Curbing schistosomiasis thru deworming

MANILA -- No appetite and sluggish -- this is how Lilibeth Mosende described her four-year-old niece, Hazel, a year ago when she had schistosomiasis.

Schistosomiasis is an acute and chronic disease caused by parasitic worms.

"Naalagaan ko siya noon sa probinsiya, lagi masakit ang tiyan niya at lagi na lang nakadapa sa paghiga sa sobrang sakit tapos nagkaroon ng lagnat ng dalawang araw. Ang sabi sa center, doon kami sa Barangay Bahay, San Policarpio, Eastern Samar, kapag ang bata ganoon dapat mapurga (I took care of her in the province, she always has stomach ache and she lies on her stomach all the time because it's very painful)," Mosende told the Philippine News Agency (PNA).

According to the World Health Organization (WHO), Mosende's province, Eastern Samar, is one of the 28 provinces in the country where schistosomiasis is endemic.

The other provinces include Cagayan, Oriental Mindoro, Sorsogon, Negros Occidental, Leyte, Western Samar, Northern Samar, Bohol, Agusan del Sur, Agusan del Norte, Surigao del Sur, Surigao del Norte, Lanao del Norte, Misamis Occidental, Bukidnon, Zamboanga del Sur, Zamboanga Sibugay, Zamboanga del Norte, Davao province, Davao del Sur, Davao Oriental, Compostela Valley, Maguindanao, Lanao del Sur, South Cotabato, Sultan Kudarat and North Cotabato.

It is prevalent in tropical and subtropical areas, especially in poor communities without access to safe drinking water and adequate sanitation. Its symptoms include bloody stool, abdominal pains, headache, lethargy and fever.

Children and adults get the disease when larval forms of the parasites penetrate the skin during contact with infested water.

Mosende said Hazel might have gotten the disease from not eating full meals and staying outdoors most of the time.

"Kendi at chichirya lang ang gusto niya tapos lagi nakatapak at walang salawal kapag nakaupo sa lupa at naglalaro sa putikan o tubig ulan, kasi kapag umihi siya tatanggalin na niya ang shorts niya at hindi na naibabalik. Sa probinsiya kasi marami ring mga anak na mas maliit pa sa kanya na inaalagaan kaya hindi na siya nasusubaybayan (Candies and chips are her favorite then she's barefooted and always without underwear or shorts when sitting on the soil and playing in the mud and water puddles, because she removes her shorts when she pees and she doesn't put them back on. In the province, her siblings are younger than her so her parents are unable to focus on her)," she added.

WHO said the schistosoma parasites can penetrate the skin of people wading, washing or swimming in contaminated water.

The parasites mature into adult worms and live in the blood vessels of the bodies they have penetrated where the females produce eggs for a few weeks. Some of the eggs may travel to the bladder or to the intestines causing severe abdominal pains.

Tondo Medical Center (TMC) pediatrician Dr. Jeffrey Castillio told PNA schistosomiasis can be prevented through proper deworming of the infected children and adults.

"Ang deworming o pagpupurga ay isang proseso na kung saan nagpapainom ng gamot sa isang tao upang mapuksa ang mga bulate sa katawan. Ayon sa Department of Health (DOH) Administrative Order 2015-0054, ang pagpupurga ay nirerekomenda para sa lahat ng batang isa hanggang labing-dalawang taong gulang. Hindi lamang ang mga bata ang pinupurga kundi maging ang mga matanda (Deworming is a process where a person infested with worms is given medications. According to Department of Health (DOH) Administrative Order 2015-0054, deworming is recommended to all children from one to 12 years old. Adults undergo deworming also, not just children)," he said.

Castillo explained deworming is done every six months, usually during months of June and July in schools and health centers when classes start.

He added deworming must be done to prevent anemia, malnutrition and weakened immune systems in children.

"Ngunit may mga pagkakataon din na hindi dapat gawin ang pagpupurga, halimbawa, kung ang bata ay may malubhang malnutrisyon, mataas na lagnat, pagtatae, pananakit ng tiyan, malubhang sakit, o allergy sa mga gamot na pampurga (There are instances when deworming must not be done, for example, if the child has severe malnutrition, high fever, severe stomach pain, severe disease or allergy from deworming medicines)", he said.

Since she suspected that her niece has worms, Mosende brought Hazel to the health center where the child was advised to take a deworming tablet at night.

"Pinainom ng isang tableta ng Combantrin nang gabi, tapos kinabukasan nang umaga may lumabas na tatlong tumpok ng bulate na malalaki at matataba, may puti may brown ang kulay, walang tae puro bulate lang talaga (She was made to take a Combantrin tablet at night, the next morning she excreted three piles of big and fat worms, there are white and brown in color, there were no feces just worms)," she said.

Mosende recalled Hazel was indisposed for a few hours after the incident.

"Ayaw kumain, nakahiga lang pero walang lagnat. Noong kinabukasan okay na siya at kumain na (She didn't like to eat, just lying down but she has no fever. She was well and had eaten on the next day)," she said.

Mosende added that Hazel's experience tore her heart so she decided make her children undergo regular deworming to avoid experiencing the same condition.

Castillo told PNA the best way to combat worm and other parasite infestation among children and adults is to keep the surroundings clean.

"Maghugas ng kamay bago at pagkatapos kumain at pagkatapos gumamit ng banyo, hugasan nang mabuti ang mga gulay, lutuin ng maigi ang mga pagkain (Wash hands before and after eating and after using the bathroom, wash the vegetables thoroughly, cook your food properly)," he advised.

Schistosomiasis can be prevented in spreading in communities through deworming programs, use of sanitary toilets and latrines, use and consumption of safe and clean water and wearing of protective clothing.

WHO Philippines and DOH celebrate every January as the National Deworming Month.

In connection with this, they offered on Wednesday deworming services in the community health centers and school-based facilities, targeting preschool and school age children from one to 18 years old. (PNA)

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