Soil-Transmitted Helminthiases in Secondary School Students in Selected Sites in Two Provinces in the Philippines: Policy Implications

Belizario, Vicente Y.; Chua, Paul Lester; Liwanag, Harvy Joy; Naig, June Rose; Erfe, J. Mark

doi:10.1093/tropej/fmu018

Cited by 9 publications

(14 citation statements)

References 9 publications

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“…Results presented here, from the first survey in August 2015, revealed that 27.81% of participants remain infected with at least one STH. Similar STH prevalence were recently recorded in the Philippines [ 19 ], Cambodia [ 20 ] and Vietnam [ 21 ]. The prevalence of each STH in SAC was also higher than the last reported measurements in 2013 [ 13 ], indicating that more comprehensive M&E is required to accurately assess the national burden of STH.…”

Section: Discussionsupporting

confidence: 86%

A cross-sectional survey of soil-transmitted helminthiases in two Myanmar villages receiving mass drug administration: epidemiology of infection with a focus on adults

et al. 2017

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BackgroundSoil-transmitted helminths (STH) are still highly prevalent in southeast Asia. The country of Myanmar has had ongoing mass drug administration (MDA) programmes since 2003 in an attempt to control STH and reduce STH-related morbidities. Whilst the MDA programmes have reported high nationwide coverage, there have been no epidemiological surveys that included measurements from adults. This paper details three cross-sectional surveys that took place over the course of a year in two villages endemic for STH and receiving MDA in lower Myanmar.ResultsAt baseline, 27.81% of participants were infected with at least one type of STH. The most prevalent STH was Trichuris trichiura (18.12%) followed by hookworm (8.71%) and Ascaris lumbricoides (5.34%). Most infections were of low intensity, measured by eggs per gram of faeces (EPG). Gender stratification revealed that A. lumbricoides prevalence was significantly higher in females, whereas hookworm prevalence was significantly higher in males. The distribution of EPG in the study sample was highly overdispersed, suggesting that most people release few eggs whereas a few people release many eggs. Adults harbour a major proportion of the overall STH burden; 65.15% of STH infections were harboured by adults.ConclusionsSTH infection remains at medium prevalence in the study villages despite past and recent MDA. Recorded prevalence of STH in school-aged children has not substantially decreased since the last monitoring and evaluation activities in Myanmar in 2013. Analyses suggest that adults are a major contributor to the total STH prevalence and EPG burden, probably perpetuating transmission.Electronic supplementary materialThe online version of this article (doi:10.1186/s13071-017-2306-2) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 86%

A cross-sectional survey of soil-transmitted helminthiases in two Myanmar villages receiving mass drug administration: epidemiology of infection with a focus on adults

et al. 2017

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“…However, these data constitute the most up to date information on the prevalence of STH infections in the Philippines. The most recent studies only cover the prevalence of STH infections on a regional level [ 15 , 18 , 24 , 25 ], but provide sufficient evidence to suggest that the national level of prevalence is still similar to that of the 2005–2007 survey. Therefore, we anticipate our survey data is still relevant.…”

Section: Discussionmentioning

confidence: 99%

“…Targeting treatment, prevention and control activities to communities with high-intensity STH infections, or co-infections, could lead to a more efficient reduction in transmission and severe STH-related morbidity compared to targeting treatment based only on prevalence of single infections [ 21 – 23 ]. Despite intervention schemes being implemented to reduce morbidity attributable to STH infections in the Philippines [ 11 , 17 ], persistently high prevalence rates among school-aged children continue to be recorded across the country [ 15 , 18 , 24 , 25 ]. Available evidence suggests that indicators based on co-infections and infection intensities, which are linked to higher degrees of morbidity, are useful for estimating disease burden.…”

Section: Introductionmentioning

confidence: 99%

Spatial distribution and populations at risk of A. lumbricoides and T. trichiura co-infections and infection intensity classes: an ecological study

