Epidemic hysteria following the National School Deworming Day, Zamboanga Peninsula, Philippines, 2015

Abstract

IntroductionIn 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).MethodsFive 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.ResultsMost (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).DiscussionThe 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.

“The Magic Glasses Philippines”: a cluster randomised controlled trial of a health education package for the prevention of intestinal worm infections in schoolchildren

“…Another important finding was the significantly increased deworming uptake in the intervention schools at the first follow-up after the delivery of the health educational package, an outcome that could synergize with the current national school-based deworming program in the Philippines, given recent reports of declining MDA coverage due to fear of treatment and side-effects, and poor communication within the national MDA program. 30 41 42 …”

Molecular identification of Ancylostoma ceylanicum in the Philippines

“…The prevalence of human hookworm in the Palapag and Laoang study area in the Philippines was lower (52.8%) than previously reported (82.3%) in 2013 (Gordon et al ., 2015 c ), likely due to implementation (in 2015) of the national school deworming program (DepED, 2015 b ; Peñas et al ., 2018). Mass drug administration (MDA) with albendazole of school-aged children for STH has been carried out bi-annually in the Philippines since 2016; community MDA is not provided (DepED, 2015 b ; DepED, 2016).…”

A Cross-sectional Analysis of Facebook Comments to Study Public Perception of the Mass Drug Administration Program in the Philippines

“…The department has remarkably improved their basic public health services for the Filipinos, but the rise of social media usage challenges them to anticipate in this era of change. 11,12 In 2018 for instance, Dengvaxia-scare, which was further intensified by social media, affected the implementation of the national mass deworming among SAC. [12][13][14] Dengvaxia is the first dengue vaccine developed by the Sanofi Pasteur, one of the biggest multinational pharmaceutical companies.…”