Soil Transmitted Helminth Control Program

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Profile/Rationale of the Health Program

                Given the relatively high prevalence rate of STH infections in the country and the existing issues confronting the implementation of the STHCP nationwide, there is a need to integrate all related efforts and strengthen coordination of those involved to ensure better complementation of resource, obtain higher coverage and generate better health outcomes. Within the Department of Health (DOH), several programs exist which are viable mechanisms to operationalize an integrated approach in preventing and controlling STH infections more effectively and efficiently. This needs to expand to the other national and local agencies and organizations engaged in the same endeavor.

The IHCP envisions healthy and productive Filipinos. It aims to reduce the deaths and diseases due to STH infections by reducing the prevalence of the infection among population groups found most at risk. Helminth infections adversely affect the health of the children and women. Program interventions and related measures have to be focused on them. Children are classified into preschoolers and school children while women include adolescent females and pregnant women. In addition, there are also special groups, which by the nature of their work and situation, are gravely exposed to helminthes infection.  These include the soldiers, farmers, food handlers and operators as well as indigenous people.  They also require the necessary attention.

The IHCP interventions consist primarily of chemotherapy, WASH and several behavior changing approaches. Chemotherapy remains as the core package in helminth infection control. The IHCP identifies the corresponding approach of deworming that must be applied for each identified population group. Water, sanitation and hygiene (WASH) serves as the cornerstone in reducing the prevalence of worm infection. The expansion of these measures reduces more effectively the transmission of worm infection. The promotion of desired behaviors ensures that these efforts on chemotheraphy and WASH are translated into actual healthy practices and better utilization of these facilities.

These interventions only become viable and effective if they are carried out in a supportive environment. Enabling mechanisms must therefore be established to support their implementation. An enabling environment entails good governance of the IHCP at all levels of operations. The political will and support of national and local leaders are essential to propel the cause of the IHCP.  Quality of deworming services and expansion of service outlet to increase access must be given due to consideration. Financing reforms must likewise introduce. The LGUs must begin to allocate budget for their own deworming program. A more equitable or rationalized allocation of deworming assistance from the DOH must be established. Local financing mechanisms to sustain the delivery of STHCP services need to be explored and established. Strict monitoring of LGUs compliance to national laws and policies must be undertaken while several program support systems (e.g., procurement and logistics management, information management system, surveillance and research) have to be installed.

Central to the achievement of the IHCP vision is the commitment and participation of all sectors concerned considering that helminth infection is a multi-faceted problem. While the LGUs are expected to be primarily responsible for the controlling helminth infection, the support of DOH, DepEd and other national government agencies including the private sector, civil society and the community is very critical to the success of IHCP.

 

Vision:                  Healthy and Productive Filipinos in the 21st Century

 

Mission:              To reduce the morbidity and mortality due to STH infections.

 

Goals/Objectives

The program aims to reduce the prevalence of STH infection to below 50.0% among the 1-12 years old children by 2010 and lower STH infection among adolescent females, pregnant women and other special population group.

 

Stakeholders/Beneficiaries:

The DOH is the lead agency in the deworming of children while the Department of Education (DepEd) is in charge of deworming all children aged 6-12 years old enrolled in public schools (Grade 1-VI).  Deworming is done by teachers under the supervision of school nurses or any health personnel.

 

Program Strategies:

1.        Improve governance through:

a.       Policies/resolutions;

b.      Securing budget for STH prevention and control;

c.       Mobilization and coordination of sectoral support; and

2.       Improve service quality and scale-up coverage.

a.       Capacity building

1.       Areas for training

·         Epidemiology, life cycle etc.

·         Proficiency training on lab diagnosis for med techs/lab techs

·         Annual/biannual updates on current technology in lab diagnosis

·         Training on drug administration, side effects, etc

2.       Target participants

3.       Training mechanisms

b.      Development and issuance of protocols and guidelines

c.       Expansion of service delivery points

d.      Availability and affordability of deworming drugs

3.       Institute financing reforms

a.       Efficiency in program implementation

b.      Mobilization of resources

c.       Strengthening LGU financing schemes

4.       Strengthen regulations

5.       Installation of management support systems

a.       Drug procurement

b.      Research

c.       Surveillance

 

Targets and Doses

1. Children aged 1 year to 12 years old

For children 12 – 24  months old

Albendazole       -  200 mg, single dose every 6 months.  Since the preparation is 400mg, the tablet is halve and can be chewed by the child or taken with a glass of water

Or

Mebendazole    -  500 mg, single dose every 6 months

For children 24  months old and above

Albendazole    -  400 mg, single dose every 6 months

Or

Mebendazole    -  500 mg, single dose every 6 months

Note: If Vitamin A and deworming drug are given simultaneously during the GP activity, either drug can be given first. 

2.  Adolescent females

It is recommended that all adolescent females who consult the health be given anthelminthic drug

 Albendazole  400 mg  once a year

Or

Mebendazole 500 mg once a year

3.  Pregnant women

It is recommended that all pregnant women who consult the health be given anthelminthic drug once in the 2nd trimester of pregnancy.

In areas where hookworm is endemic:

Where hookworm prevalence is 20 – 30%

Albendazole  400 mg once in the 2nd trimester

Or

Mebendazole 500 mg once in the 2nd trimester

Where hookworm prevalence is > 50%, repeat treatment in the 3rd trimester

4.   Special groups, e.g., food handlers and operators, soldiers, farmers and indigenous people

Selective deworming is the giving of anthelminthic drug to an individual based on the diagnosis of current infection. However, certain groups of people should be given deworming drugs regardless of their status once they consult the health center.

Special groups like soldiers, farmers, food handlers and operators, and indigenous people are at risk of morbidity because of their exposure to different intestinal parasites in relation to their occupation or cultural practices.

For the clients who will be dewormed selectively, treatment shall given be anytime at the health centers.

 

Guidelines/Administrative Orders

AO No. 2010-0023 – guidelines on deworming drug administration and the management of adverse events following deworming (AEFD)

 

AO No.2006-0028 – Strategic and operational framework for establishing integrated helminth control program (IHCP)

 

Status of the program

Deworming of target population during:

 1-5 years old – during Garantisadong Pambata (GP)  April and October

6-12 years old (school children Grade 1-6 enrolled in public schools) every January and July

Partner Organizations/Agencies:

  •          World Health Organization (WHO)
  •          University of the Philippines-National Institutes of Health (UP-NIH)
  •          United Nations Children’s Fund (UNICEF)
  •          World Vision
  •          Feed the Children International
  •          Helen Keller International (HKI)
  •          Council for the Welfare of Children
  •          Department of Science and Technology-Food and Nutrition Institute (DOST -FNRI)
  •          Department of Education (DepEd)
  •          Plan International
  •          Save the Children

 

Program Managers:

Dr. Yvonne CF Lumampao

Program Manager

Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)

Contact Number: 651-78-00 local 2352

 

Dr. Ernesto ES Villalon III

Assistant Program Manager

Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)

Contact Number: 651-78-00 local 2352