et al. 2018

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BackgroundSoil-transmitted helminth (STH) infections are highly prevalent in the Philippines. Mapping the prevalence and high-intensity of STH co-infections can help guide targeted intervention programmes to reduce morbidity, especially among vulnerable school-aged children. In this study, we aimed to predict the spatial distribution of the prevalence of Ascaris lumbricoides and Trichuris trichiura co-infection and infection intensity classes in the Philippines to identify populations most in need of interventions.MethodsData on STH infections from 29,919 individuals during the nationwide parasitological survey in 2005 to 2007 were included in the analysis. To geographically predict the prevalence of A. lumbricoides and T. trichiura co-infections and infection intensity classes, Bayesian multinomial geostatistical models were built including age, sex, environmental variables and a geostatistical random effect. The number of individuals co-infected and belonging to each of the infection intensity classes in 2017 was forecast by combining our predictive prevalence maps with population density maps.ResultsOur models showed that school-aged children (5–19 years) are most at risk of A. lumbricoides and T. trichiura co-infections and of moderate/high infection intensity compared to other age groups. We identified target provinces where the likelihood of STH-associated morbidity was highest: Luzon (Bulacan, Benguet, Cavite, Sorsogon, Metropolitan Manila, Pampanga and Rizal), the Visayas (Cebu, Iloilo, Leyte and Negros Occidental), and in Mindanao (Agusan Del Norte, Davao Del Sur, Davao Oriental, Lanao Del Sur, Maguindanao, Misamis Oriental, Sulu and Zamboanga Del Sur). Luzon had the highest estimated number of school-aged children with A. lumbricoides and T. trichiura co-infections (estimated total 89,400), followed by the Visayas (38,300) and Mindanao (20,200).ConclusionsOur study provided epidemiological evidence to highlight national priority areas for controlling co-infections and high intensity infections in the Philippines. Our maps could assist more geographically targeted interventions to reduce the risk of STH-associated morbidity in the Philippines.Electronic supplementary materialThe online version of this article (10.1186/s13071-018-3107-y) contains supplementary material, which is available to authorized users.

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“…Faecal samples were collected from individuals and examined by real-time PCR (qPCR) assay 545 All ages qPCR 58.17% - 48.07% ( Ancylostoma spp.) - - Gordon et al, 2015 [ 45 ] 2011–2012 A cross-sectional survey conducted to determine prevalence and intensity of infection in selected secondary schools in two provinces (Cavite and Guimaras) 633 14–15 years old KK 19.7% 21.5% 0.2% 31.3% 7.7% (M–H) Belizario et al, (2014) [ 41 ] 2012 A cross-sectional survey conducted in 18 rural barangays in Northern Samar to determine the prevalence of single and multiple species helminth infections and the underlying risk factors of acquiring one or more parasite species 6976 All ages KK 36.5%, 61.8%, 28.4%, 75.8% - Ross et al, 2017 [ 42 ] 2013 A cross-sectional survey conducted to determine the prevalence and intensity of STH infections and determine the nutritional status of PSAC and SAC in two villages in Southern Leyte that benefitted from CLTS 316 PSAC and SAC KK 15.8% 19.9% 1.2% 27.9% 7.9% (M–H) Belizario et al (2015) [ 32 ] 2013 A cross-sectional survey conducted to determine the status of STH in SAC in Masbate after a decade of implementation of an integrated helminth control programme 1224 PSAC KK …”

Section: Introductionmentioning

confidence: 99%

The control of soil-transmitted helminthiases in the Philippines: the story continues

et al. 2021

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Background Soil-transmitted helminth (STH) infections have long been an important public health concern in the Philippines. In this review, we describe the current status of STH infections there and highlight the control efforts undertaken to reduce STH burden. Main text A nationwide STH mass drug administration (MDA) programme was started in 2006 but the overall STH prevalence remains stubbornly high across the Philippines, ranging from 24.9% to 97.4%. The continued increase in the prevalence may have been due to the challenges related to MDA implementation which include the lack of people’s awareness about the importance of regular treatment, misconceptions about the MDA strategy, lack of confidence on the drugs used, fear of adverse events and general distrust of government programs. There are existing water, sanitation and hygiene (WASH) programmes implemented in communities [e.g., Community-Led Total Sanitation (CLTS) program and providing toilet bowls and provision of subsidy for latrine construction] and schools [e.g., WASH in School (WINS) program], but sustained implementation is required to achieve expected outcomes. Although WASH in general is being taught in schools, integration of STH as a disease and community problem in the current public elementary school curriculum is still inadequate. The Integrated Helminth Control Program (IHCP) currently implemented in the country, which is focused on improved sanitation and personal hygiene, health education and preventive chemotherapy, will require continuous appraisal. The sustainability of this programme still continues to be a challenge. Conclusions Despite the major efforts to control STH infections for almost two decades in the Philippines, persistently high STH prevalence has been reported across the country, which is likely due to suboptimal MDA coverage and limitations in WASH and health education programs. Sustainable delivery of integrated control approaches will continue to play a pivotal role in the control and elimination of STH in the Philippines. Graphic abstract

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Soil-Transmitted Helminthiases in Secondary School Students in Selected Sites in Two Provinces in the Philippines: Policy Implications

Cited by 9 publications

References 9 publications

A cross-sectional survey of soil-transmitted helminthiases in two Myanmar villages receiving mass drug administration: epidemiology of infection with a focus on adults

A cross-sectional survey of soil-transmitted helminthiases in two Myanmar villages receiving mass drug administration: epidemiology of infection with a focus on adults

Spatial distribution and populations at risk of A. lumbricoides and T. trichiura co-infections and infection intensity classes: an ecological study

The control of soil-transmitted helminthiases in the Philippines: the story continues

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