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

Abstract

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

Mitigation of Soil-Transmitted Helminthiases Resurgence in the Era of Covid-19 Disruption: A Literature Review

“…However, every effort to increase the frequency and scale of POPM must be accompanied by programs to increase access to clean water, sanitation, and hygiene. Mationg et al, (2021) The The interruption and delay of the deworming control program due to Covid-19 temporarily impacted the progress of eliminating STH as a public health problem by 2030. However, after the termination of chemoprevention, follow-up programs need time to catch up (about three years in areas of moderate endemicity and about five years in areas of high endemicity).…”

“…The positive aspect is adaptation and innovation to help sustain the deworming program, complemented with integrated interventions and collaboration (Fauziyah, et al, 2021;Mationg, et al, 2021). Adaptations made in the context of a pandemic can strengthen efforts to support deworming programs based on primary health facilities and their integration into community-based platforms.…”

“…Deworming interventions are based on each strategy and use an approach-based community to provide services to populations where STH is endemic. WASH community activities need to continue by adapting WASH messages to focus on prevention of Covid-19 transmission (Brooker, et al, 2021;Mationg, et al, 2021;Toor, et al, 2021). In addition, deworming programs can be carried out in schools.…”

Soil-transmitted helminth infections and nutritional indices among Filipino schoolchildren

“…There are existing programs currently available in the Philippines targeting STH infections (i.e., a nationwide school-based MDA program [ 16 ]) and malnutrition (school-based feeding program (SBFP) for severely wasted children [ 70 ]). Despite years of implementation, as consistently reported in a number of studies conducted across the country, the STH infection prevalence has continued to be high in schoolchildren [ 8 – 13 ] and nutritional improvements among children have not been sustained [ 70 ], indicating some challenges in the two programs. Although, it is difficult to draw firm conclusion about the impact of the MDA on STH infections levels from this study, the prevalence of moderate to heavy intensity infections observed in this study were lower compared to earlier studies, likely reflecting ongoing MDA.…”

“…In the Philippines, STH are highly prevalent and major health problem, particularly in schoolchildren [ 8 ]. STH prevalence reported from several studies across the country range from 33.8–75.9% [ 9 – 14 ].…”