, and veterinary sectors, together with the academe are needed to strengthen and enhance the implementation of SCH and STH control activities. An integrated approach may contribute to improvements in SCH and STH prevention and control of the communities in selected Haiyanstricken areas.
作为对世界卫生组织推荐的控制项目进行评估的一部分，本研究描述了血吸虫病（SCH）和土壤传播的蠕虫病（STH）发病控制的当地实施情况，以及灾难后水、环境卫生和个人卫生（WASH）干预措施。它同样确定了菲律宾东萨马省和西萨马省受海燕影响地区在血吸虫病和土壤传播的蠕虫病发病控制策略方面的挑战、改进领域和良好做法。
通过20次关键信息人士访谈和8次焦点小组讨论，记录了东米沙鄢地区血吸虫病和土壤传播的蠕虫病控制策略的实施情况。一个多学科团队进行了手动数据分析。
为控制发病率，在学校和社区开展了群体药物治疗（MDA）。学龄前儿童的土壤传播的蠕虫病群体药物治疗被纳入该项目，而学龄儿童则采用以学校为基础的教师辅助方法。通过地方政府单位（LGUs）和其他私营部门的倡议，建造了诸如卫生厕所等水、环境卫生和个人卫生设施。与国际计划菲律宾分部的伙伴关系通过开展社区主导的全面卫生措施，帮助实施了水、环境卫生和个人卫生工作。健康宣传有助于在社区中灌输行为改变。每年进行血吸虫病监测，而土壤传播的蠕虫病监测则不定期实施。在最终报告之前，通过快速覆盖评估对群体药物治疗覆盖率数据进行了验证。由于排版错误以及提交的报告中包含教师和临时移民，发现了差异。群体药物治疗实施中的挑战包括药物交付延迟、人力资源短缺、参与者不遵守规定以及药物口感不佳。水、环境卫生和个人卫生方面的挑战包括缺乏洗手设施、无法获得安全饮用水以及卫生厕所未得到使用。加强健康宣传和教育可能有助于应对这些挑战。
需要地方政府单位、水、环境卫生和个人卫生以及兽医部门等各利益相关者以及学术界的参与和伙伴关系，以加强和改进血吸虫病和土壤传播的蠕虫病控制活动的实施。综合方法可能有助于改善选定的受海燕影响地区社区的血吸虫病和土壤传播的蠕虫病预防与控制。
