IntroductionPalawan, where health care facilities are still limited, is one of the most malaria endemic provinces in the Philippines. Since 1999, microscopists (community health workers) have been trained in malaria diagnosis and feasibility of early diagnosis and treatments have been enhanced throughout the province. To accelerate the universal access of malaria patients to diagnostic testing in Palawan, positive health seeking behavior should be encouraged when malaria infection is suspected.MethodsIn this cross-sectional study, structured interviews were carried out with residents (N = 218) of 20 remote malaria-endemic villages throughout Palawan with a history of suspected malaria from January to February in 2012. Structural equation modeling (SEM) was conducted to determine factors associated with appropriate treatment, which included: (1) socio-demographic characteristics; (2) proximity to a health facility; (3) health seeking behavior; (4) knowledge on malaria; (5) participation in community awareness-raising activities.ResultsThree factors independently associated with appropriate treatment were identified by SEM (CMIN = 10.5, df = 11, CFI = 1.000, RMSEA = .000): “living near microscopist” (p < 0.001), “not living near private pharmacy” (p < 0.01), and “having severe symptoms” (p < 0.01). “Severe symptoms” were positively correlated with more “knowledge on malaria symptoms” (p < 0.001). This knowledge was significantly increased by attending “community awareness-raising activities by microscopists” (p < 0.001).ConclusionsIn the resource-limited settings, microscopists played a significant role in providing appropriate treatment to all participants with severe malaria symptoms. However, it was considered that knowledge on malaria symptoms made participants more aware of their symptoms, and further progressed self-triage. Strengthening this recognition sensitivity and making residents aware of nearby microscopists may be the keys to accelerating universal access to effective malaria treatment in Palawan.

Abstract. Schistosomiasis continues to be a public health problem in many tropical and subtropical countries. Improving the diagnostic tools for surveillance and monitoring in areas that have reached elimination level will help hasten the possible elimination of this disease. This study therefore aims to develop enzyme-linked immunosorbent assay through the use of recombinant proteins such as thioredoxin peroxidase-1 (SjTPx-1) and four tandem repeat proteins (Sj1TR, Sj2TR, Sj4TR, and Sj7TR). Cutoff values were calculated using 38 serum samples from healthy Japanese volunteers. Sera from 35 schistosomiasis-confirmed patients, four cured from the disease by chemotherapy, and 15 endemic negative controls were used to assess these antigens. SjTPx-1 and Sj7TR both had 85.71% sensitivity. Furthermore, these antigens were also tested against human sera positive for other parasitic infections and showed no or very minimal cross-reaction. These results suggest the potential defined antigens for development of an accurate diagnostic test for schistosomiasis.* Address correspondence to Shin-ichiro Kawazu, National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, 2-13 Inada-cho, Obihiro, Hokkaido, 080-8555 Japan. E-mail: skawazu@obihiro.ac.jp 675 TPX-1 AND TRPS FOR S. JAPONICUM HUMAN DIAGNOSIS the Guide for Animal Experimentation at Dokkyo Medical University Japan.Human sera. Non-endemic control sera were collected from 38 healthy Japanese volunteers from Tochigi prefecture in May 2003. 22 These subjects were without any risk of contracting S. japonicum infection and had no history of traveling to schistosomiasis-endemic areas. Fifteen endemic control sera and four post-treatment samples (1 year after chemotherapy) were collected from Gonzaga, Cagayan, the Philippines. These individuals were confirmed negative through stool examination. The schistosomiasis-positive serum samples were collected from 35 human patients from Leyte, the Philippines. 23They were diagnosed by the detection of the parasite eggs in their stool. Sera from patients with other parasites, including Trichuris trichiura ( N = 1), Plasmodium falciparum ( N = 4), Plasmodium vivax ( N = 1), and Entamoeba histolytica ( N = 4) were collected from a schistosomiasis-free area in the Philippines. They were diagnosed through either microscopic examination or detection of antibodies by immunofluorescent assay. Paragonimus westermani -positive samples ( N = 11) were taken from Japanese patients and Opisthorchis viverrinipositive sera ( N = 10) were collected from Thailand diagnosed through either clinical manifestations or antibody detection. Blood samples were taken from these subjects after informed consent in their local language were obtained by a medical staff member from each patient or their guardians. This study was done according to the ethical guidelines for epidemiological studies provided by the Ministry of Education, Culture, Sports, Science and Technology and the Ministry of Health, Labor and Welfare o...

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Blastocystis has been considered as the most common intestinal parasite in humans and has an augmented impact on public health. However, the prevalence of this parasite in the Philippines has not been determined. To contribute to a better understanding of the epidemiology of this infection, a cross-sectional study aimed at providing the first documented data on the prevalence and correlates, sociodemographic factors, hygiene practices, source of water supply, and dog ownership, associated with Blastocystis infection was carried out in randomly selected communities at Pateros, Metro Manila. Fecal samples from respondents were collected and cultured in diphasic agar medium for 3–7 days and examined using light microscopy. Of the 1,271 respondents, 12.98% (95% CI: 11.13–14.83) were detected positive for Blastocystis. Among the correlates of Blastocystis infection, dog ownership was found significantly associated as confirmed by multivariate analysis. Therefore, this factor should be considered in information to create awareness about Blastocystis and to prevent and control Blastocystis infection in particular and diarrheal diseases in general. Further studies using molecular approaches to distinguish subtype and to determine genetic characteristics of isolates from humans and dogs are recommended to analyze their relationship and provide more conclusive evidence of cross-transmission.

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